Community Health Centers Responses to Climate Change: Implications for HRD

Abstract: Abstract
The Intergovernmental Panel of Climate Change (IPCC, 2022) revealed that the highest levels of greenhouse gas emissions ever recorded in human history occurred between 2010 and 2019, caused by burning fossil fuels and the uninhibited use of natural resources. The release of greenhouse gases from burning fossil fuels and rising global temperature has been linked to various negative implications for human health and well-being from heat waves and extreme weather events, increased air pollution, and food and water supply issues, amongst others (Centers for Disease Control and Prevention, 2022).
A growing body of experts have emphasized the importance of the healthcare sector in mitigating greenhouse gas emissions and adapting / building resilience to climate change to limit negative impacts to communities and effectively meet healthcare needs (Quintana et al., 2021; Ways and Means Committee, 2022). However, there is a dearth of research on climate change adaptation, resilience practices, and actions within the sector, with virtually no research within the primary healthcare setting or within the role of HRD in addressing individual and organizational climate change challenges in this setting.
Within the US primary healthcare setting, neighborhood health centers arose during the Civil Rights movement in 1965 as a demonstration program under President Lyndon B. Johnson’s Office of Economic Opportunity. Now known as community health centers (CHCs), these are non-profit and public entities that are governed by patient-majority boards. CHCs provide comprehensive primary, behavioral, and dental health services to 31.5 million patients annually across more than 15,000 sites, regardless of their ability to pay. The majority of CHC patients represent systemically marginalized groups, with 90% falling below the federal poverty line, 64% representing people of color or ethnic minority groups, and 41% being rural residents (The National Association of Community Health Centers, 2023).
Given their history, federal statute, and mission to provide primary healthcare services to systemically marginalized populations, CHCs are called to address climate change and environmental health issues, especially because their patients are most likely to be inequitably impacted. In fact, 63% of CHCs sites are located with communities that face socio-economic, climate, and environmental disadvantages (Council on Environmental Quality, 2022) caused by racist redlining, community divestment, and sacrifice zone policies. Additionally, CHCs are trusted in their communities, with primary care providers and nurses viewed as some of the most credible sources from whom to receive climate change information (Roser-Renouf et al., 2014). Finally, CHCs have a history of serving as first responders during climate-fueled emergencies, with news articles and reports noting CHCs roles during Maui and California’s recent wild fires and hurricane Maria in Puerto Rico, amongst others.
Despite recent attention about the need to prepare healthcare systems and infrastructure for climate change and other environmental impacts, there is evidence that CHCs are underprepared to address these issues (Ways and Means Committee, 2022). Therefore, the purpose of this poster session is to discuss the preliminary findings of a qualitative study using multi-case methodology designed to understand the organizational learning experiences of CHCs as they respond to climate change issues. To accomplish this purpose, the following two questions will be investigated: “How do CHCs describe climate change issues impacting their communities?” and “How do CHCs learn to address these climate change issues?” For the purpose of this study, CHCs that have been engaged in climate change initiatives for at least one year will be selected. Document reviews and in-depth interviews with key personnel responsible of these initiatives will be conducted. Data will be analyzed using thematic and constant comparative analyses. The conceptualization of this study was informed by organizational learning and adaptive capacity theories that reveal the factors, processes, and responses of how organizations learn to address climate change. The findings of this study will inform change agents and HRD professionals responsible for learning development in CHCs and within climate change initiatives, fostering their capacity to respond to these issues.
Keywords: Community health centers, climate change, HRD