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Health Department’s New Response to Climate Change

By Catalina Jaramillo

It wasn’t too difficult for the crowd of around 40 seniors gathered at the McPherson Public Library in Kensington on Wednesday to get into the right mindset for the evening’s discussion: How to prepare for emergencies caused by climate change.

Thermometers read 90 degrees in Philadelphia, but it felt like 96. There were heavy rains and thunderstorms scattered throughout the day. And the entire metro area was hit with a Code Orange air quality alert, meaning unhealthy air pollution concentration for people with asthma, heart or lung diseases, children, and the elderly.

That might explain why seniors came from all across the city to attend the extreme heat workshop.

“Have you experienced expressions of climate change first hand?” Drexel University’s Alison Kenner asked the audience.

They replied with loud yes. It’s hotter, one said. It’s wetter, another added. I’ve had health issues, one woman said. I’ve had more asthma, agreed someone else.

“I have asthma and I’m trying to find what I can do [when it is] so hot and muggy,” attendee Sharon Williams said. She doesn’t have air conditioner at home, so she comes to the library whenever it’s really hot. “It affects my breathing,” she said.

Hot and muggy summers in Philadelphia are not new. And for years, the Philadelphia Department of Public Health has run heat awareness campaigns, stressing the health impacts it can have on vulnerable populations and advising citizens to “stay cool” during extremely hot and humid days.

What’s new is the Health Department explicitly connecting the health impacts from excessive heat to climate change. Local health departments in the whole country are only now beginning to expressly make that connection. But according to the U.S. Climate and Health Alliance, the Philadelphia Health Department is ahead of many of their peers.

“Summers in Philadelphia have always been hot, but now they’re getting hotter and wetter,” Health Department’s Marialisa Ramirez said on the workshop.

Philadelphia’s Health Department is one of 12 local health departments participating in a national Climate and Health Learning Collaborative for urban health departments. And a team lead by preparedness manager Jessica Caum has been working with community associations and city agencies to coordinate efforts through a Climate Change and Health Advisory Group.

Wednesday’s “staying cool in a climate change” workshop, one in a series of three held in south, west and north Philadelphia, was one of the products of that.

Clear Air Council’s Russell Zerbo said this is the first time the Health Department is coming out to communities and saying, explicitly: Climate change may impact your health.

“The news is really the Health Department walking into cooling centers and saying: This is a cooling center, we want you to be safe this summer because of climate change,” Zerbo said. “It’s sort of putting them in a service base position, which was not, I don’t think, before.”

Cooling centers are public spaces with air conditioning. They can be libraries, recreation centers, senior centers, or other cool, public buildings. But the Health Department does not publish an active list of them because sometimes the air conditioning in a given building might not working. Ramirez recommended that the audience call 311 before heading to a nearby library or rec center.

Zerbo said until this year, the department was announcing the health impacts of climate change through their website or in the news, sending people to the heatline (215-765-9040) “but in terms of physically going out and doing it, that wasn’t happening.”

In an email, the Health Department’s James Garrow confirmed this was their first time participating in these events.

“While working with the Office of Emergency Management to update the City’s heat response plan, we heard about these types of events and thought we could use them to help further our existing efforts to distribute information about excessive heat and what Philadelphians can do to help survive the heat,” Garrow said.

Zerbo doesn’t blame the department for not directly talking with the communities before about the connection between the dangers of heat and climate change. Climate change is a really complex issue, he said, and a lot of organizations are struggling on how to communicate its impacts and solutions. Drinking more water or keeping an air conditioner on full blast are not real solutions for climate change, he said. They only address the symptoms, not the underlying predicament.

The workshop addressed that problem through different angles. The audience was told staying hydrated and cool is vital, but experts also mention that air conditioners could be creating more of a problem by making cities get hotter.

Julia Menzo from Liberty Lutheran spoke about the importance of establishing ways to contact your family and have enough food and water in cases of power outages. Deepa Mankikar from the National Nurse-Led Care Consortium told people how to keep healthy indoor environments avoiding toxic cleaning products and keeping pests away. And Thomas Flaherty from the Energy Coordinating Agency offered tips for reducing energy conservation, like painting your roof white or disconnecting appliances when they’re not in use.

Drexel’s Kenner has been doing this workshops, independently, for four years. She said there’s three things she’s learned from them. First, that people appreciate someone breaking climate change down and bringing it to a neighborhood scale, showing them how they will be affected. Second, how difficult it is for renters to negotiate things like windows painted shut by their landlords. And third, that difficulty breathing is one of the first issues people mention.

“Changes in weather also trigger asthma attacks,” said Keener, who is writing a book about asthma and climate change. “Because the climate is changing and ecology is changing, people who have lived with asma their whole lives, may be unprepared for new environmental conditions.”

Gloria Marrero has had asthma since she was 14 years old. “Heat leaves me with no air,” she said in Spanish. “That’s why we came, searching for answers.”

According to a index, Philadelphia ranks number 10 among cities that will feel the impact of climate change the most. And the Asthma and Allergy Foundation of America says Philly is the third most challenging city to live with asthma in the country.


Low-Income Homeowners and Renters are Similarly Burdened by Housing Costs

Data reveals that homeownership does not protect low-income homeowners from experiencing severe housing cost burdens. Homeowners are less likely to be low-income than renters. But with equally low incomes, renters and homeowners suffer from similar severe housing cost burdens. Extremely low-income and very-low income homeowners are just as vulnerable to severe cost burdens as renters at the same income level. And while the cost burden looks similar for renters and homeowners at these income levels, the household composition does not. Severely burdened homeowners tend to be elderly, while severely burdened renters tend to have young families.

While renters experience the bulk of severe housing cost burdens, the data from How Housing Matters shows us that low-income homeowners, a predominantly elderly group, share some of these struggles. Since the households of very low-income renters and homeowners differ, policy solutions to address their challenges must as well.

How Important Are Home Modifications to Older Adults?

Very Important according to How Housing Matters citing The American Geriatrics Society…”Falls are the leading cause of fatal and nonfatal injuries in older Americans. Simple home modifications can reduce the risk of falls, but can rack up an expensive bill, which 75 percent of families must pay out of pocket.” read more

Housing Assistance Can Benefit Health

Having access to stable and affordable housing may lead to increased utilization of healthcare, including insurance, according to a new study published by Health Affairs.

Individuals who received subsidized housing assistance were more likely to be insured and less likely to have unmet healthcare needs compared with low-income individuals not receiving the assistance. Specifically, the authors discovered that only 31% of individuals receiving assistance from the US Department of Housing and Urban Development (HUD) were uninsured compared with 37% of those on a wait list.

Included in the study were data for adults in the National Health Interview Survey, which was then linked to HUD data from 2004 to 2012. All participants ranged in age between 18 and 64.

“We found that the benefits of giving people subsidized housing go beyond simply having access to affordable housing,” said researcher Andrew Fenelon, PhD. “Housing is good in and of itself, but even better is that with improved access to housing, you get improvements in access to health care, and ultimately better health outcomes.”

Housing assistance programs funded by HUD provide low-income Americans with access to affordable, stable housing. Individuals who receive the assistance typically have poor health and require care for mental health conditions or chronic diseases, according to the study.

Previous studies have found that access to care greatly improves health, while housing instability has been linked to poor access to healthcare. Few studies have investigated whether housing assistance can lead to improved health.

The authors discovered that nearly 50% of patients who received the HUD assistance had unmet healthcare needs, while a little more than 40% of patients receiving the assistance had unmet needs, according to the study.

Additionally, the authors discovered that patients receiving housing assistance were more likely to have a usual source of care compared with those not receiving the subsidies.

These findings suggest that HUD housing subsidies may lead to improved health among low-income patients. Currently, qualified individuals may have to wait to receive a housing choice voucher to obtain a housing arrangement, which may place them at risk of poor health, according to the authors.

“There are many reasons why having access to housing may enable people to obtain health insurance and access needed care,” Dr Fenelon said. “With the increased stability that comes from having a home and reduced financial burdens, and being introduced into the social service system and the access to other support services it provides, people receiving housing assistance are getting improved access to primary care health services. This is a clear demonstration that housing is one of the so-called ‘social determinants’ of health. The value of this program should be carefully considered in light of the far-reaching benefits it may have beyond its face value.”