Dr Colon-Rivera is the Asociación Puertorriqueños en Marcha Medical Director, a University of Pittsburgh Medical Center attending physician, and President of the APA Hispanic Caucus.
Dr Plata is a psychiatry resident at Garnet Health Medical Center in Middletown, New York.
Ultimately, the climate change crisis underlies an already growing mental health crisis and Hispanic/Latinx heterogeneity shapes different patterns of environmental injustice.
Racism & Climate Change
United States Hispanic/Latinx communities comprise a people made up of many different cultures, countries of origin, migration trajectories, social classes, ages, and genders, among other characteristics. As of the 2010 Census, there were 50.5 million Hispanics in the United States, representing 16% of the total population, and by 2060, population projections indicate that 29% of the US population will be Hispanic.1,2 However, Hispanic/Latinx heterogeneity shapes different patterns of environmental injustice. Migration history, socio-demographics, and acculturation are critical features that have influenced environmental injustice patterns in the United States.
Mass migration and population displacement from Central America and the Caribbean are among the most profound impacts of climate change. As climate change is making extreme weather events more common, we are seeing more vulnerable Hispanic/Latinx leaving their home countries.3 This is the result of a combination of factors, including lack of work, food, and shelter, all of which are in part due to the degradation of local ecosystems. The Pentagon has recognized climate change as a threat multiplier,4 with the potential to exacerbate not only environmental degradation, but also unstable governmental structures that can ultimately add pressure to the more obvious current drivers of migration, including gang violence, political upheaval, and corruption.5
Climate change has had a profound effect on agriculture in Central America. Along the Pacific coast (also know as the dry corridor), a drought has demolished crops since 2014 and threatened smallholder farmers’ livelihoods in Guatemala, Honduras, and El Salvador.6 A United Nations climate change report showed that crop shortages linked to climate change led to extreme poverty and hunger.7 The same report noted that the loss of crops is the second-largest migration factor among those living in the dry corridor. It also found that migration from this region increased significantly since 2014, and by 2050, Mexico and Central America could see as many as 2 million climate migrants.8
Research has long shown that racial and ethnic minorities in the US, particularly Hispanic/Latinx, receive lower-quality health care, suffer worse health outcomes, and have higher rates of certain illnesses.9,10 Climate change affects social and environmental health determinants including clean air, safe drinking water, sufficient food, and secure shelter. Furthermore, a Natural Resources Defense Council report found more than half of the US Hispanic/Latinx population resided in states with the highest levels of climate change threats, such as air pollution, extreme heat, and flooding.11 Many Hispanic/Latinx communities face serious health risks caused by air pollution, as they tend to live within a short distance of existing oil and gas facilities. As a result, they suffer from an elevated risk of cancer. Additionally, due to toxic air emissions, asthma rates are relatively higher in Hispanic/Latinx communities, and these individuals are more likely to be admitted to the hospital for asthma than are non-Hispanic Whites.12
Similarly, extreme summer heat in the US poses health risks for Hispanics/Latinx employed in outdoor occupations. Hispanic/Latinx account for 46% of construction laborers and 47.2% of agricultural field workers in the US.13 The World Meteorological Organization (WMO) notes that the number of heat-related deaths will double in the next 20 years.14 In the case of Hispanic/Latinx migrant and seasonal agricultural workers who depend on employers for work and wages, such occupational health hazards are particularly challenging because they typically work long hours outdoors and may be reluctant to report the work-related illness. Given the exposure among migrant and seasonal agricultural workers, they are at much higher risk for extreme heat’s effects on mental wellbeing, including impacts on mood, behavior, cognitive functioning, and psychiatric conditions.15
Low-income Hispanic/Latinx communities are more likely to live in areas most vulnerable to the impact of climate change and natural disasters, and they do not always get the disaster relief they need. The socioeconomic relational factors may impede pre-hurricane actions among Hispanic/Latinx communities and create challenges. For example, Hurricane Irma hit Puerto Rico in 2017 and downed powerlines, leaving large communities without power and causing flooding that exposed the population to contaminated water and soil draining the canals. Two weeks later, Hurricane Maria hit and caused an estimated death toll of more than 2000 individuals. It also left residents in the dark for almost a year. A large proportion of the population became infected with leptospirosis, causing a additional deaths in the aftermath. Federal government staffing and funding in Puerto Rico took 3 times as long to reach comparable levels as in Texas, and 30 times as long as in Florida.16
Puerto Rico is still recovering from these devastating natural disasters. For months, commentators talked about the shutdown of communications and power, the physical and mental scars from landslides and flooding, as well as the slowness and inadequacy of the government’s responses. Local nonprofits organizations were vital players during and after the hurricanes and continued recovery times. These organizations helped collect debris, distribute water, and find shelter and basic needs supplies for many communities. The nonprofit sector was the first and, in many areas of the island, the only responder to the disaster.
Hispanic/Latinx communities can experience a broad range of psychological responses to climate change’s disproportionate effects. Ultimately, the climate change crisis underlies an already growing mental health crisis. Climate change exacerbates chronic mental illness and increases risk of developing new-onset posttraumatic stress disorder, depression, anxiety, sleep disorders, attachment disorders, and substance use.17
It is imperative that we look at the opportunities available for action to prevent, address, and mitigate the these climate-related threats to physical and mental health. To start, it is important to process emotional responses to these threats. This may be difficult to do, given the high mental health stigma within Hispanic/Latinx communities. Acknowledging and talking about feelings and addressing anxiety and fear can help normalize emotional responses to climate change. It is vital to spread awareness about climate change and create educational resources for our most vulnerable Hispanic/Latinx communities. Providing the tools necessary to enable self-advocacy is empowering and can increase Hispanic/Latinx communities’ strength and resiliency. However, these tools and communications need to be practical, accessible, comprehensive, and understandable by all Spanish-speaking Hispanic/Latinx. Equally important is using culturally trusted modalities of delivery for these messages and tools.
We need to support nonprofit organizations like Crear Con Salud, a group that has a mission of supporting and conducting educational, research, and advocacy activities to increase public awareness and action regarding mental health in Puerto Rico and Hispanic/Latinx communities in the US. Since it received funding in 2019, Crear Con Salud has joined the recovery effort in Puerto Rico in ways far different than their normal mission.18 The organization continues to develop community leadership, local control, and resilience in affected communities to create local solutions, rather than relying on distant, unresponsive governmental agencies.
More importantly, to tackle climate change and the associated detrimental effects on vulnerable Hispanic/Latinx communities’ physical and mental health, it is imperative for policies and public health responses at any level (local, state, national) to address the range and diversity within the larger Hispanic/Latinx population.
Likewise, our communities will have better results if we find common ground and stand together with a strong commitment to climate action. Despite their diversity, Hispanic and Latinx communities share core values derived from our Indigenous roots, including a deep sense of respect and honor for the environment. We can build on these shared values. As we can increase climate change awareness, we must engage our community to demand real action and solutions. We must create the possibility of better outcomes for future generations of this fast-growing population and all communities.
Dr Colon-Rivera is the Asociación Puertorriqueños en Marcha Medical Director, a University of Pittsburgh Medical Center attending physician, and President of the APA Hispanic Caucus. Dr Plata is a psychiatry resident at Garnet Health Medical Center in Middletown, New York.
To see more on race and climate change, see The Tangled Roots of Racism and Climate Change.
1. Humes KR, Jones NA, Ramirez RR. Overview of race and Hispanic origin: census 2010. The United States Census Bureau. May 1, 2011. https://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf
2. Colby SL, Ortman JM. Projections of the size and composition of the US population: 2014 to 2060. The United States Census Bureau. March 4, 2015. https://www.census.gov/content/dam/Census/library/publications/2015/demo/p25-1143.pdf
3. National Academies of Sciences, Engineering, and Medicine. Attribution of Extreme Weather Events in the Context of Climate Change. The National Academies Press; 2016.
4. Carp R. How the Pentagon thinks about the climate crisis. Rolling Stone. September 23, 2019. Accessed April 16, 2021. https://www.rollingstone.com/politics/politics-features/how-the-pentagon-thinks-about-the-climate-crisis-887832/
5. CNA Military Advisory Board. National security and the accelerating risks of climate change. May 8, 2014. Accessed April 16, 2021. https://www.cna.org/cna_files/pdf/MAB_5-8-14.pdf
6. Food and Agriculture Organization of the United Nations. Disaster risk program to strengthen resilience in the dry corridor in Central America. September 2015. Accessed April 16, 2021. http://www.fao.org/fileadmin/user_upload/emergencies/docs/Corredor_Seco_Breve_EN.pdf
7. Intergovernmental Panel on Climate Change. Climate change and land: an IPCC special report on climate change, desertification, land degradation, sustainable land management, food security, and greenhouse gas fluxes in terrestrial ecosystems. Accessed April 16, 2021. https://www.ipcc.ch/srccl/
8. Rigaud KK, de Sherbinin A, Jones B, et al. Groundswell: Preparing for internal climate migration. Open Knowledge Repository. March 19, 2018. Accessed April 16, 2021. https://openknowledge.worldbank.org/handle/10986/29461
9. Institute of Medicine (IOM) Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care; Smedley BD, Stith AY, Nelson AR, eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. National Academies Press (US); 2003.
10. National Center for Health Statistics. Health, United States, 2015: With special feature on racial and ethnic health disparities. 2016. Accessed April 16, 2021. https://www.cdc.gov/nchs/data/hus/hus15.pdf
11. Quintero A, Constible J. Nuestro futuro: Climate change and US Latinos. Natural Resources Defense Council. October 13, 2016. Accessed April 16, 2021. https://www.nrdc.org/sites/default/files/nuestro-futuro-climate-change-latinos-report.pdf
12. United States Environmental Protection Agency Coordinated federal action plan to reduce racial and ethnic asthma disparities: President’s task force on environmental health risks and safety risks to children. May 2012. Accessed April 16, 2021. https://ptfceh.niehs.nih.gov/activities/assets/files/coordinated_federal_action_plan_to_reduce_racial_and_ethnic_asthma_disparities_508.pdf
13. United States Bureau of Labor Statistics. Labor force statistics from the current population survey, 2020. 2020. Accessed April 16, 2021. https://www.bls.gov/cps/cpsaat11.htm
14. Riojas-Rodríguez H, Quezada-Jiménez ML, Zúñiga-Bello P, Hurtado-Díaz M. Climate change and potential health effects in Mexican children. Annals of Global Health. 2018;84(2):281-284.
15. Cooper R. The impacts of extreme heat on mental health. Psychiatric Times. July 30, 2019. Accessed April 16, 2021. https://www.psychiatrictimes.com/view/impacts-extreme-heat-mental-health
16. Wilson CE, Singer PM, Creary MS, Greer SL. Quantifying inequities in US federal response to hurricane disaster in Texas and Florida compared with Puerto Rico. BMJ Global Health. 2019;4(1).
17. Dodgen D, Donato D, Kelly N, et al. Ch. 8: Mental Health and Well-Being. In: The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment. US Global Change Research Program; 2016:217–246.
18. Moran M. Psychiatrists collaborate with Puerto Rican communities after storm. Psychiatric News. November 13, 2017. Accessed April 16, 2021. https://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2017.11b5