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Maria Conchita Pozar’s heart breaks to watch her 4-year-old daughter swelter in California's eastern Coachella Valley desert sun. During frequent power outages and triple-digit temperatures, they can’t turn on the air conditioner in their mobile home.
Each year comes with record-breaking temperatures, recent reports show. Pozar and her rural community of farmworkers take the brunt of it. Families with kids sleep outside or in their running cars with the air on for a couple hours at a time.
A community advocate for climate and environmental health equity, Pozar is a mom of two girls from the Indigenous Purépecha people of Mexico.
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“Imagine how it feels that we have to tell our children and explain to them why we can't turn on the AC,” Pozar, 33, said in Spanish through a translator. “It’s hard because my daughter would say to me to turn on the AC ... because it was so hot. What I would tell her is we couldn’t.”
During hot weather, children of color like Pozar's frequent hospital emergency rooms more often than white children, researchers at the Harvard T.H. Chan School of Public Health found, underscoring the disparate health impacts of climate change on communities of color as temperatures rise.
In the most comprehensive study on heat and pediatric emergency department visits known to date, published Wednesday in the journal Environmental Health Perspectives, researchers found all-cause visits to the ER had a stronger association to heat among all racial minority children and those of low income on public health insurance.
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Specifically, children of color were much more likely to visit the ER for intestinal infections, and diabetes- and obesity-related issues, which children of color suffer from disproportionately, as well as mental health, behavioral problems, injuries and poisonings.
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Children and babies can’t regulate temperature as well as adults, making them especially vulnerable to the consequences of heat, experts say. Some studies have shown this can be complicated by chronic health problems.
“We find that heat magnifies the inequities that we have seen in other arenas, which has not before been shown (in children),” said lead author, Dr. Aaron Bernstein of Boston Children's Hospital.
A pediatric hospitalist and interim director of Harvard’s Center for Climate, Health, and the Global Environment, Bernstein said the study’s findings emphasize health equity and climate action must go hand in hand.
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“We are not going to achieve all these goals that we set for ourselves in closing health disparities when we do not address the risks, in this case from heat, that stand to push people further apart on the health equity scale,” he said.
Following the latest Intergovernmental Panel on Climate Change’s “Code Red for Humanity” report, efforts have been underway to include climate change training for pediatricians.
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The American Board of Pediatrics also recognizes children's unique vulnerabilities to climate change and the impact of severe weather on kids' physical and mental health.
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Dr. Lisa Patel, also an expert in children’s health in relation to climate change and the environment, is a pediatric hospitalist at Stanford Children’s Health and co-director of Stanford's Climate, Health, and Equity Task Force. She and other experts have been calling for better integration of environmental and climate change training for pediatricians.
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Patel has seen many kids come into the hospital from formerly redlined communities and living in urban heat islands, which studies show can be several degrees hotter than other city neighborhoods due to more concentrated pockets of pollution.
“That's had profound implications,” Patel said. “It has affected entire neighborhoods, where you don't see as many trees, you don't have as many green spaces, you have a lot more pavement, you are more likely to have a big polluting road right next to these communities.”
She remembered a teenage couple from such an area – near West Oakland, California, a high-poverty community of color – who rushed to the hospital with their baby. Two days after a heat wave, the baby wasn’t waking up to feed or wetting diapers and was severely dehydrated. The couple lived in an unairconditioned apartment.
“The kids in these neighborhoods that tend to be Black and brown children are going to be in places that are literally going to be hotter on those days,” she said. “Kids that are coming in to me with various health care ailments as a result of climate change tend to be my families that are either experiencing poverty, housing insecurity, and/or are children who are Black and brown.”
On top of that, she said, they face less access to primary health care, which Bernstein’s study highlights: Because many children of color lack a medical home, emergency room department visits are often a litmus test for disparity.
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“It's a fact that a lot of people who don't have the financial wherewithal use emergency rooms as their hospital. So, when a child has an asthma attack that's exacerbated by extreme heat or high levels of contamination blowing around in severe weather… they're going to go to the emergency room,” said environmental toxicologist and attorney, Adrienne Hollis, a former professor and senior scholar at the Union of Concerned Scientists.
She emphasized those most at risk are the communities whose children are already experiencing higher rates of environmental health problems, such as asthma. This can be due to higher concentrations of contaminants like air pollution, due to living near a highway or train.
“People may have to make a decision between paying their electric bill or buying food or getting medication,” Hollis said. “On top of living in a community that’s just challenged on all fronts, we bring in climate change.”
In the eastern Coachella Valley, activist Lesly Figueroa of the climate justice firm Leadership Counsel for Justice and Accountability works with other groups to help provide resources to Pozar’s neighborhood of farmworkers.
“The heat is so extreme throughout the summer that the transformers are blowing up because they just can't take that capacity,” she said.
During one recent outage, Figueroa and others hauled cases of water and ice to the families.
“Everyone's food spoiled. No AC unit was working,” she said.
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