Climate Change, Social Determinants of Health, and Climate Justice in Vulnerable Populations

Conclusions

• Climate change-related health harms are not distributed equally, but are amplified by social determinants such as poverty, racism, housing conditions, education, and limited access to care.
• Atopic dermatitis provides a clear example of how observed racial differences in disease burden are largely shaped by social and environmental disadvantage rather than genetics alone.
• Environmental exposures such as air pollution, wildfire smoke, temperature extremes, low humidity, ultraviolet light, and indoor irritants can trigger or worsen atopic dermatitis and other atopic diseases.
• Even when overall pollution declines over time, disparities in exposure and pollution-related mortality can persist or widen across racial and income groups.
• People in vulnerable communities often recognize their own higher climate-related health risks, especially when they live in flood-prone areas or have chronic illness and fewer resources.
• Achieving health equity requires valuing all people equally while deliberately addressing historical and contemporary injustices that create unequal health outcomes.
• Clinicians can contribute to climate justice by documenting environmental triggers, connecting symptoms to real-world exposures, and making upstream harms visible in the medical record.
• Targeted local investments in disproportionately affected communities can improve outcomes, as shown by asthma-focused HEAL initiatives that improved control, confidence, attendance, and health care use.
• Equity-centered leadership development and community-partnered training programs are important for building durable, locally informed solutions.
• Health systems and clinicians can also advance climate justice through advocacy, civic engagement, patient education, and broader efforts to reduce emissions and strengthen resilience.