Diseases like diabetes and obesity aren’t the first thing that most people think of when considering the health impacts of climate change.

But they’re among a myriad of illnesses expected to worsen as global temperatures continue to warm.

The World Health Organization expects about 250,000 will die every year between 2030 and 2050 due to increases in malaria, malnutrition, heat-related illnesses and diarrhea blamed on global warming.

And those are far from the only health-related effects of climate change.

Exposed roots along the beach at Kualoa Beach Park. Eventually these trees will die due to salt water inundation.
These exposed roots along the beach at Kualoa Beach Park signal danger as trees are expected to die due to the rise of sea level. But climate change impacts aren’t limited to environmental effects. Cory Lum/Civil Beat/2021

One of the most immediate is worsening mental health. Already climate anxiety is growing and extreme weather events are fueling post-traumatic stress disorder cases and other mental health conditions.

A lesser-known impact is how warming global temperatures are worsening noncommunicable diseases, including obesity, diabetes and asthma.

That’s a particular concern in the Pacific where Native Hawaiians and other Pacific Islanders already experience disproportionately high rates of those diseases.

Researchers have also been raising alarm about how climate change is expected to worsen heart health, which USA Today reported will disproportionately harm people of color who are more likely to work outdoors and live in hotter urban neighborhoods than white people.

The health impacts of climate change represent one of the greatest global health crises of the present century,” said Lachlan McIver, lead author of a 2016 World Health Organization study on the effects of climate change on public health in the Pacific islands. 

“Pacific island countries are among the most vulnerable in the world to the health impacts of climate change,” that study concluded, citing how Pacific islands are uniquely exposed to climate change and often have limited health care capacity to address risks.

Those conclusions are worrisome to Kealoha Fox, a Native Hawaiian public health researcher who is also on the advisory committee of the Honolulu-based Institute for Climate and Peace.

In 2018, Native Hawaiians and other Pacific Islanders were more than twice as likely to get diabetes or die from it than non-Hispanic white people nationally.

The pandemic further exposed health disparities affecting the community as non-Hawaiian Pacific Islanders have died and been hospitalized with Covid-19 at high rates. More recently, Native Hawaiians have been disproportionately infected by the delta variant.

“Climate change is deeply inequitable as is most of the current public health infrastructure,” Fox said. “The combination of the two systems failing us simultaneously is really what keeps me up at night.”

Warming Temperatures

Diana Felton, Hawaii’s state toxicologist, says some of the clearest health effects of climate change include deaths and injuries caused by warming-induced extreme weather events. But while the connection between higher temperatures and diabetes is less obvious, it’s still there.

It’s a little less like a direct line, but I think the line definitely connects,” she said. 

Part of it has to do with the way climate change is expected to disrupt food systems. The deterioration of coral reefs may make it more challenging for Pacific peoples to engage in traditional fishing, says Bob Richmond, a University of Hawaii professor who specializes in marine conservation biology.

The health impacts of climate change represent one of the greatest global health crises of the present century.” — Lachlan McIver

About 14% of coral reefs globally were lost between 2008 and 2019, according to a global report, and 7% of Hawaii hard coral cover was lost during the last 10 to 15 years.

The ability to fish and farm is more than just about eating healthy food that’s not processed. Such practices are “an important part of mental health and cultural health and social health,” Richmond said. 

Hotter temperatures also discourage physical activity outside, which can contribute to obesity. Sea level rise and adverse weather events, among other changes, can lead to more crops failing.

All of that makes people more dependent on nutrient-dense imported food, McIver said. This issue isn’t unique to the Pacific, but he said the problem is particularly stark in the islands because of the relative lack of arable land and the high rates of Indigenous people who already suffer from noncommunicable diseases.

Potential Solutions

Fox says the high rates of diabetes and other noncommunicable diseases among Native Hawaiians like herself already make life more challenging for many.

“We are feeling those effects much earlier among our people,” she said. “That quality of life is really eroded for our people much earlier.”

There’s also the cultural and emotional pain of losing kupuna to such diseases.

Fox looks to cultural practices to help combat the expected effects of climate change. Restoring local fishponds and planting fruit-bearing native trees can help preserve traditional practices and healthy eating, she says.

McIver says that in addition to empowering Indigenous peoples, there needs to be more investment in the health systems in the Pacific. Many Pacific islands lack the infrastructure and access to federal resources that Hawaii has as a U.S. state, he said.

But even Hawaii has struggled with limited health staffing and resources during the Covid-19 pandemic, facing an oxygen shortage and having to bring in hundreds of health care workers from the continent during the delta surge.

McIver added more research on the health impacts of climate change also needs to be done in the Pacific, which is relatively under-researched in climate studies.

Felton from the Department of Health thinks having a dedicated climate change and health program within the agency would help Hawaii in particular to understand and manage the problem.

“I think that would really be a great way for the state to move forward on addressing those health impacts,” she said.

She and other Hawaii Health Department officials are working on drawing up a climate health profile that would lay out what health problems to anticipate, but she believes the state could benefit from a dedicated position.

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