On behalf of the Florida Clinicians for Climate Action, I spoke to a group of farmworkers in Florida a few weeks ago about how their health risks were evolving along with our changing climate, and the conversation took on a tragic new urgency.
One of the group's co-workers, Efraín López García, a healthy 29-year-old man from Guatemala, had died on July 6 in the fields as a result of extreme heat. Community members were shaken and grieving, as well as confused and divided about what they should have done — or could have done — to save their friend.
One gentleman protested: "They shouldn't have given him ice. It was too hot, and that made it worse."
I polled the audience to see if they also thought it was wrong to give the young man ice. Almost every hand — including the children's — went up.
After nearly 40 years of practicing medicine, you'd think I'd be used to the highs and lows of patient care, but the truth is, some things don't get easier with time. I could feel their guilt for believing that they hastened their co-worker's death, and witnessing their pain tied my heart into a knot.
That fateful day would be one of the hottest ever recorded, and I could only reassure them that they did their best. In fact, doctors do something very similar when someone is experiencing heat-related illness by placing the patient in an ice water bath.
As I explained more about heat illness prevention and treatment, the farmworkers' apprehensive faces gradually relaxed. Even though they were feeling better about their efforts to help their friend, I had to be forthright about the risks that persisted for them: The days will only get hotter, and they need to remain vigilant.
Coincidentally, the Sunday I spent speaking with the group of farmworkers coincided with the National Weather Service issuing the very first excessive heat warning in Miami. The heat index, which measures the interaction between temperature and humidity, gives people a sense of the temperature it "feels like" outside.
On that day, the heat index forecast was 110 degrees Fahrenheit for more than two hours. With July being the hottest month ever, it's no wonder that heat is our country's top weather-related killer.
Most scientists, doctors, and other health professionals acknowledge human-caused climate change as the greatest threat to our health and survival. Severe heat has engulfed more than half of the United States population for the past several weeks.
Coupled with wildfires in Canada and California and tornadoes in the Midwest, everyone has felt, either directly or indirectly, the impact of extreme weather. But some communities feel it earlier, more severely, and for longer.
Black and Hispanic populations in the U.S. are more likely to live in communities that fail EPA Air Quality standards, even before the wildfires. These communities also have higher energy burdens, are exposed to more particulate pollution, live in substandard housing, and have lower wealth than white communities.
When cross-referenced with other known health disparities, the data shows that these communities also have higher rates of chronic disease and worse health on average.
Recent studies have shown that increased preterm labor and poorer birth outcomes (especially in Black women), acute kidney failure in agricultural workers, and increased allergies and asthma are all related to heat and pollution.
Caring for patients like the agricultural workers in Miami who have no protection from the environment has provided me with early exposure and understanding of the severity of the climate crisis.
Other clinicians like me also have this opportunity to identify health impacts and to act. Many studies, including this one from Gallup, repeatedly demonstrate that clinicians are "trusted messengers." Clinician messaging on these health risks can be effective in persuading patients to adopt protective behaviors.
But to educate better, we must first understand our patients better.
For example, in summertime, the human body will typically become stressed when temperatures rise above 90 degrees Fahrenheit. But, a patient who lives on the upper floors of an apartment building without air conditioning may learn after speaking with their physician that they should start hydrating when it's 82 degrees Fahrenheit outside because of their living conditions.
This is a simple example of tailored messaging, but the philosophy can be applied broadly and at scale if we all start paying attention and prioritizing climate and health education.
There are more than 22 million healthcare professionals in the United States. If we all incorporated climate change education into our daily practice, we could help prepare communities mentally and physically for the health challenges they will face. For communities like the farmworkers I serve in Miami, we can even prevent death.
Dr. Cheryl Holder is the president of the Florida State Medical Association and the co-chair of Florida Clinicians for Climate Action, where she advocates for comprehensive medical prevention and care strategies for poor communities impacted by climate change.
This editorial was produced in partnership with the Aspen Institute to continue the conversations at the Aspen Ideas: Climate event.
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