Catherine Flowers, left, addresses the audience with George Luber. By David Fouse, courtesy APHA.

Catherine Flowers, left, addresses the audience with George Luber. By David Fouse, courtesy APHA.

In rural Alabama, a woman looks out on her yard, where raw sewage is coming up from pipes in her lawn. Another resident lives close to a lagoon, which, when it floods, pushes sewage into outdoor living space. And while you might hope that these are two isolated incidents, you’d be wrong.

“It’s not just in Alabama; not just along the Selma-to-Montgomery (National Historic) Trail,” said Catherine Flowers, MA, executive director of the Alabama Center for Rural Enterprise. “It’s in all 50 states here in the United States of America. Cities are always mentioned, and we’re kind of left out.”

As hundreds of advocates gathered at the Climate & Health Meeting, held Thursday at the Carter Center in Atlanta, often the discussion turned to risks and to urban centers. But in an afternoon session on “Protecting public health from climate-related threats: From science to practice in the United States,” a wide variety of public health efforts in diverse settings were highlighted, including ACRE’s video, with work by Duke University students, highlighting the risks of raw sewage on local public health.

It is incumbent on public health advocates, and health professionals, to advocate for health policies, said presenter Gary Cohen, president and co-founder of Health Care Without Harm. “We are seen as the moral barometers,” he said. “We live by the code ‘do no harm:’ the Hippocratic oath.”

Cohen urged public health advocates to get doctors and nurses on board to bolster the climate health effort. Health care systems are often some of the largest employers in communities, Cohen noted. He shared one example: Health care workers teamed up with environmental advocates and clean energy partners to lobby Ohio Gov. John Kasich to keep renewable energy standards in the state. Showing that these groups were larger economic drivers was enough to convince the governor — he protected the standards.

The Centers for Disease Control and Prevention offers tools to use in communities to bolster climate change resiliency for communities, said George Luber, PhD, CDC’s associate director for climate change in the Division of Environmental Hazards and Health Effects at the National Center for Environmental Health. CDC’s Building Resilience Against Climate Effects, or BRACE, framework, is available for communities to use.

But what is the best way to enact such framework? Get out of the office, suggested speaker Clifford Mitchell, MD, MPH, MS. It’s the only way to share data with community stakeholders and engage them in the fight against climate change and for public health. Flowers said she visited the Standing Rock Indian Reservation, where the Dakota Access Pipeline threatens clean water for the community, because she recognized their fights were the same. She also acknowledged an audience member’s request that public health leaders consider, learn from and include American Indian communities, their history and their resilience in their research and outreach. Going into communities, observing and learning, she said was critical to improving public health for all.