Climate Change is not an ‘Equal Opportunity’ Crisis

Sam Aptekar
Phuoc Le


In the last fifteen years, we have witnessed dozens of natural disasters affecting our most vulnerable patients, from post-hurricane victims in Haiti to drought and famine refugees in Malawi. The vast majority of these patients suffered from acute on chronic disasters, culminating in life-threatening medical illnesses. Yet, during the course of providing clinical care and comfort, we rarely, if ever, pointed to climate change as the root cause of their conditions. The evidence for climate change is not new, but the movement for climate justice is now emerging on a large scale, and clinicians should play an active role.

Let’s be clear: there is no such thing as an “equal opportunity” disaster. Yes, climate change poses an existential threat to us all, but not on equal terms. When nature strikes, it has always been the poor and historically underserved who are most vulnerable to its wrath. Hurricane Katrina provides an example of how natural disasters target their victims along racial and socioeconomic lines even in the wealthiest nations. Writes TalkPoverty.org, “A black homeowner in New Orleans was more than three times as likely to have been flooded as a white homeowner. That wasn’t due to bad luck; because of racially discriminatory housing practices, the high-ground was taken by the time banks started loaning money to African Americans who wanted to buy a home.” Throughout the world, historically marginalized communities have been pushed to overcrowded, poorly-built, and unsanitary neighborhoods where natural disasters invoke much greater harm.

Photo from video on Democracy Now! article: “New Orleans After Katrina: Inequality Soars as Poor Continue to Be Left Behind in City’s ‘Recovery”

The poor also tend to work more physically demanding jobs that become particularly dangerous with rising temperatures. Scientific American reported more than 20,000 workers dying in Central America and southern Mexico from chronic kidney disease caused by extreme temperatures and unreasonable employment conditions. According to the World Health Organization, climate change is expected to cause 250,000 additional deaths per year from diarrhea, malnutrition, malaria, and stress.

Figure from May 2019 Somalia Humanitarian Bulletin (OCHA)

Moreover, resource-denied countries have the greatest economic reliance on agriculture, which is by far the most vulnerable industry to anthropogenic weather changes. Throughout the Horn of Africa, droughts have been recorded at historically intense levels (the 2016-17 rains in Somalia are the driest on record) and have destroyed the economic sustenance of millions of farmers. According to Oxfam, “The region was hit by an 18-month drought caused by El Niño and higher temperatures linked to climate change.” They estimate that 10.7 million people currently face severe hunger throughout Ethiopia, Kenya, Somalia, and Somaliland as their crops and cattle die. With resource-denied countries such as these relying so strongly on agriculture to keep their economies afloat, the World Bank reported that climate change has the ability to send more than 100 million people into poverty by 2030. More than 23.3 million people are already in need of humanitarian aid in the Horn of Africa.

Volunteers in Freeport, Grand Bahama, Bahamas rescuing families during Hurricane Dorian (AP Photo/Ramon Espinosa)

Climate change has already made certain regions of the world uninhabitable and threatens the sociopolitical stability of numerous others. According to the Internal Displacement Monitoring Center, there were 18.8 million climate-related displacements in 2017 alone. The Syrian Civil War, which left millions in search of a new home and catalyzed political instability throughout the region, holds climate change as one of its many contributing factors.

Unfortunately, these patterns show no signs of slowing down. Globally, the number of weather-related disasters has tripled since the 1960s. In September, Hurricane Dorian battered the Bahamas and left a humanitarian crisis in its wake; thousands are homeless, without food, water, and electricity as the islands remain flooded. This was just two years after Hurricane Maria destroyed thousands of homes in Puerto Rico and only one year after Hurricane Matthew killed 49 people and caused $10.8 billion in damage in North Carolina. The United States Geological Survey reports, “With increasing global surface temperatures the possibility of more droughts and increased intensity of storms will occur.”

The classification of hurricanes, tornadoes, and droughts as “natural” disasters suggests their origin are separate from human behavior, that they exist purely in the realm of nature where man has no influence. But if we look at the destruction they have caused historically, we see that their effects are almost completely determined by human action, specifically our social, economic, and political policies that continue to leave some more vulnerable than others. While the Silicon Valley dreams of future technological solutions to climate change, there are social policies that we, as healthcare professionals, can address right now.

Climate change is a public health emergency, and as guardians of the public’s health, it is our role as healthcare professionals to continuously stress the magnitude of the situation. We must assert with medical expertise that as “natural” disasters intensify and transform entire ecosystems, the poor and historically underserved have been, and will continue to be, the hardest hit. By providing honest, evidence-driven accounts of climate change and its health consequences, healthcare professionals can elevate the voices of millions who are left out of most contemporary climate movements and bring their stories to the fore as we continue to fight climate change together.

Internist, Pediatrician, and Associate Professor at UCSF, Dr. Le is also the co-founder of two health equity organizations, the HEAL Initiative and Arc Health. 

Sam Aptekar is a recent graduate of UC Berkeley and a current content marketing and blogging affiliate for Arc Health Justice.

This post originally appeared on Arc Health here.

3 replies »

  1. Thank you for your comment. Weather events themselves don’t ‘choose’ who they impact, but as we discuss, they affect certain zip codes more than others. The placement or movement of people into those hard-hit zip codes is what makes the crisis differ.

    There will always be click-bait headlines that do not tell the whole truth when it comes to climate change. But, climate change is happening and it is impacting every community differently. Climate change looks very different depending on where you live. Although it may not be influencing your life right now, it will definitely be prevalent in generations to come if we stop having important discussions about it.

    I too believe California’s wildfire problem can be mitigated by a change in how forest management is done. The poor air quality and lack of power in California recently are reasons for us citizens to advocate and push for a better protocol. We need to listen to the people who know the land the best — not the ones controlling the ballots.

    I hope that we can continually find ways to dissect misleading headlines and protocols because they cause so much confusion and polarization in our communities.

  2. None of what you say is true, but it’s impossible to have an intelligent argument on a complicated problem when climate deniers such as yourself think scientists are lying and Trump tells the truth.

  3. These are all weather events you describe, and they affect all the persons in the given zip code, indiscriminately. We’ve had them for centuries. We survived and grew exponentially and built bridges, dams, and locks. Some weren’t maintained because rapacious politicians raided the coffers. They were long gone and nobody is ever held accountable. There will always be rich and poor. Get over it. I stopped caring about Africa after I heard about Idi Amin (before y’all were born) and Mugabe. Circa 1974 I was warned in elementary school the new ice age was coming. Then I was told in 1980 the oceans were gonna go away. Then it was going to be a greenhouse, stop using aerosols! It’s always a fear based clickbait headline and I’m numb, along with millions of Americans, just trying to survive the best we can. And now today:


    California is burning because Jerry Brown and his cohorts banned the cutting down of a tree by a power line. Now millions are without clean air and without power. How much CO2 is being pumped into the atmosphere by these fires? How many taxpayers will flee California thus diminishing the states’ coffers to restore infrastructure? who will be left to tax? Cher?

    Good luck with the nice words. We’re not buying it and we’re so sick of being lectured.