An OPCA Health Equity Committee Q & A

Climate change is posing significant health risks to communities served by federally qualified health centers (FQHCs), and among them, agricultural workers are particularly impacted. In Marion County, Oregon, the heat-related dangers faced by agricultural workers have become a pressing health equity issue. Insights from an interview with Dr. Antonio Germann, a Family Physician at Salud Medical Center of Yakima Valley Farmworkers Clinic in Woodburn, shed light on the challenges he sees his patients face.

Interview questions for Dr. Antonio Germann, Family Primary Care Provider at Salud Medical Center of Yakima Valley Farmworkers Clinic in Woodburn, OR

Q: How do you see climate change (increased severe summer heat) affecting overarching community health and the patients you serve?

A: Climate change is detrimental to our local and global community members. Many of my patients work in at-risk professions: migrant farm workers, construction workers, day laborers, etc. Any work outside presents alarming risks. The reality though, is all Oregonians are at risk from weather-related and climate-related extreme events. The heat dome of 2021 and the winter storm of 2021 are examples of poor health outcomes for my patients in particular. Heat-related illnesses are commonplace for my patients due to their concern of necessity to work despite the consequences of working in these environments. There is growing research for kidney-related injuries that accumulate over time with individuals working in these worrisome heat events which I feel is insidious and needs greater attention.

Q: In what ways has your organization adapted or expanded service options to best serve your patients during the summer months?

A: This is an area that I believe all health systems/clinics could stand to coordinate better with outreach to patients and community-based organizations. Additionally, I believe coordination with the public health system with health clinics also could benefit in coordination. Our internal work at Salud Clinic is continuing to focus on individual conversations with patients during our visits and speaking about the risks with patients during these events. We coordinate locally with the city government to send out information to our patients for local shelters, cooling centers, hydration, and prevention tips for heat-related injuries.

Q: As climate change continues to threaten human lives and exacerbate health and social inequities, what specific aspects of your healthcare approach would you like your fellow Oregonian peers to know?

A: I would like to see a conversation between public health departments and health systems. Providers’ offices know the acuity of patients. They are aware of the complexities of care. These offices often have more information on social determinants of health. I would like us to pair more to promote air filtration devices, air conditioners, and heat pumps for more health conditions that would pose dire consequences. These are tools that can prevent asthma and COPD exacerbations, HRI, and promote better utility of energy efficiency with heat pumps.

Q: Drawing from your experience, what recommendations would you offer to providers or FQHCs seeking to engage in climate change-related interventions?

A: We need to alter our approach to information sharing and place heat-related illnesses or climate-related injuries into our list of ailments we need to pay attention to just as we would for diabetes or other chronic diseases. We provide recall efforts to bring back people for hypertension but we are observing more poor health outcomes related to climate events and we need to make an adjustment in our approach to care. I would encourage us all to continue to be engaged with our local public health partners and look internally into our workflows in adjusting to the new world we live in. We also need to be reflective in the changes we make in health care. We create a great deal of waste ourselves from trash created in patient care. Our lights are continuously on in these buildings and we need to focus on how we can move to renewable energy sources such as solar on our roofs. We need to promote programs such as EV’s for our staff but make it affordable. We need to promote alternative forms of transportation to work that are not as dependent on fossil fuels as the ones we use now.

If your organization is making efforts to reduce greenhouse emissions or is taking steps to address climate-related health issues in your communities, tell us about it by contacting Jordan Frazier! We’d love to learn from you.

Relevant resources for FQHCs:

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Fill out the ‘What the HEC?’ Topic Suggestion/Request to be Highlighted form.