Abstract
Abstract
Caribbean small island nations are particularly vulnerable to the impacts of climate change and some communities within these nations may be at increased risk for health and mental health consequences. Recent hurricanes and flooding in the region have highlighted the importance of preparation as well as inequities in response to natural disasters. Environmental justice offers a framework for environmental health that acknowledges inequalities arising from global climate change and directs resources to those most affected. Social work as a profession and social workers within communities are uniquely qualified to identify and respond to these environmental health challenges. In this article, the authors use examples from two Caribbean small island nations, Jamaica and Barbados, to explore environmental justice-oriented responses to climate change-related health and mental health challenges and suggest mechanisms for social work intervention.
A
Caribbean Small Island Developing States (SIDS) are in a precarious position with regard to implementing adaptation solutions to coming climate challenges. Caribbean nations are particularly at risk because of the connection between economic and environmental concerns, the devastating impact of economic drivers related to tourism 4 and vulnerability to extreme weather events such as hurricanes, earthquakes, and tsunamis. In this article, the authors highlight two SIDS, Jamaica and Barbados, as examples of Caribbean communities vulnerable to climate change, identify specific environmental justice issues in these island nations, and highlight social work practices that may begin to address some of these challenges.
Environmental Justice Framework for Social Work
Environmental social work is an emerging field of practice, with principles of community practice, 5 advocacy, and an expanded person in environment perspective. 6 Using the principles of environmental justice, as developed by the First National People of Color Environmental Leadership Summit in 1991, social work values, competencies, and strategies can be aligned and used to inform social work practice. 7 Environmental justice approaches climate change impacts from the stance of equity and social justice, centering voices of those most impacted and addressing environmental, economic, and psychosocial needs. Those living in poverty, segregation, or other forms of marginalization are the most vulnerable to natural disasters, have fewer resources, and are less likely to be able to mount an adequate response. 8
During hurricane Katrina in the United States, for example, black residents and the elderly were more likely to die in the aftermath of the disaster 9 and during hurricane Maria, those with disabilities in Puerto Rico were disproportionately affected 10 ; these patterns of disproportionate impact on marginalized populations are repeated around the globe during natural disasters, drought, and conflicts arising from competition for scarce resources before and after climate events.
Environmental justice also offers a focus away from environmentalism and conservationism that, with their historic focus on preserving the natural environment for elite consumption and pleasure, have been criticized for being elitist and dominated by white middle class values. 11 Thus, we argue that an environmental justice orientation for exploring public health issues can provide a mechanism to explore the interaction of both coastal development and postcolonial exploitation of natural resources, and vulnerability to climate change for vulnerable populations. This is especially relevant in the Caribbean where foreign investment may focus on nonsustainable industries such as tourism and the extraction of natural resources, and where disaster responses may not always align with the needs of community members on the ground.
Public Health Model of Impact of Climate Change
In 2016, the U.S. Global Research Change program undertook a climate health assessment that was subsequently published and released by the U.S. Environmental Protection Agency (EPA). 12 In this model, climate change drivers (increased temperatures, changing weather events, changes in precipitation, and sea level rise) interact with environmental, institutional, social, and behavioral contexts to directly influence population level health and mental health outcomes. 13
We know that environmental justice communities already bear a disproportionate burden from environmental hazards 14 ; this report acknowledges how climate change can have compounding effects on groups that are already at risk, especially those who live with poverty, racial segregation and discrimination, or other socioeconomic vulnerabilities. At-risk health groups include persons with pre-existing medical conditions, including disabilities, older people, pregnant women, and children 15 , 16 ; these groups tend to also have difficulty with mobility, rely heavily on social support networks, and require consistent medical treatment, all of which may be compromised by climate change-related social and environmental change.
Additional public health concerns are related to the impact of climate change on mental health. For those already seeking treatment for mental health issues, weather-related disasters can potentially interfere with or inhibit regular treatment or disrupt social support networks; furthermore, some medications used to treat mental illness can increase sensitivity to heat stress. 17 The sudden and destructive nature of natural disasters has been shown to result in increased posttraumatic stress disorder, anxiety, depression, stress, and substance abuse. 18 In addition, the loss of livelihood may result in chronic stress (as a result of changes to work, living situation, or the exacerbation of chronic disease), for example, an increase in suicide rates after drought has been noted in farming communities across India. 19
More indirect impacts include feelings of generalized anxiety, hopelessness, and helplessness. After a climate event or resulting displacement, people may experience a diminished sense of self, difficulty relating to others, diminished social interaction, and a loss of connection to community. 20 For natural disasters in particular, social workers are often first responders, providing psychological first aid and immediate assistance with basic needs; social workers also work with affected communities to build social capital in response to and in preparation for natural disasters. 21
Environmental Justice and Health in Caribbean Communities
Small islands and SIDS, including those in the Caribbean, possess characteristics that make them especially vulnerable to effects of climate change, sea level rise, and extreme events. 22 Some of these characteristics are limited size, proneness to natural hazards, and external shocks; in most cases, SIDS also have low adaptive capacity. 23 Sea level rise is expected to exacerbate inundation, storm surge, erosion, and other coastal hazards, thus threatening vital infrastructure, settlements, and facilities that support the livelihood of island communities. 24 There is also strong evidence that climate change can impact negatively on water resources in small islands; most islands have limited water supply leaving them vulnerable to reduced rainfall coupled with rising seas. 25 , 26
The public health concerns already noted may be exacerbated in SIDS, in this article we highlight some environmental justice concerns related to climate change in two Caribbean nations: Jamaica and Barbados. Although both island nations may be vulnerable to climate shocks and share similar characteristics, they have recently experienced unique impacts.
Jamaica: environmental justice and health in rural communities
Jamaica is a country of ∼2.7 million residents and about half of the population lives in rural settings. Tourism accounts for most of its gross domestic product and the fragile ecosystems of the coast represent both ecological and economic resources. Since the 1990s, environmental issues in Jamaica have been identified as including deforestation, coastal ecosystems degradation, pollution in the air, land, and water, bauxite mining, and overexploitation for the sake of tourism. 27 Like other small island nations, Jamaica is particularly vulnerable to climate change and environmental impacts for a number of reasons. As an island with miles of coastal landscape, it is vulnerable to rising sea levels and severe weather events; these risks are predicted to increase with climate change. 28
In addition, like many other Caribbean nations, the economy of Jamaica relies on tourism, compounding economic impacts from changes to the geography of the island. Furthermore, developing nations such as Jamaica may have limited resources to respond to environmental damage, relying heavily on foreign aid that may come with other obligations, including serving the interests of foreign investors over local community needs. 29 Two climate change-related areas of concern are discussed hereunder that are specific to rural communities but stem from environmental issues that affect the entire island.
Water rights
The mountains of northeastern Jamaica are rich with natural springs and water resources 30 ; however, accessing water can be difficult for local rural residents, and accessing clean water has been noted as a challenge in both rural and urban Jamaican households. 31 Water management policies may also prioritize the flow of water directly to the north coast and the tourism sector. Changing weather patterns, drought, and proposed mining in this area could all lead to water shortages and contamination, posing a significant public health risk. Access to clean drinking water has been cited as a major concern in the United States. 32 This is a social justice issue that impacts those with less political and economic capital.
The connection between climate change and the health and well-being of vulnerable populations may become most apparent in water shortages and conflicts over water access and availability. 33 Water security has been identified as a crucial issue in climate change planning and response 34 ; for example, the 2015 drought affected Jamaica's agriculture sector 35 and brought to light critical issues in the country's water system. 36
Mining versus agricultural use of land
Further concerns for mining in vulnerable Jamaican ecosystems have recently regained attention with multinational negotiations to expand bauxite mining in “cockpit country.” Cockpit country, so called because of the particular formation of the land, is the source for 40% of Jamaica's drinkable water and the water supply for much of the north coast. Home to six major rivers and countless indigenous flora and fauna, 37 the land is valued for its ecological diversity from a conservation perspective; the land is also used for local agriculture, primarily small scale farms for domestic consumption.
As water resources become scarcer and if island nations need to move from tourism to exploitation of natural resources, competition over land may intensify. Mining prospects converge with changing weather patterns, causing drought and intensified hurricane activity and can threaten both water and food (locally consumed agriculture), the economy of small rural areas, and potentially cause disruptions to social cohesion from displacement.
Barbados: environmental justice and health risks from the sea
Barbados is an Eastern Caribbean island with a population of <300,000. It is the most easterly of the SIDS and enjoys a tropical oceanic climate. In addition to exports of sugar and rum, Barbados economy also relies primarily on tourism. It is located at the edge of the Atlantic Storm Zone and is extremely vulnerable to storms and hurricanes. Barbados is already classified as a water scarce country, a further reduction in water due to changing precipitation patterns brought about by climate change may lead to serious water shortages and related health concerns. Barbados belongs to the top 20 of the world's most water scarce countries, where the competing demands for freshwater resources are increasing as it seeks to develop and grow its economy. 38 Water management and pollution of groundwater and surface water are issues that must be addressed as these resources strengthen sustained economic growth and development. 39
In addition, sea level rise on this small island has the potential to cause saline intrusion and changing weather patterns will adversely affect water supplies. Barbados has the highest rate of dengue fever in the Americas; changes in vector ecology due to increased precipitation or increased hurricanes and the displacement of water could increase the spread of mosquito-borne illnesses. The impacts of climate change on the natural and human environment are cause for concern as these are critical in terms of the sustainability of Barbados's tourism economy, 40 which is threatened by rising sea levels and beach erosion. Climate change and related weather events may lead to a strain on the economy in terms of preparing for and responding to events, for example, damage, insurance, interruptions, and back-up systems. 41
Sargassum invasion
In Barbados and elsewhere in the Caribbean (including Grenada, St. Lucia, and Tobago), a particular environmental health hazard has been the influx of Sargassum seaweed, which is believed to be directly caused by changing weather patterns and rising sea temperatures. Sargassum is a marine algae generally associated with the Sargasso Sea of the North Atlantic Ocean, made up of leafy appendages, branches, and round berry-like gas-filled structures that aid in buoyancy as it floats on the ocean's surface. 42
This seaweed, although beneficial in a balanced ecology, can wreak havoc on beaches and disrupt fishing vessels when it grows out of control, and the impacts on fish species, coastal fishing communities, and related economies cannot be underestimated. 43 The large quantities of Sargassum have already begun to cause major problems on the island to both the fisheries and tourism industries during the past several years beginning in 2014 and continuing as of this writing in 2018. 44 , 45 The 2014–2015 Sargassum invasion brought serious socioeconomic and environmental impacts to Barbados, including the forced closing fishing areas, impaired ability to operate fishing boats, and resulting effects on the livelihoods in the fisherfolk in these areas. 46
An Environmental Justice Approach to Climate Change in the Caribbean: Social Work Perspectives
“Fundamental to social work is attention to the environmental forces that create, contribute to and address problems in living” 47 and recognition of the physical environment's critical role in the socioeconomic sustainability and human well-being is rapidly growing among social workers 48 as is the acknowledgment that our work must be interdisciplinary and incorporate diverse approaches. 49 Social workers have long held important roles in responding to natural disasters, especially in the arenas of psychological first aid, crisis management, and longer term mental health impacts such as PTSD as well as in community building pre- and postdisaster. 50
The 2017 hurricane season was one of the worst in decades for small island nations including Dominica, Barbuda, and U.S. territories of Puerto Rico and the Virgin Islands. Mobilizing social workers on the ground to respond to structural, health, mental health, and basic needs using key social work skills of engagement, advocacy, and strengths-based practice 51 will be crucial in long-term preparation and response. Internationally, the United Nations' Inter-Agency Standing Committee has published IASC Guidelines on Mental Health and Psychosocial Input Support in Emergency Situations. 52 These guidelines are being used by countries as small and remote as Nepal to put into operation their disaster responses. 53
These guidelines can also be used in both Jamaica and Barbados in crisis situations. In response to effects on farming and fishing economies, as well as tourism-related economies, social work has been developing its strength in financial social work as well cross-disciplinary work in social entrepreneurship and sustainable development. Promoting sustainable agriculture, alternative economic models, and advocacy focused on adaptation, social work can address the new realities in a climate changed world. Recognizing mental health issues (especially anxiety and depression) that can surface as a result of structural and economic challenges is an important role for social work. There is a clear case for environmental justice with respect to SIDS in the Caribbean, especially with natural disasters such as hurricanes and earthquakes.
SIDS may experience rapid-onset and temporary events such as storms and flooding followed by land erosion and, importantly, the changes in the global water cycle. 54 For example, coral bleaching, saline intrusion, degrading ecosystems, species shift, habitat loss, climate-induced diseases, and casualties and damage from extreme events. 55 Consequently, if governments do not intervene at this critical juncture from an environmental justice stance, SIDS will not be supported in their quest to adequately survive in the near future.
Conclusion
As the planet warms, sea levels rise, and the geography and economy of small island nations in the Caribbean change and adjust, an environmental justice health-focused lens will be crucial for social workers and other community advocates. Challenges unique to the Caribbean include rising sea levels that will affect life, livelihoods, and local economies; changing weather patterns that can impact access to water and change farming practices and outputs; and specific vulnerability to extreme weather events such as hurricanes. Countries such as Jamaica and Barbados need to operate from an environmental justice stance as they address these challenges and social workers should play a major role in support of such a framework.
Footnotes
Acknowledgment
A portion of this work was supported by a Fulbright Scholar grant to the lead author. The views and opinions expressed in this presentation belong solely to the author and in no way reflect the official policy or views of the U.S. State Department or the Fulbright program.
Author Disclosure Statement
No competing financial interests exist.