Climate change threatens the health of everyone on the planet. Air pollution fills our lungs with harmful particulate matter that can lead to lung failure and disease, and rising temperatures increase the risk of dehydration and heat stroke.
But the climate crisis doesn’t affect everyone equally.
“All pregnant women and statistically more Black women are exposed to these environmental stressors,” says Nathaniel DeNicola, M.D., chair of telehealth at the American College of Obstetricians and Gynecologists and a liaison to the American Academy of Pediatrics Council on Environmental Health. In a study he co authored, researchers found that air pollution and heat exposure are associated with elevated risk of preterm birth and low birth weight in all mothers, but Black mothers were an especially high-risk group.
Combined with an entire ecosystem of inequality that impacts Black maternal health outcomes, ignoring the environment is just one more way we’re failing Black moms. It’s a reality Saleemah McNeil, a doula, therapist, and owner of the Oshun Family Center in a suburb of Philadelphia—one of America’s most polluted cities—sees daily. “Practically every woman I see is dealing with some level of the effects of climate change and pollution,” she says, adding that the effects seem to be more prevalent in women who come from communities where sanitation needs aren’t as urgently prioritized by local governments.
Black women and the climate crisis
The impact of climate change on Black women’s health starts with pollution. Black women are more likely to live near toxic waste facilities and in housing facilities that do not meet health safety regulations, and to take public transportation, says Linda Blount, president and CEO of the Black Women’s Health Imperative.
Black communities are faced with air pollution levels 1.54 times higher than that of the average American population, according to a study published in the American Journal of Public Health, and have a higher risk of premature death due to air pollution than white people, according to the American Lung Association.
Then there’s the heat. Black women are more likely to live in the South, where the steady creep of average temperatures is more acutely felt, and more likely to live in “heat islands”—urban areas that act like ovens thanks to an abundance of concrete and glass and a lack of greenery. “These heat islands are disproportionately in communities of color,” says DeNicola.
The heat is not just a matter of discomfort—heat and pregnancy don’t mix well. It is one of the better studied environmental stressors on pregnancy and has been linked with a higher risk of preterm delivery—at higher rates among Black mothers than white mothers.
Another study published earlier this year found that women exposed to higher than average temperatures had an increased chance of developing preeclampsia, a potentially life-threatening condition that causes high blood pressure in pregnant women. It’s one of the top three pregnancy complications that lead to maternal mortality, and Black women are 60% more likely to develop it than pregnant white women.
These environmental stressors are bad for everyone’s health, but for pregnant Black women, they are part of a particularly vicious cycle.
Black women are already at an elevated risk for pregnancy complications and are three to four times more likely to die from childbirth than white women. Black women are forced to battle chronic stress due to structural inequalities that often compound the prevalence of conditions such as high blood pressure, diabetes, and fibroids. Black women are less likely to have access to paid maternity leave (43% compared with 50% of white mothers). Black women often receive a lower quality of care, giving birth in hospitals that predominantly serve Black patients and consistently perform poorly on birth outcomes. And 22% of Black women report facing discrimination in doctor’s office and clinics. “White women are not dismissed by their health care providers, who are responsible for noting the first signs of distress in a pregnancy, the way that Black women have been,” says McNeil.
The effects of climate change could potentially widen the already large gap between the health outcomes of Black and non-Black mothers.
Saving Black mothers—and the planet
There is a silver lining: The effects of climate change can be fixed. “We have a climate crisis that has not been addressed anywhere near as seriously as it should be, given how much risk there is associated with it,” says Bruce Bekkar, M.D., a retired ob-gyn, full-time climate activist, and board member of the Climate Action Campaign. “Dealing with the climate crisis is going to take a while to have its full impact but is going to help save lives immediately—the health benefits occur instantaneously.”
So where do we begin to help those most at risk for being impacted by climate change? Some steps are simple, but can have a big impact. Having air conditioning is critical for pregnant Black women, for example, particularly those in increasingly hot climates. But to make a systemwide change, “health care professionals should be working in tandem with local environmental groups to uncover the impact [of climate change] on high-risk patients according to where they live,” says McNeil.
“A pregnancy takes place in the context of how a woman lives,” adds Blount. Everything from the air a woman breathes to the stress she undergoes daily has an immutable effect on the health of her pregnancy. “Is she walking three blocks to catch the subway to get to work? How does she feel about the air quality where she lives? Does she have central air, or a window unit to provide relief from the excessive summertime heat?” These are the types of questions Blount believes that providers should be asking of pregnant patients.
And when it comes to tackling the climate crisis, we need to vote to hold elected officials accountable for tackling environmental issues. We need to vote to prevent toxic facilities from being built near minority communities. We need to vote to make sure that all housing, including public government housing, is clean and hospitable. And we need to vote to stop the rising temperatures that are threatening Black mother’s lives first.