The link between climate change, health and poverty
-
0:01 - 0:06I arrived in the US from Kingston, Jamaica
in the summer of '68. -
0:06 - 0:10My family of six crammed
into a small, two-bedroom apartment -
0:10 - 0:12in a three-story walk-up in Brooklyn.
-
0:12 - 0:14The block had several children --
-
0:14 - 0:17some spoke Spanish, some spoke English.
-
0:17 - 0:19Initially, I wasn't allowed
to play with them -
0:19 - 0:22because, as my parents said,
"Them too rambunctious" -- -
0:22 - 0:23(Laughter)
-
0:23 - 0:26so I could only watch them from my window.
-
0:26 - 0:29Rollerskating was one
of their favorite activities. -
0:29 - 0:32They loved hitching a ride
at the back of the city bus, -
0:32 - 0:34letting go of the rear bumper
-
0:34 - 0:36as the bus arrived
at the bottom of the block -
0:36 - 0:38in front of my building.
-
0:38 - 0:41One day there was a new girl with them.
-
0:41 - 0:45I heard the usual squeals of laughter
interspersed with, "Mira, mira! -
0:45 - 0:46Mira, mira!"
-
0:46 - 0:48Spanish for, "Look, look!"
-
0:48 - 0:52The group grabbed onto the back
of the bus at the top of the block, -
0:52 - 0:57and as they rolled down laughing
and screaming, "Mira, mira, mira, mira," -
0:57 - 0:59the bus abruptly stopped.
-
0:59 - 1:03The experienced riders
adjusted and quickly let go, -
1:03 - 1:06but the new girl lurched back
and fell onto the pavement. -
1:06 - 1:08She didn't move.
-
1:09 - 1:11The adults outside ran to help her.
-
1:11 - 1:14The bus driver came out
to see what had happened -
1:14 - 1:15and call for an ambulance.
-
1:15 - 1:17There was blood coming from her head.
-
1:17 - 1:19She didn't open her eyes.
-
1:19 - 1:20We waited for the ambulance,
-
1:20 - 1:22and waited,
-
1:22 - 1:24and everyone said,
"Where is the ambulance? -
1:24 - 1:26Where is the ambulance?"
-
1:26 - 1:28The police finally arrived.
-
1:28 - 1:32An older black American man said,
"Ain't no ambulance coming." -
1:33 - 1:36He said it again loudly to the cop.
-
1:36 - 1:38"You know ain't no ambulance coming.
-
1:38 - 1:40They never send no ambulance here."
-
1:41 - 1:45The cop looked at my neighbors
who were getting frustrated, -
1:45 - 1:47lifted the girl into the patrol car
-
1:47 - 1:48and left.
-
1:48 - 1:50I was 10 years old at the time.
-
1:50 - 1:52I knew this wasn't right.
-
1:52 - 1:55I knew there was something
more we could do. -
1:55 - 1:57The something I could do
was become a doctor. -
1:57 - 1:59I became an internist
-
1:59 - 2:03and committed my career to caring
for those we often call the underserved, -
2:03 - 2:04the vulnerable,
-
2:04 - 2:08like those neighbors I had
when I first immigrated to America. -
2:09 - 2:13During my early training years
in Harlem in the '80s, -
2:13 - 2:18I saw a shocking increase
in young men with HIV. -
2:18 - 2:19Then when I moved [to] Miami,
-
2:20 - 2:22I noticed HIV included women and children,
-
2:22 - 2:25primarily, poor black and brown people.
-
2:25 - 2:30Within a few years, an infection
seen in a select population -
2:30 - 2:32became a worldwide epidemic.
-
2:32 - 2:35Again I got the urge to do something.
-
2:35 - 2:39Fortunately, with the help of activists
and advocates and educators -
2:39 - 2:41and physicians like me
who treat the disease, -
2:41 - 2:43we found a way forward.
-
2:44 - 2:48There was a massive education effort
to reduce HIV transmission -
2:48 - 2:51and provide legal protection
for those with the disease. -
2:51 - 2:54There was a political will to make sure
-
2:54 - 2:57that as many patients
as possible worldwide, -
2:57 - 3:00regardless of ability to pay,
-
3:00 - 3:02could get access to medication.
-
3:02 - 3:06Within a couple of decades
there were new treatments -
3:06 - 3:09that transformed this life-threatening
infection to a chronic disease, -
3:09 - 3:11like diabetes.
-
3:11 - 3:14Now there's a vaccine on the horizon.
-
3:16 - 3:18Over the last five to seven years,
-
3:18 - 3:21I've noticed a different epidemic
among the patients in Florida, -
3:21 - 3:23and it looks something like this.
-
3:23 - 3:29Ms. Anna Mae, a retired clerical worker
living on a fixed income in Opa-locka, -
3:29 - 3:31walked in for medication refills.
-
3:31 - 3:35She had common chronic conditions
of high blood pressure, diabetes, -
3:35 - 3:37heart disease and asthma
-
3:37 - 3:40with overlapping chronic
obstructive pulmonary disease -- -
3:40 - 3:42COPD.
-
3:42 - 3:44Ms. Anna Mae was one
of my more adherent patients, -
3:44 - 3:48so I was surprised she needed refills
of her breathing medicines -
3:48 - 3:49earlier than usual.
-
3:49 - 3:51Towards the end of the visit,
-
3:51 - 3:54she handed me a Florida Power and Light
form and asked me to sign it. -
3:54 - 3:57She was behind on her light bill.
-
3:57 - 4:01This form allowed physicians
to document serious medical conditions -
4:01 - 4:04requiring equipment that would be impacted
-
4:04 - 4:06if the patient's electricity
was disconnected. -
4:08 - 4:09"But Ms. Anna Mae," I said,
-
4:09 - 4:12"you don't use any medical
devices for breathing. -
4:12 - 4:13I don't think you qualify."
-
4:15 - 4:18Further questioning revealed
she had been using her air conditioner -
4:18 - 4:22day and night because of the heat
so she could breathe. -
4:22 - 4:26Needing to buy more asthma inhalers
left her little money; -
4:26 - 4:29she couldn't pay all the bills
so it piled up. -
4:29 - 4:30I filled out the form,
-
4:30 - 4:32but knowing she might be denied,
-
4:32 - 4:34I also sent her to the social worker.
-
4:35 - 4:37Then there was Jorge,
-
4:37 - 4:38such a sweet, kind man
-
4:38 - 4:40who often gifted our clinic
-
4:40 - 4:43with some of the fruits he sold
on the streets of Miami. -
4:43 - 4:47He had signs of worsening kidney function
-
4:47 - 4:50whenever he worked days on end
on those hot streets -
4:50 - 4:52due to dehydration --
-
4:52 - 4:55just not enough blood
getting to the kidneys. -
4:55 - 4:59His kidneys worked much better
whenever he took some days off. -
4:59 - 5:02But with no other support,
what could he do? -
5:02 - 5:06As he says, "Rain or shine,
cold or heat, I have to work." -
5:07 - 5:10But the most damning case of all
may be Ms. Sandra Faye Twiggs -
5:10 - 5:13of Fort Lauderdale with COPD.
-
5:13 - 5:17She was arrested after fighting
with her daughter over a fan. -
5:18 - 5:19On her release from jail,
-
5:19 - 5:21she returned to her apartment,
-
5:21 - 5:23coughed nonstop
-
5:23 - 5:25and died three days later.
-
5:27 - 5:29Here's what else I noticed:
-
5:29 - 5:32the data show allergy seasons
are starting weeks earlier, -
5:32 - 5:35nighttime temperatures are rising,
-
5:35 - 5:37trees are growing faster
-
5:37 - 5:40and mosquitos carrying dangerous
diseases like Zika and dengue -
5:40 - 5:43are showing up in areas
they didn't exist before. -
5:43 - 5:47I also see signs of impending
climate gentrification. -
5:47 - 5:50That's when richer people
move into poorer neighborhoods -
5:50 - 5:52that are at higher elevation
-
5:52 - 5:56and less subject to flood damage
from climate change. -
5:56 - 6:00Like in my patient Madame Marie
who came in stressed and anxious, -
6:00 - 6:04because she was evicted from her apartment
in Miami's Little Haiti -
6:04 - 6:07to make room for a luxury
apartment complex -
6:07 - 6:11whose developers understood
that Little Haiti would not flood -
6:11 - 6:14because it's ten feet above sea level.
-
6:15 - 6:20An undeniable, clear and consistent
warming trend is on the way. -
6:20 - 6:24A health emergency even bigger
than HIV/AIDS seems to be in the works, -
6:24 - 6:28and it was my low-income patients
that were dropping clues -
6:28 - 6:30of what this would look like.
-
6:30 - 6:33This new epidemic is climate change,
-
6:33 - 6:36and it has a variety of health effects.
-
6:36 - 6:39Climate change impacts us
in four major ways. -
6:39 - 6:43Directly, through heat,
extreme weather and pollution; -
6:43 - 6:45through the spread of the disease;
-
6:45 - 6:49through disruption
of our food and water supply; -
6:49 - 6:52and through disruption
of our emotional well-being. -
6:52 - 6:56In medicine we use mnemonics
to aid our memory, -
6:56 - 6:59and this mnemonic, "heatwave,"
-
6:59 - 7:03shows the eight significant
health effects of climate change. -
7:03 - 7:05H: Heat illnesses.
-
7:05 - 7:10E: Exacerbation of heart and lung disease.
-
7:10 - 7:12A: Asthma worsening.
-
7:12 - 7:14T: Traumatic injuries,
-
7:14 - 7:16especially during extreme weather events.
-
7:16 - 7:20W: Water and foodborne illnesses.
-
7:20 - 7:22A: Allergies worsening.
-
7:22 - 7:27V: Vector-borne diseases spreading,
like Zika, dengue and Lyme. -
7:27 - 7:31And E: Emotional stresses increasing.
-
7:31 - 7:36Poor, vulnerable people are already
feeling the effects of climate change. -
7:36 - 7:39They are the proverbial
canary in a coal mine. -
7:40 - 7:44Truly, their experiences
are like oracles or prophecies. -
7:44 - 7:46The guiding light for us to pay attention
-
7:46 - 7:51that we are doing something to our world
first that's hurting them first. -
7:51 - 7:54But in a matter of time, we are next.
-
7:55 - 7:56If we act together --
-
7:56 - 7:59doctors, patients
and other health professionals -- -
7:59 - 8:01we will find solutions.
-
8:01 - 8:03We have done this with the HIV crisis.
-
8:03 - 8:07There [it] was thanks to the activism
of patients with HIV -
8:07 - 8:10that demanded medications
and better research, -
8:10 - 8:13and the collaboration
of doctors and scientists -
8:13 - 8:15that we were able to control the epidemic.
-
8:16 - 8:19And then it was thanks
to international health agencies, -
8:19 - 8:22NGOs, politicians
and pharmaceutical companies -
8:22 - 8:27that HIV medication became
available in low-income countries. -
8:27 - 8:33There is no reason we can't also apply
this model of collaboration -
8:33 - 8:37to address the health effects
of climate change before it's too late. -
8:37 - 8:39Climate change is here.
-
8:39 - 8:42It's already damaging the health
and homes of poor people. -
8:42 - 8:44Like my patient Jorge,
-
8:44 - 8:46most of us will have to work,
-
8:46 - 8:48whether rain or shine,
-
8:48 - 8:49cold or heat.
-
8:50 - 8:53But together these patients
and their doctors, hand-in-hand, -
8:53 - 8:55with some basic tools,
-
8:55 - 8:58can do so much to make
this climate transition less brutal -
8:58 - 9:00for all of us.
-
9:00 - 9:03These patients inspired me
to found a clinicians' organization -
9:03 - 9:06to fight climate change.
-
9:06 - 9:09We focus on understanding
the health effects of climate change, -
9:09 - 9:12learning to advocate for patients
with climate-related illnesses -
9:12 - 9:15and encouraging real-world solutions.
-
9:16 - 9:20A recent Gallup study showed
three of the most respected professions -
9:20 - 9:23are nurses, doctors and pharmacists.
-
9:23 - 9:25So as respected members of society,
-
9:25 - 9:29we have amplified voices
to influence climate change policy -
9:29 - 9:30and politics.
-
9:30 - 9:33There is so much we can do.
-
9:33 - 9:36As clinicians, our many patient
contacts allows us -
9:36 - 9:38to see things before others.
-
9:38 - 9:42And this puts us in an ideal position
to be on the frontlines of change. -
9:42 - 9:46We can teach climate-related illnesses
in our health-professional schools. -
9:46 - 9:50We can collect data on our patients'
climate-related conditions -
9:50 - 9:53by making sure there are
billing codes to identify them. -
9:53 - 9:55We can do climate-related health research.
-
9:55 - 9:58We can teach how to have
green practices in homes. -
9:58 - 10:01We can advocate
for our patient energy needs. -
10:01 - 10:03We can help them get safer homes.
-
10:03 - 10:06We can help them get necessary
equipment in those homes -
10:06 - 10:08when conditions worsen.
-
10:08 - 10:11We can testify in front of lawmakers
as to the findings, -
10:11 - 10:15and we can medically treat
our patients' climate-related illnesses. -
10:17 - 10:22Most importantly, we can help prepare
our patients mentally and physically -
10:22 - 10:24for the health challenges they will face,
-
10:24 - 10:26using a model of medicine
-
10:26 - 10:30that incorporates
economic and social justice. -
10:31 - 10:34This would mean Ms. Sandra
Faye Twiggs with COPD, -
10:34 - 10:38who died after being released from jail
-
10:38 - 10:40after a fight with
her daughter over a fan, -
10:40 - 10:45would have known that the heat
in her apartment made her sick and angry -
10:45 - 10:48and seek a safer place to go for cooling.
-
10:48 - 10:52Even better, her apartment
would never have been so hot. -
10:52 - 10:56From the poor, I've learned
our lives are not only vulnerable -
10:56 - 11:00but are stories of resilience,
innovation and survival. -
11:00 - 11:03Like that wise old man
who loudly spoke truth to the cop -
11:03 - 11:05that summer night:
-
11:05 - 11:07"Ain't no ambulance coming,"
-
11:07 - 11:11and compelled him to deliver
that little girl to the hospital instead. -
11:12 - 11:13You know what?
-
11:14 - 11:15Listen up.
-
11:16 - 11:20If there's going to be a medical
response to climate change, -
11:20 - 11:23it is not going to be
just waiting for an ambulance. -
11:24 - 11:28It is going to happen because
we the clinicians take the first step. -
11:28 - 11:30We make so much noise
-
11:30 - 11:33that the issue cannot
be ignored or misunderstood. -
11:34 - 11:37It is going to start
with the stories our patients tell -
11:37 - 11:40and the stories we tell on their behalf.
-
11:41 - 11:45We're going to do what is right
for our patients like we've always done, -
11:45 - 11:48but also what is right
for our environment, -
11:48 - 11:50for ourselves
-
11:50 - 11:53and for all the people on this planet --
-
11:53 - 11:54all of them.
-
11:54 - 11:56Thank you.
-
11:56 - 11:58(Applause and cheers)
- Title:
- The link between climate change, health and poverty
- Speaker:
- Cheryl Holder
- Description:
-
For the poor and vulnerable, the health impacts of climate change are already here, says physician Cheryl Holder. Unseasonably hot temperatures, disease-carrying mosquitoes and climate gentrification threaten those with existing health conditions, while wealthier people move to higher ground. In an impassioned talk, Holder proposes impactful ways clinicians can protect their patients from climate-related health challenges -- and calls on doctors, politicians and others to build a care system that incorporates economic and social justice.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 12:12
Erin Gregory edited English subtitles for The link between climate change, health and poverty | ||
Erin Gregory approved English subtitles for The link between climate change, health and poverty | ||
Erin Gregory edited English subtitles for The link between climate change, health and poverty | ||
Erin Gregory edited English subtitles for The link between climate change, health and poverty | ||
Joanna Pietrulewicz accepted English subtitles for The link between climate change, health and poverty | ||
Joanna Pietrulewicz edited English subtitles for The link between climate change, health and poverty | ||
Joanna Pietrulewicz edited English subtitles for The link between climate change, health and poverty | ||
Leslie Gauthier edited English subtitles for The link between climate change, health and poverty |