She points to a recent lettuce shortage. “Lettuce got more expensive because of issues related to climate change,” she said. “As the climate changes, who will be able to afford nutritious food, and what does that mean for the health of our communities? There’s a real connection there.”
She studies health disparities caused by social inequity, and wonders how they can be exacerbated by the pressures of climate change.
“We know that people with lower income, who are experiencing racism or violence, have much higher allostatic load than those who are not facing the same stressors,” she said. “That chronic activation of stress responses can increase stress hormones like cortisol, and over time that can directly impact health. Chronic stress contributes to a host of health problems, including cardiovascular disease, which is the largest contributor to the racial mortality gap.”
Those with the fewest resources and who are the most vulnerable are disproportionately affected by climate change, in everything from the rising cost of food to a lack of secure shelter from extreme weather events to increased risk of exposure to pollution and infectious disease.
An area of particular focus for Tung is the intersection between violence and health inequity. “Violence is an outcome of inequity,” she said. “More than medical and mental health care, patients who are affected by violent injury will often say they need access to economic and legal resources. For example, eviction can be equally or more toxic to a person than not being able to fully rehab an injured leg. The chronicity of stress related to housing instability has major downstream effects on people’s lives and wellbeing.”
Add to that the effects of climate change on housing, which have already exacerbated the affordable housing crisis and increased housing damage due to flooding and other natural disasters.
These climate challenges will not only exacerbate existing health inequities, but will increase the strain on an already struggling health-care system, making it ever more difficult for those most burdened by the effects of climate change to access the resources they need to survive it. The question isn’t so much whether these issues will get worse in the future, but rather, how to address it.
“There’s a big movement in the health sciences to place a greater emphasis on the social determinants of health, but this is an existential issue,” said Tung. “Most of the solutions currently available to us rely on addressing the specific needs of an individual person or patient, but they don’t provide opportunities for systemic change. If wealth inequality continues to worsen, it will become even more difficult to sustain the services that we are able to offer. It’s a never-ending cycle.”
Environmental exposures and our genes
When she arrived in Beijing as a new university student, Yu-Ying He, PhD, was struck by the contrast to the rural area where she grew up — and especially the amount of pollution in the air, a major issue during that time.