Transcript: Climate Change Impacts on Health (CA Climate Summit 2023)

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Jerilyn Lopez Mendoza (Staff, The Climate Center) (00:00:00):

A little bit late. I apologize for that. I just wanted to say a general hello and welcome. My name is Jerilyn Lopez Mendoza. I am with The Climate Center . I am the Los Angeles Regional organizer, so on behalf of The Climate Center. Welcome. As I mentioned earlier, there are pads of paper and pens in the back if you need them, as well as ice water. please note there’s only one exit from this room, which is obviously right under the green exit sign in the back. so in case of emergency I would advise, go out in the hall, make a left, and then go outside the doors of the hotel, and I’m sure they’ll give us directions on what to do. I also wanted to give a general introduction to our moderator who will be leading us in discussion today with our esteemed panel of physicians, nurses, and policy makers. Venise M. Curry MD is our moderator today. She’s a consultant for community-based organizations, collectively working to increase voter engagement, builds civic capacity through leadership development, and create policy and system change in Fresno County. The intersection between medicine, environmental, and social justice issues are at the core of her advocacy efforts. And lucky enough for us, she also serves as the vice chair of Board of Directors at The Climate Center. So I’d like to welcome Venise Curry.

Venise M. Curry MD (00:01:30):

Thank you, Jerilyn, and thank you for all of your hard work in organizing, but also just in




There’s a door back,

Audience (00:01:43):

<laugh> <laugh>.

Venise M. Curry MD (00:01:45):

So, yeah, I just really am thrilled to be here and really pleased that we are actually talking about health and climate change. So I am a physician. I did a lot of preventive medicine, and what I’m doing now is what I consider preventive psychiatry. And that really brings for me the intersection of social justice, environmental justice, climate change, health, and all of those pieces that we talk about when we say social determinants of health. But it also covers for me the realm of political determinants of health. And so I’m thrilled that we are talking health and policy, environmental justice, all of the pieces that really impact the way that we live and how we are able to thrive or not. So we are really thrilled. I’m thrilled to have such an excellent panel of quality speakers who’ve done so much prolific work around environmental justice, health, and equity.


You’re going to hear from each one of them. You’re going to notice that there are some common themes, and one of the themes that it stands out the most is that they’ve taken their own expertise and they’ve integrated it with climate and environmental health in a way that is really particular to their discipline, but really plays to the strengths and the talents that they have. So you’ll hear about research, you’ll hear about policy making, you’ll hear the gamut. And what you will find is that there’s always a space for us to speak to advocate for what we believe is the best interest of public health. But there’s always a way to fine tune your skills and continue to add to them so that our voices are collectively stronger. Our messages are consistently shared with in disciplines that we sometimes don’t consider talking about or, or aligning ourselves with.


And that collectively we are stronger when we actually have a strong message, when we repeat the message with clarity and when we back it up with good science. And so I’m thrilled to introduce our first speaker. I’m gonna give you a little bit of a bio, but really you can read their bio in the other spaces, and we really want to give them the sufficient time to talk about what they’ve done. So our first speaker is Dr. Arianne Teherani, and she is a professor of medicine and education scientist in the Center for Faculty Education at the University of California San Francisco School of Medicine. Her research has informed research agendas and policies and focuses on advancing knowledge and equity and social justice around climate change and health. She has really helped to establish training that is really designed for health professionals to grow, to understand the role of health, science and health systems in promoting decarbonization and the car and addressing the carbon footprint. And she leads the vision of the center to further equitable and just climate solutions that promote, promote human health and a healthy planet. And she oversees the center’s pillars of research, education, health system, sustainability, preparedness, and policy. What is she not doing? <laugh>,

Audience (00:05:02):


Venise M. Curry MD (00:05:04):

So really it’s a pleasure to have her here, to have her give us a little bit of what she does talk about her work and all of her wonderful research and just to share with us the way that she intro got introduced to climate health and equity and what she’s doing in terms of promoting her message. So please welcome Dr. Arianne Teherani.

Dr. Arianne Teherani (00:05:37):

Thank you Dr. Curry for the wonderful introduction. There we go. Sorry, everybody. <laugh> thank you everybody. And thank you to Dr. Curry for the wonderful welcome. I am gonna be giving you an overview, really, of the impact of the climate crisis on health. That’s really the role that I’m here to serve today and to represent the University of California Center for Climate Health and Equity, which really oversees the work that’s happening, looking at the intersection of climate change, health and health justice across all of the 10 uc schools and the five healthcare systems. So I’m gonna talk a little bit, sort of about the identifying the health Im impacts of the climate crisis. And I’m gonna talk about some of the pathways by which climate, the climate crisis impacts health outcomes. And then I’ll close out a little with a sort of a brief overview of opportunities for action. I won’t get to go into solutions today, but I do welcome the dialogue around solutions because there are plenty of health focused solutions that we can talk and think about in this dialogue.


Okay? So the line, the lance of two 2019 countdown quoted this this beautiful piece that I, that I really opened many of my talks with, which is a very stark reminder about the impact of the climate crisis on health. That the life of every child born today will be profoundly affected by climate change without accelerated intervention. This new era will come to, and some may argue, has already come to define the health of people at every stage of their lives. I don’t think I need to tell you this audience really about the impacts, but I do want to just quickly sort of lay the groundwork for the kinds of pathways that we’re seeing affecting health. So we know that by mid-century, we’re gonna have 200 million climate migrants. That means one out of 45 people will be displaced because of climate events.


Global hunger will rise up to 50%. and that will be so by about mid-century as well. about one third of the human population will be living in extreme heat. and we are looking at about an sort of economic loss of about 23 trillion over the course of the next 30 to 40 years as a result. And all of these have significant impacts on health. what I wanna introduce you to is this model, which is a very nice way. So Sam Meyers at the Planetary Health Alliance has put forward this model to help us think about how is it that climate change is going to be impacting health? Like what are the pathways by which this will happen? So what we do know is that there are underlying factors. So what you see as sort of the red arrow coming down, underlying factors, which include our human consumption patterns.


So the things that we are doing as human beings to impact the world the demographic shifts technology are all going to impact the ways in which the earth experiences changes. that in turn affects what we call our ecological drivers. So really, pollution, climate change, biodiversity loss, all of those are subsequently then impacted, which then in turn impact sort of what we call our proximate causes. So those are things that we see happening in the near term. And those include things like our air quality, like our access to fresh water, to food. And then there are these mediating factors that really will exacerbate or make worse what we see happening. So those are things like philanthropy, wealth, governance which can make things worse or better depending on where you are, which all finally result in what we are speaking to sort of as our health effects.


So these are malnutrition, infectious disease, so on and so forth. I’m gonna talk about some of this a little bit more. So this really shows the pathways by which all of sort of health will be impacted. I’m not gonna go into all of these. I’m gonna talk about two specific examples that are relevant mostly to us in California, but I just wanted you to see the range of impact that we’ll see here. So, you know, how will extreme heat, natural hazards, really what are the kinds of health impacts? We’re going to see how some of those indirect causes, like food supply, water supply quality, air quality, how will those impact which pathways to health? So specifically focusing on extreme heat, which we know is the largest killer of all weather events. So we know it accounts for most of the deaths. we see average temperatures are increasing in heat, and that will intensify with global temperatures becoming warmer and warmer over the years. And the pyramid nicely shows you sort of, you know, the health impacts we’re seeing mild symptoms, discomfort to really severe health illness, and then sort of this push towards chronic disease being exacerbated mental health, which Dr. Satler will talk about a little bit more. And then really death. We do know that, for example, between 2000 and 2018 the elderly population around the world has experienced almost 60% more health related mor heat related mortality.


And the other area that we think about often in California’s really wildfire smoke. So what we do know is that more than half of Californians now are facing unhealthy air quality index for a month or longer. So over and above what we used to experience as a result of air pollution. So really wildfire smoke is now accounting for half of that particular matter, 2.5. So that’s our more, the most dangerous thing to breathe in all of the Western US because it’s not just California as Oregon and and Washington that have experienced this. And then smoke travels. and then of course the health outcomes that we see, there are beautiful systematic reviews that talk about sort of what we’re seeing as a result of wildfire smoke, premature mortality poor pregnancy and neonatal outcomes, very things that you would normally expect, like asthma and C O P D and then cardiovascular disease. And also there’s a, there are two beautiful pieces that came out recently that talk about sort of the impact of wildfire smoke on neurocognitive decline, so Alzheimer’s disease and also skin health.


 so what does climate change mean for health related disparities? So what we do know is that there’s really no understanding of the climate crisis that would be incomplete without acknowledging that it drives significant health disparities. So we know that vulnerable regions throughout the world, communities those who are already experiencing highest level food insecurity, poverty, large disease burdens, are gonna continue to experience more of those. And those vulnerable populations are the ones that you really see listed on the left. So migrants, like I talked about earlier, elderly children, women farming in rural communities, and I’m gonna talk about each of these a bit more. climate justice amplifies ex existing structural injustices to worsen outcomes. And we do, we do know that those who contribute the least of the problem will bear the brun of the health harms. So we’re seeing, if you look at these two beautiful pictures, actually, they’re done so well.


They really show that, for example, on the bottom for you, it’s the bottom left that carbon, the countries that are really the highest carbon dioxide emitters. So those, the United States, Canada, Aus Australia, Russia have the lowest mortality rate related to climate change. And you see that sort of on the top right. And the countries, of course, like or the continents like Africa, south America, which are the lowest carbon dioxide emitters actually are experiencing the highest mortality rate based on climate change. we see the climate gap. So what we call the climate gap is really that sort of those are the, the climate injustices that we experience as a result of those existing disparities. We know, for example, in California or in Los Angeles, African American communities are two times more likely to die from heat waves. We know that those communities that work outdoors, so our agricultural workers, construction workers are more likely to experience heat related deaths.


And then communities like our Latinx communities are African American communities in general, are experiencing greater amounts of burdens of the health conditions. we know historically redlined neighborhoods are on average five degrees warmer, you know, because of the heat sort of heat island effects. So, you know, warmer surfaces fewer trees that are then leading to more heat related illness. same thing with wildfire. So while we know that non-latex communities have more exposures to ambient particulate matter 2.5, we do see from the literature that older, smaller, low socioeconomic status homes and neighborhoods of higher elephant infiltration of outdoor air pollutants. And, you know, for example, we do know in a recent study of Denver that nearly four times higher indoor air pollutant amounts were seen during wildfire events in low socioeconomic neighborhoods. And then of course, all the natural hazards that you see listed here have all had significant injury health disparities across communities.


 I do not want to leave this on a negative note because I do think that there are a lot of opportunities, and this is from the very original Lancet countdown, that action on climate change could be the greatest global health opportunity of the century. And why is that? That is because we know that there are many co-benefits. So when you help, for example stop investing in fossil fuels and you to, to make sure that the air is cleaner, you’re getting people off the roads, they’re walking more, that creates better health outcomes. So thinking about those co-benefits is very critical. these are some excellent recommendations from the Department of Health and Human Services, which really point to the areas, the directions in which the health community needs to go in order to play a significant role in helping address the climate crisis and its impact on health.


And I think some of the low hanging fruits that we think about really advancing knowledge on climate health equity links very straightforward, right, are health professionals are not trained. So they need to be trained to help patients deal with health outcomes and things like you know, preparing communities for for what’s going to come. So preparing them for climate impacts and to help protect them. And so with that, I will stop. climate change is an unprecedented threat, and we’re hoping that some of those co beneficial climate, health and equity pathways can play a significant role in the changes that we see in our communities. So thank you everybody.

Venise M. Curry MD (00:17:13):



You Dr. Teherani. That was so comprehensive and also so clear and easy to follow. We want to give you an opportunity to ask a few questions at this pnt. Otherwise, we will hold a space at the end where you will be able to ask questions. Are there any questions right now?

Dr. Arianne Teherani (00:17:33):


Venise M. Curry MD (00:17:37):

Okay. We will then transition to our next speaker. We’re really honored to have Assemblywoman Luz Rivas here. She was born in LA to an immigrant family. She grew up in Northeast San Valley. She at is a proud attendee of LA Unified Schools before earning her bachelor’s degree in electrical engineering from M I t and a Master’s of Education from Harvard. her career is at the intersection of engineering and education, and she has used these gifts wisely. She has founded DIY Girls, which is a nonprofit that really provides enrichment programs focused on encouraging young girls to pursue careers in science, engineering, and technology. In 2016, she was appointed by the mayor to the Los Angeles Board of Public Works but she was elected and sworn into the California State Assembly in 2018. She has been appointed as the chair of the Assembly Committee on natural resources and currently serves on the assembly committee, on budget committees, on budget, budget subcommittee number three on resources and transportation. I’m going to stop there, but I do wanna just say that she has been extraordinarily successful in leading and developing subs substantive policy reforms that address education K through 12, that address California Youth Empowerment Commission and that address excessive heat. And we’re gonna hear a little bit more about that. So please welcome our Assemblywoman Rivas. Thank you.

Assemblymember Luz Rivas (00:19:16):

Thank you, Dr. Curry. and I’m very excited to be here. I’m Luz Rivas, assembly member from the San Fernando Valley. it’s the 43rd Assembly District. It’s where I grew up and very excited to represent my community in the state legislature. I’ve been in the assembly almost five years. It’s gone by so fast. and honored to be here today. Thank you to JN for inviting me to be part of this conference. ed, you know, I think when I first got elected, I, you know, of course my, like Dr. Curry mentioned my background’s in engineering. I’ve, I’ve been a STEM science educator. that’s what I have focused my career on. Of course, when I came to the legislature, I thought, okay, that’s gonna be my priorities, which they are. And, and I like science, and it’s, of course I wanted to work on climate change and and things that are science related.


 but I never had envisioned that I’d be working on the intersection of science and public health. Right? I think I, I was reflecting as I’m like, oh, I’m on a panel with medical doctors and PhD researchers in this area. You know, what am I doing here? and and I thought of, you know, five years ago, I’d never thought I’d be doing anything related to health policy. I’m like, I’m not a medical doctor. There’s others in the legislature that do that stuff, right? but when I was an assembly member, I would go home. we have a lot of hospitals and clinics. You know, healthcare is a big industry, I would say in terms of in my district. we have a county public hospital. We have private hospitals and many clinics, you know, the majority of my district is on Medi-Cal.


You know, it’s a very low income district. And I started to see how we really needed to work on this issue, you know, for my constituents. and, you know, I’d go visit hospitals and schools you know, and I grew up in this area, and I remember every summer it’s very hot. If you’re not from Los Angeles, the San Fernando Valley is one of the hottest areas in LA County, in case you don’t know. and so it’s, it’s always, you know, over a hundred degrees in the summer. we experience heat waves and, you know, so I was used to that, but now it’s gotten worse because of climate change. and this, these are communities that are, communities like mine are also ones that ha that in the past were red line we have less trees poor air quality, and it’s very hot, right?


And so now with climate change these issues are, are becoming worse for our, our communities, for the people that live there. and I started, you know, realizing that, that, wait, what can I do now as a legislator that represents this area? Because if I do something related to climate change and health there’s, there’s many communities across the state that are similar to this, right? And so, kind of dived into that and and started working on extreme heat and, and how that affects health. And what can we do to mitigate extreme heat during these extreme heat waves that are now just becoming an annual event, right? It used to be once in a while, and now they’re becoming an annual event. And I’m like, okay, so what can the state do? What can I do in this position? and so I’ve introduced legislation related to extreme heat, you know, creating an extreme heat and community resilience program.


Also, have worked through the budget, you know, with lots of advocates and organizations that have been supporting and leading this work. I’ve worked on, you know, green school yards, you know, because the kids, they have to go out for recess or the preschoolers, they send ’em out to play and it’s very hot, and it’s just asphalt, you know, and it gets even hotter in the summer. and so I thought that we need more green space and shade. I know it’s like a basic right, right? Having shade on your playground. and, you know, this is a few years ago and now we have a program, the state has a program where schools can apply, you know, to, to make their campuses greener and more trees, more shade, depending on what they want. and I, I have passed, I intro authored some bills and some have been signed by the governor.


 one of ’em created the state’s first like heat wave ranking system. and it will be created soon to alert communities on how bad the heat wave is going to be so that local governments can prepare and, and have a, and that our communities will know how to prepare for these heat waves. Cuz what happens a lot of times is, as I’m sure all a lot of, you know, are most vulnerable or elderly, they’ll just stay at home. They have nowhere to go. The, you know, the, sometimes there are cooling centers, but what are you gonna do there? Just sit there all day. People don’t want to go necessarily just to a temporary cooling center. and, and they don’t have air conditioning. There’s no trees around them. and then by the time, you know, something happens to them, they’re in their emergency room, right?


And when I’ve met with medical doctors in my district and outside of my district they talk about how the impact on emergency rooms during a heat wave, right? And unfortunately, the state doesn’t record that data. You know, we, we find out what the condition was, the health condition was. maybe if someone died, you know, they died of a heart attack or something else, a health condition. but if you correlate that with the dates, you’re like, oh, there was an extreme heat wave that week. Right? And so we’ve also pushed our public health department to collect this data, right? So we know how many deaths are occurring, and so we know where to do, you know, implement some of these interventions. and so it’s been an exciting field. I’ve met so many people, continue to work in this field and learn from the researchers and other advocates on, you know, what we can do better as a state because it’s becoming an annual event.


 and we wanna make sure that our, our most vulnerable are protected. so through legislation and our state budget is one, you know, two ways that I have worked towards mitigating extreme heat in, in California. now I, I have a lot of colleagues that are interested in this field, which is very exciting, and we’re trying to figure out what else can we do. So if you have any ideas, you know, please feel free to reach out to me and, and others. but it is a topic that we take seriously in California, and that’s what’s exciting. and I’m here to learn con continue to learn. And so thank you for having me today. and and I look forward to continuing this discussion as my allergies are bothering me. So I’m sorry.

Venise M. Curry MD (00:27:04):

Thank you so much. we wanna make sure that you have an opportunity to ask questions. I know the assembly woman will have to leave, so we will take questions now. Yes.

Audience (00:27:14):

 my question is actually to both of the speakers have already spoken mm-hmm. <affirmative> systemically. What is the one metric that you each might think could actually move the needle? Does it have to be depth in like, the state of California? Like, what is available that you think could really be extrapolated in a way healthwise that starts to change lines, change budgets, and change measures?

Dr. Arianne Teherani (00:27:49):

We should go first as you’re leaving. Okay.

Assemblymember Luz Rivas (00:27:51):

No, I know. I, right now that you said, does it have to be deaths? It, it like struck me. but I feel that we’re not even recording that as, you know, a result of a extreme heat wave. and it feels like a lot of people don’t know that heat is the biggest killer, right? in terms of weather events, right? We, we focus on a hurricane in another state or maybe an earthquake. but this is something that happens annually. I haven’t thought, I know that I’ve been looking and talking to people about ways, how can we prevent that? When do we know, right? That someone is in danger and either needs to go to a medical center or needs some kind of intervention. and just I continue to work with, you know, public health and other professionals in this area. I don’t know if I have a specific answer on that. Like a metric, right?

Dr. Arianne Teherani (00:28:49):

Yeah, I think, I think that’s exactly right. I think health appeals to anyone, right? So if you think about it, we’re all concerned about our health. So really it’s any health outcomes that we wanna make sure we look at, we wanna make sure that we’re letting communities know about this. so two quick things is that we do have a huge database of health records in the uc system, and we’re going to be running some machine learning techniques to be able to see if we could identify profiles of patients who were affected by recent heat events and wildfire smoke events, to see how we could have created an emergency response system to be able to help those folks in advance. So once you have the profile and you know, which, which folks are most at risk, how can you reach them? And how can you help? And I do think that in and of itself, like that awareness to communities is extremely critical because that also is a, a major message in that dialogue.

Venise M. Curry MD (00:29:46):

<laugh> Okay. I think the gentleman in the gray. Thank you. And then

Audience (00:29:51):

I’m wondering if you could talk a little bit about the current efforts to record conditions, fatalities, illnesses that may be heat related. Cause as you mentioned, they’re knock on more toward

Assemblymember Luz Rivas (00:30:08):

Yeah, I know the LA Times did a story, was it last year or two years ago? And they interviewed me while they were you know, writing that story. and they you know, they talked about our Department of Public Health on how we’re not collecting that data and why we’re not, right. And how and I think, I know we had a bill last year that was pushing for that and that didn’t make it. But we continue to try to get that data from Department of Public Health and for, for it to be required from our hospitals.

Venise M. Curry MD (00:30:51):

let’s see this right here. And then I think we have time for, okay, we’ll just continue

Audience (00:30:59):

On. I’m, I’m thinking about the wildfire smoke issue. And I know, like I’m a private homeowner. I’ve done a lot myself to try to keep the smoke out of the house. I’m in. I’m up in the foothills. I’m in a heavy smoke area. Two years ago, was successful last year. Everything I tried, the smoke was coming in and I have resources mm-hmm. <affirmative> and I, you know, I like went to the hardware store repeatedly and kept doing things. and I went online and I did the four filter thing with the fan and put three of those in the house. But, you know, more publicity on that work, like federal program or state programs that could help people who, you know, like we need to seal our homes better. Also, my daughter last summer during it was a barista at Dutch Brothers, which they don’t have, you know, their windows are open and they, the masks they provided to them were flimsy at best. You know, so there she was not, you know, considered really a frontline worker, but to go to work every day. Men, she was being exposed to an incredible amount of wildfire smoke. I tried to get her to wear a mask I was providing, and she was like, nobody else is, and not teenagers, but, you know, but things like that for the wildfire smoke would, I think be hugely


Impactful.I have some colleagues in the legislature that have focused on outdoor workers and the effects of wildfire smoke, especially agricultural workers. And a lot of us saw those photos a couple years ago with the big wildfires and you saw the farm workers, they’re still working right in in those conditions.


And you think about that. But like my kid, she’s just a barista.

Venise M. Curry MD (00:32:50):

Yes. You

Audience (00:32:51):

Know, but she was breathing the smoke and like, you know, 20 hours a week on the job for weeks and, you know, there’s no requirement around masks being provided. There’s no, you know, each business just does whatever they want to do. Right.

Assemblymember Luz Rivas (00:33:07):

Yeah, please. Definitely. There is a need there. It’s coming back.

Audience (00:33:10):


Venise M. Curry MD (00:33:10):

Won’t do the last, no, unfortunately not right. <laugh>. Okay. I see a hand on this side of the room. So I’m gonna call on Amanda.

Audience (00:33:16):

I’m just gonna add a, just a quick insight and idea percolation of co related to how we know what’s going on with heat related death and, and other climate related impacts. I’m a pediatrician actually, and I’ve been talk about a little bit about what it’s like to try to code and bill for services that we’re providing where these events are happening and they’re, I just wanted to put out, there’s a huge need for advocacy to change our coding. When I search for wildfire smoke, there is one code and it is wildfire smoke pemphigus, which I can guarantee you I’ve never diagnosed. Hopefully you will diagnosed. So, but anyway, all of this to say is, this is I think at a federal level mostly as opposed to California specific mm-hmm. <affirmative>. But I think this, there’s a huge need part and it’s complicated. Cause there’s also this question of attribution and if we code, you know, that this happened during a heat wave, are we saying that it happened? Cause of the heat wave, which I think makes people very uncomfortable, but more just getting a flavor of what’s happening, your lease, which we’re not capturing in the coding at all. So I just wanted to put that out there.

Assemblymember Luz Rivas (00:34:33):

It’s interesting cuz as a medical doctor you may want to, but those codes aren’t available. Right. So when you’re making the

Audience (00:34:40):

My note and the coders are like, what are you doing? And I’m like, I, this is the only way I can get this in the note. So Yeah. Yeah. There isn’t earlier way right now mm-hmm. <affirmative>.

Venise M. Curry MD (00:34:54):

 okay. I see Two more questions and then we will close this portion. Okay.

Audience (00:34:59):

Yeah. Just gonna building off of what she said. I think a lot of the time when we talk about, you know, the, the reactions to disaster and wildfires, we really focus on hospital and curious how we’re engaging in, you know, the community health, community health centers, services to medical beneficiaries, indocumented and uninsured. cause that can really support leveraging data that we need. and providing prevent interventions to climate change and really need the support and resources into those new LED healthcare industry.

Venise M. Curry MD (00:35:52):

Thank you. Our,

Dr. Arianne Teherani (00:35:52):

Oh there is, so there’s so many layers to that question. I guess I’ll start off by saying there are a few groups that are beginning to do that, that are beginning to use health advocates within those communities to reach to reach those who are so proactively and also making sure there are resources available. there’s so many thoughts that are coming to mind for me. I feel like I have to give you a list of those resources. So why don’t we talk after the session. I’m happy to share those with you.

Venise M. Curry MD (00:36:31):

Okay. Our last question. Yes.

Audience (00:36:33):

llGreat. Amazing panel. And thank you to the assembly member. as you may know, I grew up there. Mm-hmm. <affirmative>. so my next question is about humidity and the rising, humid key wave that we’re having as more reminiscent of the Midwest or the East Coast. Is that quite a factor in emerging research, but most importantly and to the policy of interventions?

Dr. Arianne Teherani (00:37:02):


So there is some evidence that is pointing to the fact that yes, that is changing for us in California, for example, we’re seeing that the nighttime temperature is not dropping like it used to. And then what does that also mean for folks who are typically accustomed to that, right. That biological clock, sort of going back to that state of, I guess, are you asking what’s happening? There’s a small group at uc, San Diego that’s doing work in this area, but there is still a lot that we don’t understand about it. So I don’t think that I personally have an answer to it. I don’t know if either of you, that is the only group I know that’s sort of doing that, that work on really understanding the nighttime temperatures and how that shift in the way California California’s climate is working, is actually impacting health. Barbara,

Barbara Sattler, R.N., DrPH (00:37:56):

I don’t, is this is on. Yeah. Hi, I’m Barbara <laugh>. The only thing I would add to that is that as you have more moisture in the air, people cannot sweat. And that is one of the ways in which we temper our internal temperatures. So we do know as we begin to see more moist air, more humid climate that then accelerates or is it like a multiplier factor on the heat in a way that the dry heat is not. So just to note that.

Dr. Arianne Teherani (00:38:36):


Venise M. Curry MD (00:38:37):

Well, thank you so much for your questions and for your responses and for your presence. Again, we do have one more speaker and we’re really happy to bring her up as well. This is Dr. Barbara Sattler. She is a professor emeritus at the University of San Francisco and an international leader in environmental health and nursing. She is a founding member of the National Alliance of Nurses for Healthy Environments and a founding member of the California Nurses for Environmental Health and Justice, which focuses on California’s specific issues and their policies. She has been an advisor to the US EPA a’s Office of Child Health Protection and the National Library of Medicine for International Needs of Health Professionals on Environmental Health. she’s a registered nurse, she’s a fellow in the American Academy of Nursing, and she brings a wealth of information. she’s going to share with us a little bit about mental health and climate change. Thank you for joining us

Audience (00:40:16):

Basics, but also I love that there’s so much interest in the medical community. Can I


Ask a question?


Yes. Oh, sure.


I’m sorry. I I was wondering if you have an idea, like if you dream of a policy you would love to get is place. I know you’ve struggled with other policies,


We all do. I know, but


Like, if you could do any policy or a policy around health and climate change, like what do you dream of being able to do that we and the NGO can do to help support the

Assemblymember Luz Rivas (00:40:58):

Oh, that’s such a great question. I know, maybe I’m not dreaming enough, right? <laugh>, I’m more right now buried in the reality of getting a bill out or yeah, that’s, you know, well, you know, of course I think of heat, but you know, all of the extreme weather events mm-hmm. <affirmative>, you know, now I’m trying to think. We, you know, we’ve just went through flooding, you know, in the Central Valley, right? we have some communities that are not prepared. So I’m thinking of like also the emergency preparedness of vulnerable communities. Like how did we let that happen? Right? I was just in a morning discussion on this. So I think that’s fresh on my mind what’s happening in, in Baha right? In, in the flooding. but you know, we wait until something there’s a disaster or like someone had mentioned, do we really have to track deaths? Why is that our goal? Right? and so I’m thinking of, you know, how could we be more proactive on this and not wait until it gets too extreme, right? That we feel the government feels like it has to intervene. Right? and so not something specific, but just in general, I’m thinking of that right now as this discussion is happening.

Audience (00:42:13):

Okay. Thank you. Thanks for all your leadership.

Assemblymember Luz Rivas (00:42:15):

For sure. Oh, thank you. Thank you for your support.

Audience (00:42:19):

Yeah, thank you. Thank you.

Barbara Sattler, R.N., DrPH. (00:42:21):

So, hello I am going to talk about mental health and I am one of 497,000 registered nurses in the state of California who are mostly embedded in our communities in a way that a lot of other health professionals may not be. And so we are we are viewing this now as a crisis at a lot of levels. And so I was asked specifically to talk about mental health, and I’d like to note that first of all, we are in a mental health crisis. Generally we have a, an an underlying mental health crisis. We also have, we have a broken healthcare system. We have an even more broken mental healthcare system. So that’s two of the balloons here. The third one is then we have climate induced mental health stress. And so I’m gonna try and talk about each of them very quickly, individually, and then talk about them in sort of compounded.


So it is really honestly depressing to look at mental health statistics these days. The fact that there is even a statistic for five to 11 year old suicides is a fact that takes your breath away. The fact that it’s on the rise is an indication that we have a real societal problem in terms of mental health. The fact that suicide ideation among our youth is also up. And I’ll talk specifically about climate relatedness there. And we have a nationwide deficit in terms of pediatric inpatient facility so that when a child is in crisis, we don’t have a place for them to go. And of course, y’all know the pandemic didn’t really help any of our mental health and it especially didn’t help our children’s mental health. The other pandemic that hasn’t been spoken about very much except for by the surgeon general of the US is that we are experiencing an epidemic of loneliness in this country.


People are feeling extremely socially isolated and alone. And there’s a wonderful book, it was out years ago called Bowling Alone. And it was a book that talked about how so many of our sort of social infrastructures have gone away. The bowling alleys in our small communities where mostly the guys and some of the women would get together and have a beer and hang with each other and get to know each other and talk to each other. Where there were other ways, there were skiing rinks for youth to go to where there were places for folks to go and aggregate and get to know each other. We are living a much more isolated, much more connected to devices life these days. And it’s playing its toll. And the health effects actually associated with, with loneliness, according to several epidemiological studies is that people who experience it have the same level of risk for cardiovascular disease as if they were to smoke three packs of cigarettes a day.


So loneliness has a, a significant effect on us. Wow. We also, if you google mental health and climate change, you’re gonna see there are a lot of reports, there’s a lot of information on this. The psychiatric associations, the psychologicals associations, the public health associations, the World Health Organization all have reports on this. It’s well founded that this is a serious issue. What also needs to be noted is that race and poverty play an incredible multiplier effect on mental health in the same way they do on social determinants of health, on health parameters, generally. One of the most recent specific studies about mental health and climate change came out a year or so ago, and it studied 10,000 youth in 10 countries, the US being one of those countries. And it found disturbingly that our youth, and those were 18 to 21 year olds, something like that.


 they are extremely worried about climate change. They are having a sense that their future has been stolen from them. And they are experiencing sadness and anxiety and anger and powerlessness and helplessness and guilt. They also feel we have failed them. We have failed them. And and this is what they’re carrying into their daily lives. And for many of them, up to 45% of them, this actually is affecting their daily life and their ability to flourish. So then on top of that, we’ve got then these things that are happening that are the po the climate crisis, including the top right here, which is the levy in Paco, that that failed just a couple of weeks ago. And this woman on the top left who talk about a mental health crisis, you’ve got the immediate crisis of these events. You then got the crisis of displacement in these two pictures here.


I I live in Sonoma County where we have had lots of displaced people from fires and more recently from the floods around the Russian River as well. And so they wind up sometimes temporarily displaced and sometimes permanently displaced. But what that means for the first year or so is that they don’t have a home to return to. This is from the fires. They don’t have a school to return to in some instances, they don’t have a job to return to. This puts a community into a health and mental health crisis. And the thing that happens is that the movie cameras are there during the fires. They are not here during the aftermath. They are not here to see that. If you are a renter, you get virtually nothing after a fire. Your furniture is gone. If you are homeowner with homeowner in insurance, you can get new furniture, you can get a place to live.


And if you’re a renter, a whole other set of of sort of FEMA and state responsibilities fail them, we’re doing a little bit better. Cuz every time we have one of these crisis, we get a little bit better. But there’s still incredible disequilibrium there. The other thing is that these folks suffer from post-traumatic stress. Their children, generally, it’s a year later, their children start acting out. Their children start failing in schools. Their children maybe had to go to two or three different schools while their parents were trying to find places, you know, a landing zone for them. Finally, these are mental health issues associated with climate change. We also know that displacement is happening. Sorry, this is similar. Well, here we go. We also know that displacement is happening in, in another way. We have got to close down certain sectors that now currently gainfully employ union workers with good benefits and good incomes.


We have to close them down. We have to say to these mostly men in these sectors who have powered us up for a a hundred years and gotten us the electricity and the power that we’ve needed to have. The society we have now, our thanks to them is we’re gonna take their jobs away from them. That’s how they see it. This is something that is going to create another public health crisis. I lived in Baltimore when the steel industry went offshore. I worked for the United Steelworkers Union. We had 2.4 million workers before steel went offshore. We had 700,000 steel workers after that was done. Those were good paying good benefits on jobs and we didn’t have a plan for them. We now have to have a plan for the workers that we are going to displace. And we don’t, we need a significant plan for those folks.


But what we do know is when a sector leaves town, the tax base leaves with it. And that means less health services, less education, less mental health services. So you’ve got these duplicating crisis all at once. So I’d like to suggest some revolutionary shifts that are going to help us be more resilient. I’d like us to think about infrastructure as also being social infrastructure, which is what’s going to help us have more resilient communities when all of these things are coming down the pipe pipeline. I want less commun consumerism and more community. Anybody here with me on this one? I want less internet connection and more real connection.


I want less cars and more active transportation. I want less isolation, more engagement. Yes. And less built environment and more time in nature. Yes. And I want joy. I want joy. That is really important. And, and to that end, I wanna just share with you <laugh>. I live in Santa Rosa. I live outside of Santa Rosa, Rosa. We have Taco Tuesday. It was started by the Latino community during the pandemic. They got the kids and the, and the all ages on bicycles. They have boom boxes, they have other things. And then one of my friends who’s the pre white woman president of the bicycle coalition, she said, let’s go join them. So we went and joined them. Now it becomes multi-generational, multi-age. We’d ride for an hour and we wind up in a place where the taco trucks are <laugh> and we eat together in all of these picnic tables, it gets us doing active transportation.


It helps to create community resilience. It helps to develop relationships cuz you’re right next to somebody who you didn’t know before and you’re hanging out anyway. There are way things that we can do. We also as hospitals, as as other community organizations, we can really things that are going to create this social infrastructure that’s going to create a resilient community. Community gardens, block parties, book clubs, concerts, farmers markets. These are the things that are gonna help our communities hang together in the very many ways that we’re going to have problems in the near future. The World Health Organization says we have to in, you don’t need to look at all the words we have to integrate mental health into the way we’re thinking about infrastructure and social infrastructure. And with that, I want y’all to think, love and act everywhere right now. So thank you.

Venise M. Curry MD (00:54:16):

So I jokingly said to Barbara that she was the closer I, but I correct. She is the closer. So we wanna thank you for not only providing the information, but for giving us a little bit of a lift and some aspiration and hope. So thank you so much for that talk. we wanna just give our, all of our speakers a round of applause for joining us and I think we have some time or a minute or two for some questions if there are any. Good to meet you. Yes, I see too.

Audience (00:54:53):

Yeah. Hi. en


Los Angeles, based by the name of climate and for over a dozen years now, we’ve adapting our communities to extreme heat. And I wanted to first off thank Gerald for assembling such a distinguished panel of experts on extreme heat and the important medical perspective that you’re providing. sometimes when we work in climate change, there are some counterintuitive strategies that unintentionally emerged. And one of those strategies that I’d like to talk about is the need to find ways to cool people’s homes as a life-saving intervention. And the state has invested a lot of money in making sure that people will get air conditioning systems in their homes, making sure that homes are properly weatherized. And I wanted to ask Barbara, oops. climate Resolve is really concerned that we are now drawing attention from the public right way and making people go into their homes where that seems to make loneliness worse. and I invite you to keep the conversation going with us because I think it’s really important to start addressing how a lot of our solutions may be counterintuitive.

Barbara Sattler, R.N., DrPH. (00:56:28):

I agree. Well, thank you for that. Thank you.

Audience (00:56:33):

Yeah. Hi I’m William Berg. I’m from Public Health Advocates. I just have quick comments and then one second question. I just wanna say this was a great panel. it touches on a lot of the work that we do as public, public health advocates when it comes to like mental health climate change. and I think one of our priorities is definitely toward building a more sustainable future. We’re touching on things and all these things. but I actually do have a question for this. Remember really quick, I’m so sorry. It’s really quick, but you might not have to answer either, but something I thought about too, when we think about how we build, how we build our environment, is there a way that as we build our our communities, can we use the like weather for example, to cool our homes?


 so I think about how in like traditional Korean architecture, and I’m sure this is applicable in a lot of other indigenous and vernacular architecture where they use like wind to harness wind power mm-hmm. <affirmative> before like electricity and all that to keep the homes cool. And they would place homes in a way that would utilize the existing natural environment to help either cool the homes or keep the homes. And that way we’re not, we’re not I think Senator Skinner mentioned this earlier that we can do more by consuming less electricity. So how can we build an environment where we’re using nature in a natural state and avoid having to rely on technology and electricity consumption to keep our own. Cool. so that’s just a question that maybe you don’t have an answer to. But’s definitely something I’ve thought about a lot and how we can build a more inclusive environment through the way we build around this.

Assemblymember Luz Rivas (00:58:07):

Oh, that definitely a good point. You know, I’ve read a lot on this, on what can we do with our existing buildings and when we’re building, you know, right now a lot of the talk in the legislature is on, you know, housing production building new housing and you know, how can we integrate some requirements, right? That, like you mentioned, that use the natural environment or conditions to make sure these buildings or homes are better cooled and they’re not designed the same way that we’ve been doing it you know, all these years now. Those are great points.

Audience (00:58:46):

 some of the great examples of that are also in South Africa with the roofs. So yeah, that’s a great point.

Venise M. Curry MD (00:58:52):

Thank you so much. I think we do have to end at this point, so thank you again to our panel.