In Alaska's arctic communities, Inuit contemplating the need to relocate have reported that the loss of sea ice would make them feel like they are lost or going crazy. Zika and other vector-borne diseases have been a concern primarily for people in the southeastern United States. Recent research on the long-range internal migration of people from the coasts to the interior suggests a broader national concern regarding "climate augmentation" of disease. These are just two examples of the many public health effects we can expect as climate change forces people to uproot themselves.
In the future, extreme climate events — including more severe fast-acting coastal storms, rising seas, and more widespread droughts — will dislocate people and affect our public health infrastructure.
Migration can result in poor health outcomes when migrants find they have to face marginalization and discrimination, poverty, exposure to disease vectors, malnutrition, and crowding. Host communities may also experience increased demand on health services as they seek to accommodate migrants.
Climate change leads to three types of migration-related effects on health: 1) primary or direct effects such as injuries and death resulting from extreme weather events; 2) secondary or indirect effects from the increased geographical range of and populations exposed to new diseases; and 3) tertiary or delayed effects from disrupted health services for individuals in need.
To combat these effects, new efforts must be taken to adequately address increasing healthcare needs. Whether it's a disruption in services caused by events such as Superstorm Sandy (when critical healthcare infrastructure could not function for weeks) or the wide range of health maladies that force Marshall Islanders to migrate to the United States for better care, the public health infrastructure will need a new climate-migration minded approach.
Physically, climate change can influence the geographic range, seasonality, and incidence of infectious diseases as they move with migrants and increase the risk to host communities. Vector-borne diseases, such as Zika, are of particular concern. They can have grave impacts, because climate change augments them, increasing the rate of vector reproduction, the frequency of vector interactions with humans, and the geographic distribution. Moreover, climate change will also affect services for those suffering from chronic health conditions such as cancer, hypertension, coronary heart disease, and diabetes. As migrants move into new communities, they will further strain public health infrastructure.
The mental health impacts of migration are also often overlooked; though, research has revealed high rates of poor mental health. For example, in Hurricane Katrina-affected areas, suicide and suicidal ideation more than doubled, one in six people met the diagnostic criteria for post-traumatic stress disorder, and 49 percent of people living in Katrina's path developed an anxiety or mood disorder such as depression. Additionally, the loss of one's home or community has inspired new terms like "solastagia," which describes the feeling of losing a place that is important to one's sense of self as well as the accompanying erosion of social networks.
To minimize any health inequities and to ensure migrants get access to services and that their health needs are met, we must first recognize the complexity of migration (especially climate-induced ...