July was first declared as National Minority Mental Health Awareness Month in 2008 by the United States (U.S.) House of Representatives. Since then, July has been a time to acknowledge and explore issues concerning mental health, substance use disorders, and minority communities, and to destigmatize mental illness and enhance public awareness of mental illness among affected minoritized groups across the U.S. Studies suggest that racially minoritized groups show higher levels of anxiety, depression, suicidal tendencies, post-traumatic stress disorder (PTSD), and other mental health disorders. In observance of National Minority Mental Health Awareness month, the Weitzman Institute policy team highlights the intersection of climate change, specifically extreme heat, and its adverse effect on minority mental health.
Several areas across the U.S. are experiencing extreme heat, with 100 degree weather becoming the daily norm. In June 2023 alone, 62 million Americans were at risk of exposure to potentially dangerous heat with this trend expected to continue for the rest of the summer. Unfortunately, the health impacts of extreme heat are not experienced equally, with low-income families, outdoor workers, people experiencing homelessness, and communities of color disproportionately impacted. These same groups oftentimes include racial and ethnic minorities that often suffer from poor mental health outcomes. With the impact of extreme heat on mental health well documented, there is a need to consider specific initiatives and actions that can be taken to further support and protect minorities mental health during this time.
Mental Health and Extreme Heat
Research has consistently shown that rising temperatures will lead to increased mortality among individuals of color than among Whites. Non-U.S. citizens, of which many are Hispanic and tend to work in the agricultural and construction industries, were found to have increased mortality risk compared to U.S. citizens for heat-related deaths. However, increased mortality risk is not the only adverse outcome for exposure to extreme heat. Research has found that exposure to extreme heat can affect mental health. Extreme heat can increase depression symptoms and suicide. Further, increased temperature during the summer has been associated with an increase in emergency department (ED) visits for mental health issues, such as mood disorders, schizophrenia, and anxiety among others. As measured through ED visits, Black and Hispanic individuals have been found to experience greater mental health issues, such as anxiety, psychosis, and substance use disorders with temperature increases compared to Whites. Extreme heat can exacerbate mental health disorders due to the inability to regulate body temperature, which can be due to psychiatric medications, and to adapt to increasing temperature. Action must be taken now to reduce the effects of extreme heat on both physical and mental health, especially as children will face an increased risk of experiencing heat-related illnesses in the future. More than half of children in the U.S. are children of color, and it is expected that by 2050, more than 2 billion children globally will be exposed to high heat-wave frequencies, which is 1.5 billion more children that are currently exposed.
Recommendations
Establish and Provide Mental Health Services at Community Resilience Hubs
Cooling centers are a saving grace during extreme heat for communities that have no access to air conditioning; however, cooling centers often lack much needed community services. Knowing that poor mental health outcomes among minorities is associated with a lack of proper access to mental health care, community resilience hubs present an ideal opportunity to address these concerns. Community resilience hubs not only provide residents shelter from extreme weather, but one of the core foundations of community resilience hubs is to provide services and programs to promote community preparedness and improve a community’s health and well-being. Cities like Baltimore, Minneapolis, and communities across the state of California are implementing community resilience hubs to improve the health of their residents. Implementing mental health services at community resilience hubs would further expand racial/ethnic minority individuals’ awareness and access to these services. Earlier this year in Oregon, state legislators considered a measure that would provide grants to establish community resilience hubs, while the bill was still in committee upon the legislature’s adjournment, other states should consider similar bills to fund community resilience hubs to provide much needed services for communities.
CHWs Training to Incorporate Extreme Heat and Mental Health
With research documenting the effectiveness of community health workers (CHWs) on communities’ health outcomes, workshops and webinars that increase their capacity to help communities experiencing extreme heat, poor mental health, and resources for addressing both is a gap that must be addressed. For example, the Migrant Clinicians Network (MCN) has created a workshop to help CHWs recognize and prevent heat-related illness among at-risk outdoor workers. Thus, there is an opportunity for the Federal government to work together with organizations such as MCN, as well as the National Association of Community Health Workers (NACHW), and other stakeholders in replicating and expanding training opportunities for CHWs to serve minority populations at the intersection of extreme heat and mental health. Such trainings may help CHWs become key staff and a resource in the community resilience hubs previously mentioned.
Passing National Heat Protection Standards and Mandatory Mental Health Screening for Outdoor Workers
An ongoing conversation has been the urgent need for Federal action to protect outdoor workers, a group disproportionately represented by Black/African Americans and Hispanic/Latinos. There is currently no national heat protection standard for outdoor workers; instead, the Occupational Safety and Health Administration (OSHA) relies on states and cities to establish their own mandates. With only three states, (California, Minnesota and Oregon), having permanent statewide heat protection standards, permanent policies from the Federal government are imperative in implementing national emergency heat standards to help protect all outdoor workers. Moreover, research suggests that farm workers experience high levels of stress and anxiety while construction workers rank second highest in suicide rates among major industries. Thus, OSHA could also mandate that permanent heat protection standards be coupled with mental health screening and resources for all outdoor workers.
Looking Ahead
Urgent action also includes countering the impact redlining has had in placing racially minoritized populations at a higher risk of extreme heat and climate change impacts. These communities need green spaces, free access to mental health services, but most importantly, permanent action from the Federal government that creates long standing infrastructure and systems that both reduce communities’ vulnerability to extreme heat and increase access to mental health health care in an effort to promote equitable health and social outcomes for all.
*If you are interested in partnering with us on the topic of health and social impacts of climate change please contact:
Tonantzin E. Juarez, MS
Senior Health Policy Analyst
Weitzman Institute
Email: [email protected]