Addressing Health and Climate Change: It Takes a Village

April 25, 2019 | By Palmetto Project & Transform Health

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On the heels of Earth Day 2019, we are highlighting one community, among many, whose health has been impacted by climate change and is mobilizing to demand environmental justice in order to address systemic barriers to care and tackle health disparities occurring at the local level. Dedicated community members of North Charleston, SC are working to develop a civic infrastructure to promote advocacy, education, and action on air & water quality, persistent flooding, and health equity issues arising as a result of climate change.

The Intersection of Health and Climate Change

Located in the South Carolina Lowcountry, North Charleston, SC is a working-class, racially-diverse, urban island surrounded by communities of increasing affluence and gentrification. Its residents have been underserved and afflicted by the effects of poverty for generations with 28.4% of the population, including 45% of its children, living below the Federal Poverty Level (FPL) with a population that is 68% African American and 28% White. North Charleston also faces climate-related challenges that not only threaten the quality-of-life of its citizens, but their ability to remain healthy and economically viable.

An industrial city, North Charleston residents already face environmental hazards such as air, land, and water pollution that threaten their health; hazards which are worsened with flooding that distribute pollution into their neighborhoods from nearby industrial and contaminated sites. Recent studies have found unsafe levels of pollutants in the drinking water in several Lowcountry communities. South Carolina is ranked 48th out of 50 states for salmonella cases in 2017, an infection caused by contaminated food or water. Charleston sees more than 50 days of tidal flooding each year, often with standing water of over 1 foot, resulting in standing water and groundwater being contaminated with untreated sewage and industry waste. Investigators recently found rates of fecal contamination in standing flood water 400 times acceptable EPA levels when sampling in North Charleston.

Mold from flooding causes asthma and other health issues. Among children, the highest rate of hospitalization in South Carolina is for asthma, and Charleston County’s child asthma hospitalization rate is higher than half of all other South Carolina counties. Children with asthma are more likely to be African American, living in poverty, under- or uninsured, and experience more frequent hospitalizations.

Trusted Community-Based Organizations, Working in Partnership to Solve Big Problems

North Charleston’s community health has been impacted by the adverse effects of climate change, and its citizens are building partnerships between community members, healthcare institutions, and policy-makers to advance policies and solutions that drive equitable climate strategies in the effort to reduce health risks. Spearheaded by local organizations who have built trust within the North Charleston community, the coalition combines the forces of community members, local institutions, and policy-makers to assess community needs, prioritize initiatives that will improve health equity, build community resilience and partnerships, and empower residents to demand and obtain environmental and health equity in their neighborhoods.

The Palmetto Project has been a leading advocate for a more effective system of health care for South Carolinians regardless of their financial circumstances, race, or residency. Its Insure SC program is the nation’s first statewide non-profit health insurance agency; enrolling residents in Medicare, Medicaid, and marketplace options, its resource specialists/licensed insurance agents are embedded in underserved communities. In 2016, Palmetto Project trained insurance navigators to educate community members about negative health effects caused by environmental issues as part of their eligibility appointments, as a means to make environmental issues relevant to community members by connecting them to their health care.

Lowcountry Alliance for Model Communities (LAMC) was founded by grassroots leaders in North Charleston who are acutely familiar with the needs of their underserved and under-resourced focus communities. Past successes include leveraging plans to expand the port on the former Naval Complex in North Charleston into tangible revitalization commitments from the South Carolina State Ports Authority (SCSPA) and the City of North Charleston. LAMC negotiated with these parties to develop a Community Mitigation Plan in an effort to minimize any negative impacts and maximize the benefits of the expansion. This Mitigation Plan is the first of its kind in the nation to focus and incorporate community efforts into the formal plan. LAMC also authored a Revitalization Plan for North Charleston to provide a concrete blueprint for development in the focus area that ensures maximum community benefits are secured.

Conservation Voters of South Carolina (CVSC) is both an education and advocacy non-profit with expertise in environmental legislation and policy, endorsement campaigning, and voter engagement. They have a long track record in communicating the environmental impact of policy to the public and partnering with state and local governments to impact projects and legislation. In 2018, Conservation Voters of South Carolina started the UPowerSC campaign to ignite the next generation of energy advocates across the state. South Carolinians were paying the highest power bills in the country and South Carolina was on a collision course with a 2% cap on its solar industry that would have put 3000 citizens out of work. CVSC put regional field directors on the ground in communities across the state and have been able to drive thousands of South Carolinians to contact their legislators.

These three organizations are working in partnership to build a community-driven plan to address the intersection of climate change and health in order to gain equity in North Charleston around flooding and its effects on residents’ health. In the process, they aim to strengthen the voice of the community around environmental justice. Here’s what their blueprint for advancing health equity looks like:

Community engagement, information gathering, partnership building, and communication strategy

The groups are working together to build a coalition of community leaders and diverse partners with expertise in health, climate action, policy and equity. Future plans include convening a series of meetings, research sessions, and community forums to gather information and build trust. They will implement a communication strategy to give voice to community concerns, report on and build support for existing projects and policies, and find innovative solutions for the issues regarding community health as caused by the adverse effects of climate change.

Climate Health, Assessing Risk and Disaster Preparedness

Particular attention must be paid to assessing known health risks facing communities, mitigating the causes, disaster preparedness planning, and building resilience and capacity within the healthcare system to provide services to low income communities adversely impacted by climate change.  This may include the following activities:

Water quality monitoring; identifying and mitigating causes of water pollution; preparing a clean water access emergency plan; preparing health professionals to diagnose and treat illness caused by water pollution;

Assessing and improving the ability of building structures in low income communities to withstand impacts of severe weather events; planning for temporary shelter; helping residents prepare an evacuation plan and access transportation;

Assessing the capacity and preparedness of Charleston healthcare system to serve low-income communities and the ability of low-income communities to access health care; planning to build capacity and training  healthcare professionals to serve low-income communities.

Funding is Needed to Advance Climate Change, Health Care Access and New Policy Solutions

While this coalition is working to mobilize a strong constituency for equitable climate action among community-based advocates, healthcare institutions and health practitioners , like many groups across the country, they require funding to move the needle in these ways and work to make their communities healthy.

North Charleston faces grave and severe health and economic challenges when the results of generations of social inequity are compounded with climate change. The community has mobilized to act and advocate for itself, and the result will be better cohesion among the citizens and professionals involved in health, climate, policy and equity to ensure the community becomes the driver of all work. The community’s priorities will provide the underpinning of all work that is produced from the new multi-disciplinary coalition. This will also build support for multidisciplinary partnership across sectors to help organize a wide coalition to advocate a unified message for policies that address the impacts of climate change on low income communities.  These policies can be broadened to advance policy in other communities across the US.

Contact Us

If you would like to learn more about the Palmetto Project contact Shelli Quenga at and follow their progress via Twitter. To learn about Transform Health, please contact Heather Bates at