Health Equity Tip: Work on the Shared Root Causes of Health Inequities and Climate Injustice

Image of earth with plants on a protest sign which reads “Climate Justice is Public Health Work.” On the sides of images are other protest signs and signage depicting the recycle logo, a heart, and a scale.
Illustration by Raina Wellman

Health departments who are working with communities fighting for their health and wellbeing must confront those shared root causes.

We are talking about public health’s role in a complete systems overhaul. It’s a heavy lift, and health departments cannot and should not do it alone. That means health departments must get more aligned with community organizers and advocates to advance big systems changes in a coordinated and meaningful way.

Where to start:

First, look at the history of your jurisdiction to understand how you arrived at the current climate change and health inequities.

It is best if you can engage with residents to directly hear their perspectives and stories, since so much of history has been suppressed. For example:

  • What is the jurisdiction’s history of stolen land from Indigenous, Japanese, and Black farmers or landowners? Who owns that land now? Who works on that land now? What forms of government subsidies or loans enabled Whites to own land or maintain solvency as an agricultural grower?
  • What is the history of redlining, segregation, White flight, urban disinvestment, and urban renewal that produced current inequities in living conditions, resources, or exposures that put BIPOC communities at greater risk of health and climate change inequities (e.g., urban heat islands, fewer trees and parks, more air pollution, food apartheid, lack of drinking water, good schools and jobs, public transportation)?

Next, learn about the various forums of public policy and decision-making where the field of public health can use their power to advance climate justice and health equity.

For example:

  • If your jurisdiction is involved in Climate Action Planning, Climate Adaptation or Resilience Planning, General Planning, transportation planning, or Emergency Planning, it’s critical that public health is at the table centering those who are most impacted!
  • If your colleagues in labor, workforce, business, or community development are working to address income and wealth inequities, public health should be there to ensure that they also address climate and health inequities at the center. We can provide the public health evidence, provide research, voice, and authority to these planning processes, ensuring that people we know are facing the worst health inequities are also prioritized in climate change planning.

One example:

How power dynamics, policies, and conditions put farmworkers at increased risk of climate change

To understand how climate injustice and health inequities share the same root causes, we can look at farmworkers in the United States. Farmworkers are experiencing some of the worst impacts that stem from the shared root causes of climate change and health inequities. Power imbalances, racist and xenophobic immigration policy, and capitalism have produced a set of laws, policies, and social conditions that put farmworkers at high risk to climate change impacts. These workers already faced some of the worst exposures to pesticides and toxins and resultant health outcomes in the country. And COVID-19 further deepened these health inequities. Now, with extreme heat and wildfires, farmworkers are facing additional burdens of working in extreme heat and unsafe air quality. Among farmworkers, heat stroke is the leading cause of death.

Where health departments can play a role:

Taking action with farmworker power building organizations to protect health

In our last Health Equity Tip, we described how the Santa Barbara County Public Health Department partnered with community organizers CAUSE and MICOP to protect farmworker health and safety during COVID-19 by establishing the Latinx and Indigenous Migrant COVID-19 Task Force, documenting community conditions impacting COVID-19 risk, issuing a Health Order on H2A housing, and increasing attention to Indigenous workers’ COVID-19 risks and language needs. The health department had already been working with these community power building groups for several years before COVID-19 hit. Working in partnership, these groups were able to use their respective forms of power to resist pushback against public health protections from employers, ultimately shifting the balance of power in public decision-making. They also shifted the balance of power between the powerful agricultural companies and Indigenous agricultural workers.

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