Introduction
The relationship between the global climate change crisis and public health is increasingly becoming stronger. The two issues affect each other, particularly for historically marginalized populations. The issues that contribute to health disparities in diabetes care are often amplified by climate change.
Climate change is the long term shift in temperature and weather patterns. While many think it just has to do with rising temperatures, climate change is the phenomenon of more intense weather. This could manifest as extreme heat, extreme cold, and more natural disasters. In terms of public health, climate change can affect security. Whether it is food and water security, mental health, or a decrease in air quality, climate change is a public health issue. In fact, a study published in Early Human Development found a bidirectional relationship between diabetes and climate change. Climate change makes diabetes worse, especially for populations that are considered already vulnerable.
Health Access and Climate Change
Climate change will likely exacerbate already existing health disparities in diabetes and access to healthcare. A study published in the American Diabetes Association shows that geographical location will play a crucial role, as some places are more prone to extreme heat and flooding, and they have limited resources to support those with chronic conditions like diabetes.
Furthermore, food insecurity complicates the management of already existing diabetes. The CDC found that people experiencing food insecurity are 2-3 times more likely to have diabetes. With climate change disrupting agricultural systems, the price of fresh foods will increase. To economize, many may have to choose between healthy foods and prescriptions.
Aside from food insecurity, extreme weather can disrupt access to medical care. The CDC expressed concern for the storage of insulin in extreme heat. With an increased frequency of heatwaves, floods, droughts and wildfires, temperature sensitive medications like insulin may not be able to be stored properly. Power outages can make refrigeration unstable. Infrastructure damage can make it difficult for medication to be produced and transported, risking medical complications and compromised health in individuals.
Unequal Access to Care for Vulnerable Populations
Looking at diabetes prevention through a holistic lens can allow us to address the various risk factors an individual may have in developing the condition. Research conducted by the American Diabetes Association emphasized the interconnectedness of physical, mental and social factors in addressing diabetes. Creating a plan that patients can realistically follow is key in diabetes prevention. Socioeconomic status is another determinant. People who live in lower SES areas often lack access to resources like air conditioning, nutritious food options and transportation to healthcare appointments.
The alarming disparities in historically marginalized and low-income communities’ access to healthcare is rooted in historic systemic factors. The discrimination in access to housing, education, employment and healthcare continues today. These communities are more likely to live in areas with increased pollution and a depleted ozone layer, with the EPA finding that Black communities are 15% more likely to live in an area highly affected by pollution. This makes marginalized communities more susceptible to the public health consequences of climate change.
Strategies to Address the Challenges
Empowering Healthcare Providers:
Healthcare providers are key in addressing the growing impact of climate change on diabetes and must be equipped with the knowledge to provide effective care. A study published in the International Journal of Environmental Research and Public Health found that both patient and provider education can significantly help raise awareness on climate related health access risks. This includes guidance on staying hydrated, ensuring proper storage of insulin, and recognizing access issues. Providers should be vigilant about the disparities climate change brings to vulnerable individuals. Using telemedicine and remote monitoring can enhance access to care.
Using a PCMH (Patient-centered Medical Home) Model
Preventative care can help address diabetes while it is still easily manageable. Taking a proactive approach can help provide more effective diabetes care. The International Diabetes Federation found that several factors influence the relationship between climate change and health. A PCMH model would take the social determinants of health and access to food and housing into account. PCMH models encourage team based care. In regards to environmental justice, the utilization of health information technology, meteorological data, and patient’s health history can help address the evolving needs of patients.
Advocacy for a Healthier Future
Fighting for environmental justice, or the idea that everyone has the right to a healthy environment, is an important part of promoting health access. Policies that promote environmental research can assist in identifying and aiding areas that are particularly vulnerable to climate change. Advocacy efforts can focus on the root causes of climate change, such as the overuse of resources and release of CO2 in the air. Taking a participatory approach, where multiple stakeholder perspectives are taken into account, can aid communities in accessing holistic care.
Conclusion
As we work towards equitable access to care, we must take the growing role of climate change into account. Emergency preparedness is a large disparity in healthcare, and it can lead to difficulties accessing the essential resources for diabetes. Implementing sustainable healthcare practices that are reliable in uncertain times can help address the social determinants of health. By advocating for climate-resilient systems, healthcare providers can mitigate the impact of climate change on diabetes management.