Spotlight on Climate-Related Health Challenges

During a presentation Elizabeth Rojo stopped at a slide listing two names and photos. The two people had recently died working on North Carolina farms in high heat conditions.

With 2.3 million farm workers in the U.S., the state of North Carolina has the sixth largest farmworker community nationwide, said Rojo, a Ph.D. candidate at Duke. Climate change is putting many of these lives at greater risk.

“Heat protection needs to happen now. What are we going to do?” Rojo asked the audience at the Innovative Strategies for Addressing Climate-Related Health Challenges Symposium at Duke on April 8.

The symposium, organized by the Department of Population Health Services, spanned a range of topics, including data science and AI, mental health, education, and local and global health challenges. Participants highlighted that climate change is having a disproportionate effect on those who are underserved in communities, including those working outside and on farms.

Throughout the event, the topic of heat repeatedly surfaced. Speakers shared how heat-related illness affects individuals, families, communities, the region and the nation -- and what could be done.

Autumn Locklear, climate and health epidemiologist for the North Carolina Division of Public Health, presented information about the Heat Health Alert System that the NC Climate and Health team uses to send out heat alerts when the forecast is projected to reach unhealthy levels.

Heat & the Risks

Anna Strasma, assistant professor in medicine and nephrology at Duke, shared research about community perceptions of chronic kidney disease in rural communities. Chronic kidney disease of unknown etiology, also known as CKDu, has higher risk factors for males living in low-income, tropical environments and working on farms.

Highlighting the headline from TIME magazine “Chronic Kidney Disease Is Poised to Become the Black Lung of Climate Change,” Strasma said heat stress is a major factor for CKDu. One person she interviewed told her: “Heat is a huge impact and it’s alarming.”

Rojo’s doctoral project is people-centered, her tenet in community-engaged research. Rojo is interviewing farm workers and growers to discover ways to help them in high heat conditions.

“It’s important to include the community in the intervention to be sure it is tailored and developed with the community,” Rojo said.

Some examples of community engagement, according to Rojo: ensuring farm workers can receive heat alerts in the field; understanding that taking breaks even in the heat might not be incentivized for someone trying to earn work hours; and accepting that the topic of climate change might feel like too much for some people already dealing with so much.

“What does the community want and how can we help? We need to build the relationships, participate in events, volunteer, and care about the community that we are working with.”
Elizabeth Rojo, Ph.D. candidate

“As researchers, we often say, ‘I need to look at this problem.’ But researchers need to relinquish that and really talk with the community and really sit with them. What does the community want and how can we help? We need to build the relationships, participate in events, volunteer, and care about the community that we are working with,” Rojo said.

In Our Communities and State

Rojo, fellow Ph.D. student Rebecca Filippo and clinical research coordinator Sarah Jackson organized the symposium. The event aimed to foster interdisciplinary collaboration and showcase innovative and important approaches to mitigating and addressing the health impacts of climate change, said Lesley Curtis, chair of the Department of Population Health Sciences.

“We used to think of climate change as the future reality, but now we see every day it is a current reality,” said Curtis. “We see floods, extreme heat, storms – these are affecting people. We have seen that in our communities and state. We are trying to elevate ideas, collaboration and stories that we can build on.”

Opening remarks by John Balbus, former director of the U.S. Department of Health and Human Services Office of Climate Change and Health Equity, set the tone for the day. The keynote speaker was Robert Saunders, senior research director of the Duke Margolis Institute for Health Policy

Hayden Bosworth, professor in population health sciences, lauded the doctoral student and staff leadership of the event during the closing, adding, “Hopefully this is the beginning of a conversation.”

Photo by Eamon Queeney / Duke University School of Medicine