Medical community must sound alarm on climate change’s negative effects on health

By CHERYL L. HOLDER | Originally posted on February 20, 2019 in the Miami Herald

Hearing that 2018 was the fourth hottest year on record reminded me of a family I visited a few years earlier.

I was with the medical and nursing students of FIU’s Herbert Wertheim College of Medicine NeighborhoodHELP, which provides home healthcare visits to Miami’s underserved communities. This household visit was supposed to be like any other. But when I stepped out of my car in Little Haiti and felt the stifling June heat coming off of the pavement, I knew, unfortunately, what to expect.

Miami’s Little Haiti, a 3.5 square mile area , about six miles north of downtown Miami, formerly known as Lemon City, has about 34,000 people, mostly poor Haitian immigrants living in old homes without air-conditioning.

My students were excited to meet their first family: a mother and her four children. The mother met us at the door wearing a white T-shirt and cotton floral skirt. She was a tall, thin woman appearing younger than her age, hair pulled back in a neat ponytail and with a smile on a face in need of no makeup. She graciously welcomed us into her home: a tiny, one-bedroom apartment.

From the door, stepping into the living room, where, instead of a couch, was a double bed with a toddler sleeping quietly, she directed us to the chairs, a foot from the end of the bed, near the kitchen, to conduct the interview. The un-airconditioned apartment’s only ventilation were front and back windows and doors. The heat was unbearable, like a wet mattress in an oven.

Through a telephone interpreter, we learned that the family had moved to the United States, after gaining Temporary Protected Status following the 2010 Haitian earthquake. As the history-taking continued, we became flushed and drenched in sweat. Despite our efforts, we could not hide our discomfort. Seeing this, she moved the only fan in the room from the baby, pointed it toward us and offered us water. We accepted the water, but refused the fan. The baby needed it more. Luckily, another child brought us a fan from the bedroom for some relief. We said nothing of the heat, continued with the visit and wrapped up 30 minutes later. We thanked the family for hosting us, grateful that we could leave, but with the sad understanding that they could not.

Twenty of the warmest years on record have occurred in the last quarter century, with the most recent five years being the hottest. There is a clear and consistent warming trend and it’s undeniable that these warmer temperatures negatively affect our health.

Climate change causes more extremely hot and humid days, which increases the likelihood of dehydration, heat stroke and heart attacks, and worsening conditions such as COPD and kidney disease. People who lack air conditioning or spend time outdoors — like farm and construction workers and student athletes — are more exposed and face greater risk.

Children and the elderly suffer most because they are less able to regulate their body temperatures. In fact, new research on college students shows that working in a hot classroom actually impairs their ability to do simple math. Imagine the impact the heat had on that sleeping baby’s learning.

In 2016, I stayed silent. Today, it is time for health professionals to speak up and help our patients understand the risks of a warming world. As co-chair of the newly formed Florida Clinicians for Climate Action, we aim to train Florida’s clinicians about the impact of climate change on health, right now.

It is a start, but it is not enough.

Hotter days are just one symptom of climate change. We need to expand our knowledge of the issue, and realize that everything is connected. We all bear responsibility for making our city, and our world, a healthful place to live and raise our families. And it starts at home.


Dr. Cheryl L. Holder is an associate professor at the Florida International University Herbert Wertheim College of Medicine and the co-chair of Florida Clinicians for Climate Action.