Climate Impacts Mental Health: The Importance of Climate-Resilience

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Good afternoon. I’m Kathryn Santoro, Director of Programming at the National Institute for Health Care Management Foundation. On behalf of NIHCM, thank you for joining us today for this important discussion on the mental health impacts of climate change.

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The United Nations recently highlighted, for the first time, the mental health challenges caused by rising temperatures and extreme weather events, in its latest climate assessment.

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Mental health challenges are expected to only increase as temperatures continue to rise, and people experience more extreme weather events.

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67 percent of Americans agree that climate change is already impacting the population’s health–and 55 percent are anxious about the impact of climate change on their own mental health.

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Today we will hear from a prestigious panel of experts to learn more about the connections between climate change and mental health and strategies to promote climate-resilience.

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Before we hear from them, I want to thank NIHCM’s President and CEO, Nancy Chockley, and the NIHCM team, who helped to convene today’s event.

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You can find biographical information for our speakers, along with today’s agenda, and copies of their slides, on our website.

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We invite you to join the conversation on Twitter, using the hashtag #ClimateChangesHealth

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Am now pleased to introduce our first speaker, doctor Susan Clayton. Dr. Clayton serves as the Whitmore-Williams Professor of Psychology at the College of Wooster in Ohio, and a visiting fellow at the Paris Institute for Advanced Studies.

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Drc Clayton’s research focuses on examining people's relationship with the natural environment, how it is socially constructed, and how a healthy relationship with nature can be promoted.

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She has written extensively about the effects of climate change on mental health and about climate anxiety.

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We're so honored to have her with us today to help us understand how climate change impacts mental health.

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Dr. Clayton?

2:17

Great. Thank you. Thanks to all of you who are here. And thank you for the opportunity to discuss this important topic. What I'm going to do is outline the ways in which climate change can affect mental health. I'm going to describe some of the different ways in which it can do that. And I'll say a little bit about how I think we can respond in a way that will preserve and promote mental health, although you will certainly hear more about that from the remaining speakers.

2:48

So, Ryan, if you go ahead and move to the next slide, I think we're all increasingly aware that climate change is something that's affecting us as humans. It's affecting us, economically. It's also affecting our physical health.

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But it's less obvious to a lot of people that it also affects our mental health and well-being.

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And there are essentially four channels that I'll describe through which you can do that.

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Maybe in order of obviousness or lack of obviousness, it can have an effect because of the ways in which climate change is affecting mental health, sorry, acute events. It can have an effect through the chronic changes that are a part of climate change. It can affect mental health through the Indirect Consequences, and then there are these essentially vicarious or perceptual impacts of climate change.

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And I'll talk about those one at a time.

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Next slide, please.

3:48

So natural disasters are something we're all aware of. Many of us have experienced, and certainly read about the effects.

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And I think it's, it's very clear that it can be a very difficult, challenging and traumatic experience to live through a natural disaster. So not surprisingly, natural disasters are associated with increased threats to mental health. And we know this from decades of research. Before people were really even thinking about climate change, we knew that extreme weather events did have an effect on mental health. They tend to increase rates of post-traumatic stress disorder, depression, anxiety, lead to increased rates of suicide, substance abuse, even sleep disorders, And even domestic abuse and interpersonal violence tend to increase for people who have experienced an extreme weather event.

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And these events, or these impacts don't necessarily resolve within a few days or a week as the natural disaster as we begin to recover from that disaster.

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Instead, they can persist for months and even years.

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Next slide, please.

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So, society can help us protect mental health in response to these kinds of impacts.

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And one of the things about mental health is that it's not it's not determined, it's not just a clear cause response effect. There's a lot of room for things to magnify or minimize the impact on mental health. So society can do a lot. And one of the things it can do is to give people adequate warning about impending extreme weather.

5:47

Something I think we're seeing more of, but there's still lots of room to improve on that. And when I say inclusive, we need early warning systems that actually are accessible to all kinds of people, Including, for example, people who might be hearing impaired or who don't have access to the Internet.

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We need more support for mental health services. We need this kind of support in general, but particularly after disasters, and there are ways in which societies can facilitate that support. Often by training people who are not necessarily mental health professionals, but can be trained to give that kind of early psychological first aid in response to the impacts of the extreme weather.

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And I think we also need to be thinking about nature based solutions.

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In other words, the extent to which there's an impact of an extreme weather events such as a major storm or wildfire can be mitigated somewhat by design solutions that might reduce the impact of flooding or reduce the impact of the wildfire and that will, of course, serve to protect mental health a little bit as well.

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Next slide, please.

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The chronic changes that are part of climate change, I think, are less.

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They're less frequently thought of, partly because they're less dramatic. We don't see them, because the changes are subtle and day-to-day. But we know that gradually heat is increasing.

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So are things like sea levels and even decreased air quality is associated with climate change.

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Many of these things can have impacts on mental health, but I want to particularly highlight the impact of heat, because, again, we have lots and lots of research highlighting the fact that heat has a negative effect in all kinds of ways of heat.

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It's been shown to be associated with increased rates of suicide, as well as psychiatric hospitalizations.

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It also just makes people grouchy, and I'm sure many of you can attest to having experienced that yourself.

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Or in those you love, it tends to decrease our mood, which, of course, in turn, has an effect on social relationships. People are more likely to get into arguments and fights when the temperatures are high.

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And that, of course, can have an effect on mental health.

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And even cognitive functioning, we're less able to concentrate on people's ability to do their work. School tends to be impaired by by high temperatures, so something we very much need to be aware of as we think about climate change. Next slide, please.

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Again, there are things society can do to help to head off some of these impacts of

higher temperatures.

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Once again, nature based solutions are an option and tree canopy is a surprisingly simple and effective way of reducing the levels of heat.

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And this matters, because quality matters for all kinds of reasons, but one recent matter is that poorer neighborhoods are likely to have fewer trees nearby, So they tend to actually be hotter than richer neighborhoods. Meaning they're more exposed to those impacts on mental health. It's also important for communities to set up cooling centers, where there might be free air conditioning for people who do not have access to air conditioning in their homes.

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And so, the idea of an inclusive safety net that's mindful of the fact that not everybody has access to, to trees, is not everyone has access to green space or to air conditioning.

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Next slide, please.

9:30

The indirect effects of climate change are actually some of the ones that are going to be most powerful. And I'm not going to go into detail except to say that food insecurity is one of the major ways in which climate change is likely to impact human health and mental health, as is affected by food insecurity as well.

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So there's good evidence that malnutrition can have impacts on your mental health.

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And those might, if you, if you experienced malnutrition as a child, that might extend into adulthood, Many people are displaced by the effects of climate change. Their homes might be flooded or because of changing patterns of precipitation, they're no longer inhabitable so they have to go someplace else. And we know that involuntary displacement is a major hazard for mental health.

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Next slide, please.

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So, in response to these indirect impacts of climate change, I think society needs to be thinking about how, to, how to mitigate those, how to head some of them off by encouraging people, in some cases, to change agricultural practices.

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So that food harvest is not as seriously impaired by the changing climate, Encouraging people to eat in a healthier way that maybe does not require as many environmental resources by helping with community migration.

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And one of the things I mean about that is helping a community, too, if necessary, if the community is displaced to move together rather than piecemeal. Because maintaining those social safety nets are really important to mental health and acknowledging the importance of place so that people's mental health might be impaired if their place is threatened.

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Next slide.

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I really want to stress something that's been getting a lot of attention in the news in the last year or so, which is the idea that we're responding, not just to the effects of climate change, but to the perception of it, to the awareness of it.

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So, these quotes show some of the ways in which people's understanding of the world has been affected by their experiences of climate change, their hurricane response or hurricane survivors who are saying that everything is temporary. That they don't feel really at home doesn't feel like home. Those are very powerful emotional responses. Next slide, please.

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And we tend to see around the world rising levels of anxiety, as people, again, around the world, are increasingly.

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yeah, Concerned. Not only that climate change is happening but they will personally be harmed by it. And so I put up these results from Pew Research survey from last year showing that you do see a lot of variability.

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But in every country studied, more than half of people are at least somewhat concerned about the personal impact of climate change. And in another study that was done last year, 10000 young people surveyed around the world, 45% of them reported that their worry about climate change was having a negative impact on their daily functioning. So these are levels of anxiety that are really beginning to impair people's day-to-day lives.

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Next slide.

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And, as I kind of hinted at earlier, not everybody is equally affected. And this is important as well. Some groups are at greater risk of the effects of climate change, including mental health impacts, than others. Next slide.

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Do you see vulnerability due to, of course, geographic location? If you're located in a coastal area, is your work subject to coastal erosion? If you're located in an area that's prone to while there, are you more affected by that?

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But also the lack of financial resources can make people vulnerable.

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Social marginalization and discrimination can make people more vulnerable.

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For example, we know that there's a history of people from ethnic communities being, um, essentially, steer to less desirable areas to live in through bank lending practices, for example. So they might end up in areas that are more vulnerable to the effects of climate change. And even physiological factors can affect your vulnerability.

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Next slide.

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So among those groups that might be affected, might be particularly affected, women are, are sometimes more physiologically vulnerable particularly during pregnancy. But also, their social role can make them more vulnerable to the effects of climate change. Women are primarily responsible for caregiving in a lot of families, which means that they are looking after other people, which gives them more responsibility in the case of extreme weather events. They also, in many cases, have less access to financial resources or informational resources that would help them protect themselves from the effects of climate change.

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People with preexisting health conditions could be more vulnerable, partly because of the fact that they, if there is medical supply, and including psychotherapy, if their access to that is disrupted, that can be particularly harmful. But also, their health conditions or the medications they're taking, perhaps, for mental illness may make them more vulnerable to high temperatures.

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We know that elderly people are more vulnerable to high temperatures. And I want to highlight in particular indigenous peoples, whose mental health is particularly vulnerable to changes in the environment because of the cultural history of their relationship to the natural world.

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And, on the next slide, I want to highlight that children are particularly vulnerable, again for physiological reasons, because their bodies are still developing. Therefore, it's easier to disrupt their systems, including their nervous systems. These show greater prevalence of mental health impacts after an extreme weather event, And they're learning may be affected. Their behavior may be affected, their ability to regulate their own emotions, in ways that are, in some cases, long-term, or even permanent.

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So, next slide. The last point I want to make is that, although it's very important for society to respond to these threats, individuals can respond as well. And I think it's important for us all to think about how to react to climate change. Individuals can be helped to learn how to regulate their own emotional response, so as to not be overwhelmed by climate anxiety. They can benefit from increased social support.

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And that's something that people can try to build for themselves. It's a more supportive social network. A sense of optimism is important in maintaining mental health in the face of climate change, as very importantly, is a sense of efficacy, a sense that what you do matters. And finally, behavioral engagement will not only help to perhaps mitigate the impacts of climate change, but also increase an individual's ability to be emotionally resilient in the face of the mental health impacts that climate change is bringing. And I'll stop there. Thank you for your attention.

17:05

Thank you so much, Dr. Clayton, for sharing the human impacts of climate change and highlighting how individuals and society can respond.

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Next, we will hear from doctor Yulia Carroll, the Associate Director for Science at the Division for Environmental, Health, Science, and Practice at the Centers for Disease Control and Prevention, where she advises on various climate and environmental health issues. The divisions, climate, and health program support state, tribal, local, and territorial public health agencies as they prepare for the health impacts of a changing climate. We're so grateful. She is with us tonight to share more about CDC's leadership on this topic, Dr. Carroll?

17:51

Thank you very much for this introduction, and I would like to go to the next slide.

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As Dr. Clayton described mental illness as one of the major causes of suffering. Can the United States, in extreme weather events, affect mental health in several ways? So this is a graphic that we often present, but the reason is that the arrows in the center reading rising temperatures, more extreme weather, rising sea level, and increasing CO two levels, represent some of the direct effects of climate change. And going from these drivers.

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In the middle, you see how we have a, very, a variety of health impacts, one of them being mental health, of course. A very important part of climate change, and its effects on human health. Next slide, please.

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So, by addressing the drivers in the middle of the circle, shown in the previous slide, we can also address mental health.

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So, the challenge is, how do we address these problems, and how do we move to adapt to a changing climate that is already causing these things to occur.

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Next slide, please.

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So, today, I am going to talk about the Climate and Health Program at the Centers for Disease Control and Prevention. We have been in existence and funded by Congress since 2009, and we are the only federal government investments in designing and building climate change capabilities for the local Health departments. Much of our work is really on building resilience to the health effects of climate change, and the states and the local jurisdictions.

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We have four objectives to serve as a resource for federal, state, local, and tribal health agencies by providing technical assistance and identifying and showcasing promising practices.

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We also prepare public health practitioners to address the health effects of climate change. We provide tools, guides, and processes to help assess vulnerability to possible health effects. We develop and distribute guidance and integrate information from many sources. And finally, we serve as a reliable leader in planning for public health effects of climate change. Next slide, please.

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So here, I want to present how, over more than 10 years, we have funded jurisdictions across a wide geographic range. This is a map of both current and historic CDC climb withheld grantees, so the climate impacts vary by location. For example, coastal areas may be worried about health impacts of sea level rise. While north, eastern and mid-western areas might be tracking the influence of temperature T distribution. So we are just really critical that we develop capacity around the country. And we have done this by funding and providing help to states, but also to tribes, territory, cities, encounters.

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So we have been funding tribes since 2016, and we have funded, since then, nine tribes in three territories, and have been working in partnership with the National Indian Health Board and the Association of State and Territorial Health Officials.

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Currently, no occurrence of Funding cycle Overfunding nine states into city health departments, to prepare for the health effects of climate change. And the focus of 20 21 grantees is to implement and evaluate the adaptations that can be identified, developed, and implemented to minimize the health effects.

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They're already occurring.

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Um, so, in this way that you are seeing right now, I also wanted to show some other work that we have been doing.

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Because climate change is projected to increase the frequency of natural disasters and increase their intensity and CDC's crucial partner with the states for both preparedness, prevention, and post activities providing technical assistance.

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We do provide situational awareness to rapid needs assessments.

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And these are some examples where we have provided mental and behavioral health during a variety of disasters. But also, we have assessed mental niceties in post recovery periods, and this has been great in identifying resource limitations in making sure that the priorities of the communities are myths, and also there is a basis for interventions, and they have been told we have more information on this on our website.

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Another way that we assist with mental hills is through the vast source of CDC surveillance data, one such example is the Behavioral Risk Factor Surveillance System, so it contains depression and anxiety models. And most recently, we have been studying those in relation to exposure to wildfire smoke and self reported symptoms to fixing mental health in Oregon, which is an area affected by wildfires. So next, I will present the work that CDC does to increase community resilience to climate change. And then we'll give you some specific examples.

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Next slide, please.

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So, in the next slide, the actions taken to address climate change are told to fall in two buckets.

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One is adaptation, which is managing the impacts of climate change, with the goal of being less vulnerable, more resilient, and the other is mitigation, which is about reducing the emissions of greenhouse gasses that make climate change wars. And there are actions that can be taken that both reduce emissions that cause climate change, and increase health and preparedness at the same time.

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An example is alternative transportation, such as taking public transit or riding a bike, that reduces both carbon emissions, but also improves health, including mental health, physical morbidity.

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I'm going to now move to the next slide, where I will want to talk to you about the CDC Building Resilience Against climate effects framework.

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So, we use this framework, when we fund our states, or tribes, local health departments, is the five step process that helps them identify strategies and programs to build a coordinated community response for adapting to the health effects of climate change.

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So in the first steps, health departments or local communities identify what climate effects are relevant locally, how those might lead to new or expanded health threats, including mental health in who is most at risk.

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The next step is to calculate the expected impacts on the local population and rank the severity of each trip.

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This is the projecting, the disease burden, and what it does is helps health officials tackle the worst risks.

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Then, in step three, they can identify ways the community can intervene to prevent or reduce health effects.

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For example, health officials who are expecting more high heat days might consider whether it would be more effective to open community cooling centers or to collaborate on housing and development plans to protect vulnerable residents.

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Instead, health officials work with other community sectors to develop and implement their plan. This is a very communicative collaborative way where health officials work with city planners to reduce impacts of urban heat islands where they can work with broadcast meteorologists to alert people to prepare for extreme weather.

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And in Step five is evaluations where we assess the success, our lessons learned, and how we can apply it for future activities. Next slide, please.

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So, here, I just want to highlight one of our many reports here. We looked at the regional health impacts of climate change in the United States, and we will publish this report in 2020.

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You lose it, seven held domains, including mental health in the different regions of the United States, as Dr. Clayton said, like in different areas or regions. We're going to also look at slightly different mental health impacts, For example, in Alaska.

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The Native Americans being, uh, you know, relying on their substance foods, their culture and traditional knowledge, being much more linked to environment, and, of course, the effects of potential replication from long established, traditional size due to climate change, are associated with feelings of depression, with increased substance abuse, and other mental health effects. While in the midwest, a mental stress foals flooding events, those are the forces associated also with substantial. Health impacts identified sleepiness, anxiety, depression, post-traumatic stress disorder. But this is just an example of a report where we try to look.

26:54

It's a different region with different environmental climate change stressors, and mental health and other issues localized and how they can be addressed.

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Next slide, please.

27:06

So, it is important to know there is no single solution to solve the climate crisis, and that is why understanding the climate impacts, the community circumstances is important, and that's why we use it in our brief, A framework. We have a lot of different adaptation plans. Whether for state others, or for cities, for tribes, we have them even for sector, water, and transportation.

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Next slide, please.

27:32

In addition, we have developed a variety of documents, How to plan and adapt to the changing climate.

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So, these are resources for both health professionals, but we also have full, general public.

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We have fact sheets for health departments, how to incorporate climate climate resilience.

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We especially focus on how to help health departments with limited stuff and the resources to adapt to those. We provide a lot of communication materials.

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We even identify partners, local partners in the community, how to approach what they're always. We provide a lot of different examples of health harms, what are the most vulnerable populations and examples of success stories, and how this can be applied to you. So, I want to also touch base in my next slides.

28:22

Please, on the few examples of what CDC funded recipients, you've done. So we have many more examples, but for this time, I'm just going to focus on three.

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So, again, as Dr. Clayton said, heat is really one of well identified associations with where mental illness patients are especially susceptible, and she said, you know, we have suicide rates increase. We have a lot of areas during hot weather, with a variety of illnesses.

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So that's why I wanted to highlight the New York City example of how they addressed extreme heat.

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In this case, they identified the communities of low socioeconomic status, faced increased risk of heat related illness, and death, as there was less access or use of air conditioning in the home.

29:09

So the New York City climate inhaled so the department implemented the buddy program.

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It's aimed at strengthening relationships between residents and local organizations to increase resilience to extreme heat. In the participating, community, organizations receive training, so he tildes, emergency preparedness, voluntary management.

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They were able during an extreme heat event to identify and enrich residents of the greatest risk.

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So, for example, during the first 19 months of the project, 17 events were activated, and a network of 64 trained volunteers reached 454 residents. This project had a long lasting impact and strengthened the connections between the local organizations and the residents, and, you know, community feeling is very important, also, for addressing mental health issues. So in the next slide, I wanted to highlight more resources that CDC has developed in our environmental Public Health tracking portal, but we have this tracking program, we're specifically focused on hits. So, you know, other states and grantees have opened more centers with air conditioning during heat waves to identify vulnerable areas by using these tools as their own resources. But just an example, where you can compare anyone who can have X is in comparison. For example, heat days on one side and population aged, 65 and above. So, you can see in one place where you can have a vulnerable population in which days, on this side, we also forecast in the future.

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The monthly heat waves, you can identify again, where this will be more impacted, and we also provide sources of how to deal with it.

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So, in the next slides, oh, for example, this is just a dashboard where different vulnerabilities identify different groups, but also on this website, you can see when and where to activate or post cooling centers, where they're located, to predict if the seasons are gonna start earlier. Again, who and where do the most vulnerable populations live? Provide resources specific to you.

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Area and more resources from CDC.

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Next slide, please.

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This is from a tribal tribe in Alaska, where teak ice in the winter is used for transportation by snowmobiles and the warming has the warming kisco staining of ice, which has created hazardous travel conditions, increase the number of instances of people fall through the ice into tribal village of when writing Alaska funding from the Climate Health Program. Supported the distribution of injuries devices which are used for emergency communication when snowmobiles get stuck into the ice and people are stranded. So, it improved community awareness of the hazards of ice, equipped them with lifesaving, lifesaving communication devices and also helped with reduction in helicopter rescue pumping.

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In the final slides, Florida is protecting residents during hurricane season, which are, you know, hurricanes are getting more and more with longer seasons. So Florida, these are really more prone to flooding with increased need and use of emergency shelters.

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So what the Florida Department of Health does is they evaluate the emergency shelter use and whether they were sufficiently serving individuals with disabilities.

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So this evaluation led to a collaboration with FEMA and the Red Cross, and they implemented changes to really make communication and operation of emergency shelters, to be more equitable access for those with disabilities.

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So, and in my last slide, I just want to highlight the majority of resources we have. So this is from our coping with a disaster or traumatic events. So this is specifically during disasters, resources for children, from communities, for leaders.

33:09

We have much more in-depth information if you want, on all of our data, statistical resources, communication, efforts, partnerships. So, I'm going to leave you with my last slide, which is the general website for Climate and Health Program, and our e-mail, where you can reach us, you know, ask for local community assistance or any advice, any, follow up questions we cannot address today. Thank you.

33:40

Thank you, Dr. Carroll for sharing these solutions and resources to mitigate the mental health risks associated with climate change. Next, we will hear from Susan Towler, the executive Director of the Florida Blue Foundation, the philanthropic affiliate of Florida Blue. She is also the Executive Director of Corporate Social responsibility for Florida blue and has responsibility for the company's philanthropic strategy. We're so grateful to have Susan here with us today to share health plan and foundation perspective on this topic. Susan?

34:16

Thank you, Kathryn, and again, thank you to NIHCM, and to Dr. Clayton and Dr. Carroll. You really set me up nicely to talk about what our health plan has done. There's a lot of connection between what you talked about, and I'm really honored to be part of this conversation.

34:34

Will you progress the slide, please? First, a quick look at who we are. GuideWell is a health solutions company that is a national company. We, us and our affiliated companies, employ more than 18,000 folks and serve more than 46 million people in 45 states, including Puerto Rico.

35:01

Florida blue is part of Guidewell

35:04

Florida blue is the Blue Cross and Blue Shield Plan for the State of Florida, and we are the leading health insurance company here.

35:15

The Florida Blue Foundation is our private corporate foundation. We were founded in 2001, and next slide, Ryan.

35:25

Our mission is to connect to our Guide Well, corporate social responsibility work as well as our ESG, Environmental, Social, and Governance. I'll talk about that in a moment and we talk about it in terms of social impact. So, just like guide walls, the mission is to help people and communities achieve better health.

35:48

That is the work of our foundation and our CSR work as well. Next slide.

35:56

How do we think about these issues at guide Well, again, like I said, if you think about our social impact, and what is the value, or the imperative that we have in the social space, the environmental space, as well as governance, and are inclusive business practices? When you talk about holistic health, we believe that physical health and mental health go hand in hand.

36:24

Again, Dr. Clayton and Dr. Carrolll kind of reinforced that, and when you think about the social determinants of health, that really dictate most of your healthy life and your lifestyle.

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That's where we're trying to find, again, this intersection.

36:46

We do have a role in environmental sustainability, um, and, um, I'll get to that in a second.

36:54

But, you know, we know that we can play a role as a corporation to be environmentally responsible throughout our operations as well, So we think about this work again, and kind of this ESG framework. Next slide.

37:12

We do have focus areas for our philanthropy, as well as our CSR strategies. And back in 20 20, right before the pandemic, we align to these three drivers of health. They are food security, health, equity, and mental well-being. They were critical issues then.

37:38

But, now that we're through the pandemic, two years later, these three have really proven to be even more critical areas of focus for us.

37:51

And, again, I think Dr. Clayton talked about food and the issues that climate can have an impact on food and food security.

38:01

Dr. Carroll talked about equity, and we know that a person, your life is often dictated by the zip code that you are born in. So, if there are, you know, climate issues or environmental issues with that, and that causes challenges as well, and the mental well-being, as what we're going to talk about today, Next slide, Ryan.

38:26

Please. Going back to our ESG and our work with the environment and the importance of sustainability. I, at first glance, you might say, well, what can a health insurance company do for the environment?

38:41

Right? You don't make something, you don't manufacture things, right? So we have gotten really creative.

38:48

We have an amazing corporate services team and are really focused on what we can do in the sustainability space. As a business. We have championed solar power. Our headquarters are in Jacksonville, Florida, and we are committed to go 100% solar. And, our buildings, we have a project with the Jackson Electric Authority, were the first company to do that, improving our water management, all of our retention ponds. And the way we water. Our property is all reclaimed water 100%. Cutting, food waste, working with our food service providers and how we eliminate extra food and I'm reducing paper waste. Again, you would think, well, gosh, we've been at home for two years. We haven't used any paper but as you know, insurance regulations.

39:39

There's a lot of paper that needs to be shared with members and providers and vendors and our partners in the light. They're regulated. So, we're encouraging people to use electronic submission and electronic records as much as possible.

39:55

Next slide, Ryan.

39:58

So, how do we show up with this intersection between climate change and mental health?

40:06

You know, to be honest, we have not set out a strategy that said, We're gonna go do that. Right, And how do we do it? So, when we talked about this issue with NIHCM, we really talked about it in the space of our disaster relief efforts, and, again, Dr. Clayton and Dr. Carroll talked about that.

40:25

How that's been, I'm not going to say low hanging fruit, but that's been a way that we and other organizations can plugin and collaborate with other partners. You heard them say, Florida, obviously, that's our largest state where we operate as Florida blue and his guide well, and I'm Florida has its own unique challenges in its Peninsular being surrounded by water everywhere and lots of sunshine, right? And lots of development, mind you, Thousand, you know, a thousand people move to Florida, a day, give, or take, so all of those pose unique challenges to our state. They mentioned the Red Cross.

41:11

We have a longtime partnership and strong partnership with the American Red Cross and when both before disasters and during and after a disaster.

41:24

You can see that 30% of those Red Cross cases seek help with mental health after the disaster, and some of our support for them has gone to help with that issue.

41:36

Remember the source side condo collapse last year in Broward County, the Champlain towers, horrible tragic disaster.

41:47

Some have said that it was exacerbated by sea level rise and by, you know, the pounding waves and erosion.

41:57

On the beach in Broward County, we knew that that not only had a major physical toll on that community, but also a mental one as well. And, so, we joined forces with about 30 other non nonprofits and organizations to create a mental health collaborative down there that still is working today with both the survivors and the victims and the community.

42:25

During Hurricane Michael that affected our Pan handle, our Beautiful Panhandle badly.

42:31

A few years ago, the schools were really impacted, Schools had to be closed in, there were a lot of issues. So we partnered with the Consortium of Florida Educational Foundations.

42:43

Um, each county in our state has a school district, and those school districts have a public education foundation attached and it's that group, and we really worked with them to provide mental health training to school employees, and, again, continue to, to work with them in times of these disasters and others. Um, we have our mental health partners, new directions. That's our behavioral health company, and they have often stood up a 24 hour hotline that anyone can call.

43:16

You don't just have to be a member to just talk with someone, and we have found that really beneficial for people. Sometimes you just need someone to listen and talk to in times of a disaster or things happening. So we've found that that's been very effective.

43:36

Next slide, Ryan.

43:40

We do, with our three drivers of health, as I said, our mental well-being grants. We give those annually through our foundation through a competitive RFP process. Um, the next one, the deadline to apply is April 15th.

43:55

So, if you work in Florida, and you work in this space of mental well-being, please go to our website, floridabluefoundation.com, and take a look at those applications.

44:09

These are our partners from last year's grant program, and, again, if you said how many of those relate to climate change, probably none, but we're trying to strengthen the mental health system, right, And we're trying to create that infrastructure, So it's like our other speaker said, you need some in that infrastructure bill, so that you can be there for people when they need it.

44:35

Next slide, Ryan.

44:38

Just some results from our grants present and past, We do, as a, you know, foundation take measuring our impact seriously. And our grantees, we have a robust evaluation process, And you can see some of the results that we've had. You know, I think it's interesting as we talk about climate change in the future, and what those outcomes and metrics will be.

45:06

How we will know that we're being successful in this space. Again, that's industry-wide, not just unique to us. Next slide, Ryan.

45:16

I'm not gonna spend a lot of time on this, but just to say, you know, we think about our members, We think about our employees, and we think about our community. And I'm with our employees. We have a program called Lift by Guidewell, it's an Employee Assistance Fund. Lots of companies offer these, and that can be short-term assistance to employees in times of financial hardship. Often it is. Disasters are things that have happened to their home or property, and since the program began in 20 16, we've given more than 2800 grants totaling two point eight million dollars to our employees and need.

45:56

Next slide. Please.

45:59

Finally, I'd like to invite you to our next Community Health Symposium and our safar awards. It's May fourth.

46:06

And fifth, it is for everybody. You don't have to live in Florida. You don't have to work for a non-profit. It's a great discussion on community health.

46:17

We are focusing on health equity, but, again, lots of topics and great speakers, both nationally in the state and locally. So, we encourage you to come. It is in Orlando. Again, you can go to our website, Florida blue, foundation dot com to register. And we would love to see you there. Thank you so much.

46:42

Thank you, Susan, for highlighting Florida Blue and Florida Blue Foundation's leadership to support climate resilience. We'd like to use our remaining time today to engage in a Q&A session with our audience.

46:54

You can continue to submit your questions in the Q&A tab, and I'll ask all of our panelists to come off mute and back on to video.

47:07

Dr. Clayton, a follow up question for you, but I know Susan, you also talked a little bit about food insecurity as well. How can efforts to address food insecurity promote climate resilience? For example, by fostering the growing of one's own food, which also puts the individual out in nature. How can that help with, or prevent, or mitigate, you know, mental health concerns, climate, anxiety?

47:37

Thanks, that's a really interesting question. I think the questioner has partly answered it. So for the individual who's engaged in growing their own food, just being out kind of with that experience and the natural world, having the, you know, the the multi-sensory experience can be a real stress reducer, It might increase your sense of self efficacy and kind of control over your life to know that your own. You can produce some of your own food so you're not dependent on getting it somewhere else.

48:11

Just briefly at a broader level, food is actually a really important contributor to climate change in many ways. And, Susan Taylor talked about food waste and how significant that was.

48:26

So, if people can learn to eat in a more sustainable way, which can certainly include, for example, eating, you know, more local foods and foods don't don't require as many environmental resources. So, reducing your consumption of meat, But, very importantly, just reducing your food waste. That can certainly help to mitigate climate change. And, I think knowing that you are well, certainly because of the connections between physical health and mental health, eating a healthier diet is likely to support mental health in that way as well.

49:03

Dr. Carroll, a follow-up question for you. How is the CDC looking at population and demographic dynamics projections alongside the climate impact projections under different scenarios?

49:21

Yes, thank you very much for just questioning the Sioux. We have.

49:28

Very as I showed on the environmental health tracking portal. So we collaborate with all other federal agencies, including the Census Bureau. So, we do have robust information on demographics, where you can, you know, look, it's a different county. And, also, our work has, you know, always has focused on environmental justice.

49:57

And we have been even no more emphasizing that, in recent years, especially with no climate change, being most impactful in those areas. But, we are looking good in all areas, health equality and, you know, demographics. And I said, like, we have a special vulnerability assessment guide that we work with our grantees and anyone else, when they identify the local climate issues, they also look at the variety of vulnerabilities of their population in how they can address it. So, it's actually an internal part of this brace framework that I've provided, looking into demographics and vulnerabilities of the local population.

50:52

Thank you.

50:55

This question is, for any of our panelists, what do you think is the mental health impacts of media coverage on extreme weather events and climate change?

51:05

We're continuing to see increased coverage of these issues and curious about your perspectives on this, and how we can continue to inform on this topic.

51:21

I can jump in, and then maybe others might want to add. Absolutely. I think there's some evidence that media coverage can increase anxiety. Now, the answer is not for the media to stop covering these events, because I think we need to know what's happening. And if anything, we need to be paying more attention than we are already.

51:42

But I think it would be great for the media to kind of highlight more positive stories as well. And sometimes, to protect our mental health, we might all need to kind of step away from what's described as doom scrolling.

51:58

Yeah.

52:00

No, I know I am, I echo Dr. Clayton.

52:04

I think that it does media coverage on lots of things, right? So, and social Media, right. I would throw that in as well.

52:16

That, uh, your own kind of individual responsibility to monitor yourself to Dr.Clayton's point, so that you don't get that dooms scrolling. That's a good term.

52:34

And so, if we can also add, I think what is important and what we have been also trying to develop and have some immediate communication materials on their website, where we also want to emphasize on what the communities and individuals can do themselves. You know, again, the best if we can prevent it ahead of time, but also we have resources during disasters.

53:05

You know, or heatwaves, was, You can do where you can, what actions you can take, whether it is, you know, finding a cooling center or other resources your community has also provided resources for, though, state health departments are preparing to do.

53:25

So, individuals are better prepared, both, so understand what it means, but, again, like, what they can do and be empowered, and have some options that, you know, they can, they can take action. And, I think, you know, this has shown to help with dealing with mental health issues when the public, you know, the individuals and communities, have resources to empower themselves to take on some action.

53:57

Um, so, again, I would be happy to share those resources within our website.

54:05

Great, thank you.

54:07

You mentioned in your presentation, you know, a lot of different resources. We had one question, whether you have resources or others can speak to how we can continue to provide mental health support to the disaster first responders, whether that, you know, our firefighters fighting the wildfires or, you know, any any other first responders?

54:38

Was that for Dr. Carroll, you can think of?

54:42

Yeah, So, I'm with the National Center for Environmental Health, but another group, the National Institute for Occupational Safety and Health, which is also part of CDC, their focus is actually first responders, and they have done a lot of research.

55:02

They have especially because I have been working on wildfires and response recently, you know, for the community response, but, NIOSH, the National Institute for Occupational Safety and Health, they have a lot of resources in research regarding, for example, firefighters, but also they have a lot of their own team that deals with disasters that have such resources.

55:28

So I can, you know, be happy if you give me an email later to give you their websites and connect to Hmm, Which subject matter experts there work in this area.

55:43

If I could just add that, that's such a great question because we often don't recognize the mental health burden of these first responders are facing, and I think especially especially with the increased frequency and intensity of storms and the wildfires, you know, the first responders are just feeling overwhelmed and the mental health needs are significant.

56:08

Yeah.

56:10

This is another question for any of our panelists, and you could perhaps address, kinda, from your different perspectives. Could you speak to the need, or potential resources for financing to address these issues?

56:25

Whether it's an additional research to be able to measure at, you know, how healthcare providers and systems no might be able to address, whether it's public health or private, and how might they need to differ between sort of the upstream prevention efforts that we've talked about, as well as the downstream acute impacts?

56:52

Well, I can start.

56:54

Now, that's not unlike, right? Other health issues. Do we focus on prevention of diabetes, or treatment of diabetes writing? You can talk about every issue like that. You know, More and more health organizations and Medicare are looking at social determinants of health, And one of those is the environment. Now often you it's couched in terms of an environment that isn't like your neighborhood or kind of where you live, but the environment can also be, you know, these climate situations. So, you know, I think the answer to everything is collaboration, right, And working together. No one sector, government, business, non-profit, can do it alone.

57:38

So I think it takes partnerships and collaborations to work on these issues together, to bring the best minds, to solve it.

57:53

Yeah, if I can, it's. So similarly, you know, I want to emphasize some collaborations and partnerships. For example, CDC has participated in the National Academy of Sciences workshop on the interplay of environmental exposures and mental health outcomes. But we also work very closely with other federal agencies, such as the National Institute for Environmental Health Science.

58:20

And I want to emphasize that the hip recently published their new research agenda for climate change and climate public health impacts, So they're emphasizing research into climate health effects, including mental health, as well research into interventions for both, you know, community level and public health level.

58:47

We do partner with a lot of other agencies, especially agencies during disasters but also EP NASA and I said it was talking about my work on wildfires at the Wildland Fire Leadership Council.

59:06

So there's a lot of organizations, both federal and non federal, that are involved in different aspects, this work.

59:18

Thank you.

59:20

Maybe a follow-up, just to follow up, Dr.Clayton, could you talk about any additional research that's needed to really inform efforts and to understand, you know, some of the treatments or interventions?

59:32

And then, I think Susan Towler alluded to this at the end of her presentation. How do we, how do we measure going forward? if what we're doing is having an impact, you mentioned some survey data.

59:47

Yeah.

59:47

We definitely need more research, because, although I emphasized, there's a lot that we know already, there's so many questions that didn't even occur to people to ask 10 years ago or sometimes even five years ago. Particularly with regard to those indirect and vicarious impacts and levels of climate anxiety.

1:00:06

So we definitely need more research on the levels of climate anxiety, the extent to which they're a threat to mental health. Who is more likely to experience it? And we need a lot more research into what are the best ways to address the mental health issues that are associated with climate change. So, in what ways are these, essentially, requiring some different responses than other kinds of mental health issues? And we, you know, we're beginning, there's people working in this area, we know some things, but we're really just at the beginning of this.

1:00:43

We had an audience member, say, they're a crisis counselor for hurricane survivors, and commented that many people don't believe a natural disaster impacts their mental health.

1:00:55

You know, we've talked about, you know, mental health stigma, and other events that NIHCM has done.

1:01:02

How can any of you speak to how you address mental health stigma with climate change and mental health?

1:01:13

I'll give a quick response.

1:01:15

I think, I think this is true, that mental health is to our mental health problems are stigmatized as it's kind of true all over the world, and they're under resourced.

1:01:26

But I think that, in fact, coven if there, if it's done anything useful. One of the things it's done is to highlight the ways in which any of us can have our mental health impacted by these external events. So, it doesn't indicate personal weakness, it just indicates that you're dealing with something very stressful.

1:01:45

And, so, I'm, I'm, I'm optimistic that people are beginning to be more aware of the fact that mental health needs are real needs. And, you can't just tell somebody to pull themselves together, And, we can look at economic impacts of mental health, and the link between mental health and physical health, if those are more compelling arguments for people.

1:02:10

Well, thank you. Unfortunately, we are out of time. Thank you to our speakers for being with us and sharing your work and perspective and engaging in this Q&A session. Thank you to our audience for joining this discussion. Your feedback is important. Please take a moment to complete a brief survey that will open on your screen after the event. You can also access the webinar recording, slides, and our recent infographic on climate change and mental health.

1:02:41

Thank you all again so much for joining us tonight for this really valuable discussion.