For Climate Health

Tuesday, April 9, 2019

Physician advocacy on global climate change may be the greatest public health intervention of our lifetime, Dr. Sheri Weiser said at the April 2 event “Confronting the Link Between Climate Change, Migration, and Human Health.”
Organized by three MS1s, Nuzhat Islam, Karly Hampshire, and Colin Baylen, the event explored how climate change plays a key role in the migration of people worldwide today.

As changing climates raise sea levels, salinate agricultural lands, and increase rates of natural disasters, people are forced to move from their native homes to new lands and nations. This movement is accompanied by food insecurity, struggles with mental health, and loss of access to healthcare.

“Food insecurity is perhaps one of the largest drivers of migration . . . in some of the areas most vulnerable to climate change,” Weiser said.

The event organizers emphasized climate justice: climate change was not created equally, and the effects are being felt disproportionately by communities experiencing poverty or structural violence around the world.

The current political debate tries to label migrants either as potential sources of crime and disease or as victims fleeing violence. Climate justice proposes that though these migrants may be fleeing violence, the effects of climate change also drive this migration.

Migrants flee those areas where they have no food or resources and move to places such as the United States in search not only of opportunity but safety from the changing climate.

Weiser, an internist at UCSF who researches the connection between food insecurity and HIV/AIDS, described student-led research that has elucidated the connection between disease spread, climate change, and migration.

The 2015 Lancet Commission Report on Climate Change and Health stated that climate change is one of the largest threats to worldwide health, so Weiser believes this is our chance to make a sizable investment in the health of current and future populations, especially climate migrants.

These are those populations who have had to leave their habitats now or soon in the future due to gradual or sudden climate change effects.

Loss of crops, heavy rains, and even flooding or salination of fields prevents people from relying on native lands for sustenance. Alarmingly, loss of these resources seems to have secondary effects: according to Weiser, Department of Homeland Security data has found that exposure to drought increased the odds of interpersonal violence exposure in Sub-Saharan Africa by 20%.

Research also shows a rise in chronic stress, PTSD, insomnia, and depression.

People, therefore, flee these regions to escape not only the loss of their land but also the associated effects on mental and physical health.

Migration, however, can lead to the expansion of sexual networks, transactional sex, and associated increases in sexual violence, especially towards women.

These can all cause a greater risk of transmission of HIV and STIs, especially due to reduced access to care. In addition, often the migration is from rural areas to urban areas, where people take jobs for less pay and longer hours, separating them from their families.

Movement into urban centers such as San Francisco also leads to overcrowding, which can be a major issue for disease spread, according to the second speaker, Dr. Sarah Coates, a dermatology resident at UCSF.

“In the setting of a known homelessness epidemic, adding onto that… is something we need to keep in mind,” she said.

Conditions like scabies, lice, and even louse-borne relapsing fever have been reported among refugee populations in Europe, and providers in these areas may be unfamiliar with how to treat some of these rarer diseases.

Leishmaniasis, a disease thought previously to be endemic only to areas outside the United States, has begun to be found here.

“Due to climate change, the vector will continue to move northward as more areas become “tropical,” Coates said. “People move and bring their diseases with them, yes...but also vectors move, and vectors move because people move. It is projected that by 2080, all the places where humans live will have at least one month where disease transmission by the Aedes aegypti mosquito vector is possible, including dengue and Zika.”

Given all this, the students and speakers recommended physician advocacy on climate change. Joining or advocating groups such as Physicians for Social Responsibility or the Medical Society Consortium on Climate and Health allows us to take a more active role in fighting climate change and its effects.