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OHE | Climate Change & Health Equity

Racism Increases Vulnerability to Health Impacts of Climate Change

By the Office of Health Equity's Climate Change and Health Equity Program

Both climate change and the health inequities share similar root causes: the inequitable distribution of social, political, and economic power and the subsequent creation of inequitable systems and living conditions. People experiencing historical and current systemic discrimination based on race tend to experience worse health outcomes on average, as a direct consequence of these power imbalances, systems, and living conditions. Climate change exacerbates the existing health inequities experienced by some communities of color. Indeed, the capacity for resilience in the face of climate change is significantly driven by living conditions and the forces that shape them (e.g., wealth, education, housing, transportation, and environmental quality), as well as access to resources and services (e.g., health care, healthy foods, and community safety and cohesion). Thus, some communities of color experiencing health inequities are likely to have fewer resources to prepare for, adapt to, and recover from the effects of climate change, including the health effects.

For example, due to racial discrimination affecting economic assets, housing and lending, and municipal services, communities of color are more likely to reside in high risk areas with greater climate threats, such as more impervious surfaces and less tree canopy. These conditions result in greater heat island effect. In Fresno County, African-Americans were 8.6 times more likely and Latinos 4.5 times more likely than whites to reside in high risk areas. Populations of color are less likely to have air conditioning, less likely to own a car, and more likely to have one or more chronic health conditions, all of which increase susceptibility to injury and death from climate-related events.[1],[2],[3] It is important to note that people of color are not inherently less resourced or more susceptible to illness.   It is due to racism and the impacts of public policies that have impoverished communities of color that there is a correlation between race, poverty, health outcomes, and climate change impacts.

Though there are a number of risk factors and exposures that intensify vulnerability to climate impacts, the experience and impacts of racist policies on living conditions and resources is a recurring element that influences the health and adaptive capacity of some communities of color. In addition, repeated experiences of discrimination, such as racism, create chronic stress, which leads to a host of impacts to physical, mental, and emotional well-being.[4] Prolonged stress elevates levels of the hormone cortisol, which impacts brain structure and function, and damages the body's systems, resulting in poor health outcomes such as depression, low birthweight, maternal mortality, hypertension, and mental illness. In addition, this chronic stress weakens the immune response, increasing susceptibility to illnesses such as chronic diseases and cancers. It also causes changes to the genetic structure, which can be passed to offspring, causing multi-generational impacts of current stress and historical trauma.[4],[5],[6],[7],[8] Therefore, many of the health disparities experienced by people of color may be considered a consequence of historical and continuing racism. Some epidemiologic evidence indi­cates that chronic psychological stress may also alter susceptibility to physical exposures, such as air pollution.[9],[10]  We hold that by extension, chronic stress can also alter susceptibility to other climate change exposures such as extreme heat. 

Because of the above, a social environment that is implicitly or explicitly discriminatory must be understood as a toxic environmental exposure, in addition to exposure to pollutants, which is more common among communities of color.[11],[12] Along with living conditions (e.g. housing, neighborhood conditions, and schools), and traditional environmental exposures (e.g., pollutants, toxins, and climate changes), social exclusion also increases health inequities and climate vulnerability.  Conversely, societies with more social inclusion and policies that intentionally work to assess and reduce discrimination will have less physical embodiment of discrimination and the attendant negative health impacts, and be more resilient to changes of all kinds—be they climatic, economic, or political.

Institutionalized racism may be understood as unearned advantages and opportunities for white people and disadvantages for people of color that are systematized in institutions. Eliminating these facets of institutionalized racism to eliminate their health consequences requires deliberate and systemic assessment of institutional policies, processes, and procedures.  Opportunities must be sought to reverse historical disadvantage by providing additional resources (financial, services, access to power, education, training, and jobs) to communities facing inequities. Government, civil society, community groups, businesses, and individuals all have a role to play in creating an equitable society where the location someone is born or the shade of their skin does not determine their health status or vulnerability to climate impacts. Explicitly naming and addressing inequities based on racism will improve resilience to health impacts of climate change among people of color, and improve health for all people, as everyone does better in more equal societies.[13] 

For further resources on the climate impacts of racism on health, see The Climate Gall Full Report (PDF):    (

[1] Gronlund CJ. Racial and socioeconomic disparities in heat-related health effects and their mechanisms: a review. Current Epidemiology Reports. 2014;1(3):165-173.

[2] English P, Richardson M, Morello-Frosch R, Pastor M, Sadd J, King G, Jesdale W and Jerrett M. Racial and income disparities in relation to a proposed climate change vulnerability screening method for California. International Journal of Climate Change: Impacts & Responses. 2013;4(2).

[3] Shonkoff SB, Morello-Frosch R, Pastor M, Sadd J. The climate gap: environmental health and equity implications of climate change and mitigation policies in California – a review of the literature. Clim Change. 2011;109(1):485-503.

[4] American Psychological Association. Fact sheet: Health Disparities and Stress. 2016. www. Accessed November 22, 2016.

[5] Chae D, Nuru-Jeter A, Lincoln K, Francis D. Conceptualizing racial disparities in health: advancement of a socio-psychobiological approach. Du Bois Review: Social Science Research on Race. 2011; 8(1):63-77. doi:

[6] Kuzawa CW, Sweet E. Epigenetics and the embodiment of race: developmental origins of US racial disparities in cardiovascular health. Am J Human Biol. 2009; 21:2–15.

[7] McEwan, B. S. Protection and Damage from Acute and Chronic Stress: Allostasis and Allostatic Overload and Relevance to the Pathophysiology of Psychiatric Disorders. Annals of the New York Academy of Sciences 2004;1032: 1–7. doi:10.1196/annals.1314.001.

[8] David H. C, Nuru-Jeter AM, Lincoln KD, Jacob Arriola KR. Racial Discrimination, Mood Disorders, and Cardiovascular Disease Among Black Americans. Annals of Epidemiology. 2012;22(2):104-111. doi:10.1016/j.annepidem.2011.10.009.

[9] Clougherty JE, Levy JI, Kubzansky LD, Ryan PB, Suglia SF, Canner MJ, et al. Synergistic effects of traffic-related air pollution and exposure to violence on urban asthma etiology. Environ Health Perspect. 2007; 115: 1140–1146.

[10] Chen E, Schreier HMC, Strunk R, Brauer M. Chronic traffic-related air pollution and stress interact to predict biological and clinical outcomes in asthma. Environ Health Perspect. 2008; 116:970–975.

[11] Perlin S, Sexton K, Wong D. An examination of race and poverty for populations living near industrial sources of air pollution. Journal Of Exposure Analysis & Environmental Epidemiology [serial online]. February 1999;9(1):29. Available from: Academic Search Complete, Ipswich, MA. Accessed July 24, 2017.

[12] Clark L, Millet D, Marshall J. National patterns in environmental injustice and inequality: Outdoor NO2 air pollution in the United States. PLoS ONE. 2014; 9(4):e94431.

[13] Wilkenson R, Pickett K. The spirit level: Why greater equality makes societies stronger. New York: Bloomsbury Press; 2009. (PDF). Accessed by January 20, 2017.



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