Impact Stories

The Dire Need for Climate Change & Health Equity Roles in Public Health: Ventura County Leads with New Environmental Justice Initiative

Impact Story | October 3, 2023
Los Angeles, CA (Public Health Alliance of Southern California)--   In the heart of Southern California, Ventura County holds a rich history of climate resiliency work and activism. The county's sprawling landscapes are lush with strawberries, citrus, and avocados, showcasing California's vibrant agricultural sector. 

Noted as the most rapidly warming county in the lower 48 states since preindustrial times, Ventura is confronting several crises like hazardous floodwaters, forest wildfires, and pesticide-related air quality concerns. At the core of these environmental crises is climate change, intensifying the already pressing economic and health challenges for the county's 40,000 farmworkers. Most of these workers are undocumented immigrants, who face extraordinary risks to put food on our tables; during these disasters, many lack adequate protection and access to  medical care, leaving them vulnerable to severe health complications, even death.

Ventura’s farmworkers embody strength and adaptability. Mobilizing their skills and wisdom, they’re actively pursuing solutions to thrive amidst growing climate disasters. Organizations that work closely with farmworkers, including the Mixteco Indigena Community Organizing Project (MICOP), Californians for Pesticide Reform, and the Central Coast Alliance United for a Sustainable Economy (CAUSE), have championed worker safety and climate resiliency initiatives to better protect workers and their families for generations.

To aid their efforts, Public Health Alliance member, Ventura County Public Health created a new position: Climate Change Health Equity Coordinator. This job, created last November, focuses on raising awareness around mounting climate challenges and supporting community-led initiatives. Filling this role is Paulina Nava, MPH, who views her return home to serve her community as a calling.
  “A lot of the most impacted communities are inherently resilient. And that's true in Ventura County. Thinking about our immigrant or indigenous Mexican communities and farmworkers, these are people who are dealing with housing instability, which is an increasing issue in California. These are inherently resilient communities, but because of what climate change is impacting and how it's impacting different folks, they are made systematically vulnerable to have their health worsen or to have new health issues arise,” Nava said.
 Nava, as the dedicated driving force behind the county's Environmental Justice Initiative, is developing the program from the ground up. Guided by the American Public Health Association’s framework for local health departments, she’s focusing on three central areas:

Bridging Climate Action and Health Equity with Trust Building & Community-led Collaboration

Throughout the past year, Nava has formed ties with farmworker advocates and community organizations that work closely with farmworker leaders who have consistently championed change; together, they're exploring ways to strengthen climate resilience and worker safety at the speed of trust. A central aspect of this collaboration is understanding current challenges, identifying where existing resources fall short, and working at the intersection of public health and climate change to address the gaps and emerging concerns.
  “It's really important to understand the past and that we have community members who feel hurt, who feel like the government doesn't do anything for them, who feel discarded. We have farmworkers who feel when the fields flooded, the only people who got compensation were the growers. It's really about rebuilding that trust or building that trust from scratch,” Nava noted. She then explained that trust is built on accountability, understanding, and connection, “I can say I’m from here, I can communicate, hold meetings, and submit applications in both Spanish and English.  I can understand where people are at or at least try to understand where people are coming from. They can trust me.”
From Nava’s conversations with the community, several issues have come to light:
"Understanding the concerns of community members is everything. While I initially believed issues like asthma from wildfire smoke and extreme heat were the biggest concerns, I've learned that many are more worried about the long-term mental health implications of witnessing catastrophic fires, especially for children. We often assume acute issues are the most pressing, but there are many health impacts that aren't evident in emergency room data or 911 calls. That’s why I’m focusing on building relationships to better capture and share this information,” Nava explained.

Guiding Strategies for Public Health Departments to Build Community Climate Resilience

Drawing from a suite of climate resiliency reports by the Public Health Alliance, and insights from Nava's interview, here are select best practice recommendations:

Enhance Capacity for Community-Driven Resilience: Historically, only a handful of health departments in California dedicated staff to climate change. However, this is changing as departments innovate to increase their capacity in this area.  Climate change initiatives require sustainable resources tailored to the challenges at hand to achieve real progress. Long-term funding for staffing, technical assistance, and support for community engagement and partners is crucial. Allocations should be determined using a formula that considers population size, need, and climate vulnerabilities. Through state and local partnerships, a cohesive program vision and goals can be established, allowing for adaptive, effective local variations. 

Build Regional Partnerships and Coalitions: Nava is working with county-wide departments and external organizations on ways to scale up and incorporate existing farmworker-led initiatives like ones supported by Achieving Resilient Communities (ARC). The ARC project is a collaboration between the Public Health Alliance, the Public Health Institute, Roots of Change, and Tracking California. It partners closely with CAUSE, MICOP, Líderes Campesinas, & other community groups in the region to make measurable progress. Based on years of advocacy and leadership by community-based organizations and support from the ARC team, the Ventura County Air Pollution Control District improved the county's air quality alert system to better serve indigenous workers. Previously in just English and Spanish, it now includes audio alerts in Mixtec and Zapotec, common languages among farmworkers. This ensures all are quickly informed about hazardous air conditions due to wildfires and pollution.

Check Out ARC’s Stories of Resilience Video Series California Wildfires, Heat, and Health Español/Mixteco

Offering Resources for Shared Knowledge: Community groups, culture bearers, and residents need to be compensated for their time and expertise. Community representatives must be equally valued relative to traditionally compensated stakeholders. Ventura County Public Health's "Creando Comunidad" program offers a model that addresses both the underlying inequities of families in survival mode while building capacity to address the public health-related challenges of climate change. Creando Comunidad trains Latinx community health workers to become Promotores who serve as grassroots health advocates. These community participants gather monthly to learn about a new public health subject. Upon concluding the program, they will be better positioned for employment opportunities for their valuable work. Nava encourages other counties to prioritize expanding or creating similar initiatives.
“We need to not only gather stories from the community but also build capacity for them to be the compensated emergency responders and healthcare workers. It's essential to understand how we can help those in survival mode to develop climate resilience. I've heard from community members that they're still grappling with immediate concerns, like feeding their families.,” Nava explained.
 Prioritize Climate Change within Departments & Leverage Effective Communication:  Elevate the role of the public health sector in local, regional, and state climate planning and action to ensure health equity and community led preparation is “front-burner issue.” Everyone plays a role in addressing climate issues; this means choosing the appropriate methods of engagement when conveying this connection to decision-makers from all political backgrounds to ensure broad buy-in on initiatives. Start by establishing a foundation of allies already receptive to the conversation. Maintain neutral language and focus on universally understood values, like everyone's shared concern for personal and family health. Leverage the teaching moment of California’s recent climate-driven disasters. In regions with varied political views, terms like "environmental shifts," and "extreme heat,” might resonate better than "climate change." Present information compellingly while uplifting solutions and collaboration rather than just pointing out problems. The goal is to educate, unite, and integrate climate resiliency & health equity priorities into the mainstream of local government. Nava highlighted that these strategies are also relevant in the healthcare sector. She has employed them when speaking to medical professionals from both private and county hospitals to showcase the gravity of climate change as a public health issue. Nava explained the presentations are all about sparking shifts in mindsets and, in turn, the quality of care provided,
It's really important to emphasize equity. Even when we believe we're tackling climate change or climate action, we might unintentionally worsen health inequities and vice versa. Focusing on equity isn't just about doing what's right—it's the best public health practice that benefits the entire community. COVID-19 taught us that our health is interconnected, and climate change is reinforcing that our well-being is tied not just to one another but also to the planet.”
 Focus on Equitable Multi-Benefit Strategies: For example, green infrastructure, such as urban parks and permeable pavements, offers multi-faceted solutions to address climate challenges and promote resilience. Green infrastructure benefits communities through enhanced access to tree canopy coverage, healthy transit, and economic support. It's vital for residents to actively participate in green infrastructure planning and decision-making. You should set aside green infrastructure funding for communities that are disproportionately impacted and use tools like the Public Health Alliance’s Healthy Places Index Extreme Edition (HPI: EHE) to guide eligibility requirements. HPI: EHE allows governments and other key stakeholders to scan their community and understand which areas and populations are likely to be most affected by heat and climate change now and in the years to come. 

Advancing Climate Resiliency through Enhanced Research, Data, & Benchmarks: Local health departments are realizing the importance of collecting data on climate-related conditions and green infrastructure needs due to its direct link with the health of communities. It's essential for local governments to address climate-related data gaps, disaggregate data by location, race and ethnicity, and develop standardized tools for evaluating green infrastructure and climate initiatives. Securing funding for evaluations and setting benchmarks is vital as a deep understanding of climate change’s impact on residents can guide equitable interventions. Ventura County has taken steps in this direction with the county's first dedicated dashboard that monitors climate-related health impacts. Understanding that data alone doesn’t capture the full story, Nava hopes to expand the dashboard to allow residents to share their experiences.

Urgent Need to Sustain & Create Climate Change Health Equity Roles in Public Health

 Roughly a year into the role, Nava is bursting with ideas she hopes to bring to life. Yet, she's navigating uncertainties about sustaining funding for her position and community investments. This is a challenge echoed across California, where many local health jurisdictions face unknowns around financing such crucial health equity roles that are supported by COVID-19 Relief Funds, despite being indispensable to public health. But Nava isn’t backing down and is forging partnerships across multiple counties to address sustainability concerns. 

Anticipating this challenge, the Public Health Alliance included a funding brief in its Green Infrastructure, Climate Resilience, & Health Equity Policy Agenda.  This brief outlines ways local governments can sustain their climate change efforts and incorporate green infrastructure guidelines into existing and upcoming funding plans to enhance regional climate resilience.
"I strongly urge health institutions and public health departments to recognize climate change as a public health issue deserving of investment. Particularly in various regions of California where the full impact hasn't hit yet, we have a moment to breathe, to plan, prepare, and share information. Short-sightedness is a human flaw, but we have the opportunity to integrate climate change and health equity from the start, making it community-led and equity-driven, rather than adding it as an afterthought years later,” Nava said.
 The Public Health Alliance has compiled a collection of resources detailing best practices, strategies, and advocacy objectives to strengthen local health departments, communities, and the state's ability to enhance climate resilience and incorporate green infrastructure. Included in these resources are: