Starting the Conversation

The Western North Carolina Health and Climate Working Group is engaging public health leaders in climate change action.

Mickey Snowdon
Oct 31 · 6 min read
Photo by Hush Naidoo on Unsplash

By Mickey Snowdon, Communications Liaison for The Collider

Climate change isn’t always obvious; in fact, it can sometimes be downright difficult to describe, especially when trying to explain its threats to human health. But this difficulty makes it all the more important to understand.

The Western North Carolina (WNC) Health and Climate Working Group is rising to this challenge by engaging local hospital and local public health agency leaders in conversation around the impacts of climate change on public health in the region.

Comprised of seven key partners specializing in public health practice, policy-making, nursing, science communication, spatial mapping, environmental modeling, and climate epidemiology, the Working Group seeks to provide solutions and co-benefits to building climate and health resilience in WNC.

Marian Arledge, Executive Director of WNC Health Network and one of the public health specialists in the Working Group, says the ambiguity of climate change is a major reason why more work needs to be done by climate advocates to effectively engage with local health care officials around this issue.

This urgent need is what is driving the Health and Climate Working Group.

Dr. Jennifer Runkle, an Environmental Epidemiologist at the NC Institute for Climate Science (NCICS) and the Climate Epidemiology specialist in the Working Group, says the Group is interested in examining how social determinants of health — particularly racial, ethnic and socioeconomic disparities — influence health patterns in vulnerable populations across the region.

Runkle identifies vulnerable populations as those who stand to be hit the hardest by climate change. She notes that these rural communities already lack the resources needed to fully adapt to external stressors like persistent poverty or high unemployment, and climate is no different.


WNC is a mostly (88%) rural region comprised of the 16 westernmost counties in the state. Although WNC is predominantly white, it also contains Hispanic, Latinx, and African American populations, as well as tribal members from the Eastern Band of Cherokee Indians. The region faces many challenges, including chronic health conditions, low socioeconomic status, and lack of education. Over 50% of residents in Western NC live in a rural, under-resourced county.

So where should the Working Group begin?

“One of our first steps will be to gather data from socially vulnerable populations such as veterans, the elderly, and infants and children within various WNC counties,” Runkle says.

But the Group won’t be starting completely from scratch in collecting this information. According to Arledge, WNC Health Network has nearly a decade of data on a variety of health indicators for every county in the region, including its most vulnerable populations.

“WNC Health Network has set the groundwork for our research already,” Runkle says. “Local health leaders have never had a better opportunity to engage in the climate science. They stand to be their communities’ greatest allies.”


A challenge, says Runkle, is that most WNC residents don’t realize that climate already affects them — or if they do, they’re not sure what to do about it. Her example is clear and direct:

“Climate hazards like extreme heat and flooding can impact peoples’ mental health and lead to maladaptive behaviors such as substance abuse. Further stress from climate change can exacerbate these health issues. Landslides can shut down roads, cutting people off from their jobs and impeding their access to food and medicine.”

Runkle says that another obstacle preventing local health care systems from introducing climate change planning into their agendas is their excessive workload. “Hospitals are just literally trying to save lives. Health departments are trying to get immunizations to treat life-threatening diseases today,” she explains.

Jennifer Powell, founder and Principal of Powell & Associates, brings a systems-based, human-centered approach to health care and the Working Group. Powell cites the politics surrounding climate change as an immediate barrier to initiating conversations around how climate impacts health.

She explains that discussing “extreme weather” rather than “climate change” helps her understand the physical and social risks posed to a community by a climatic event and target their needs.

“It’s so important that we meet people where they are,” Powell says. “And sometimes that means finding common verbiage to begin conversations.”


The Collider, a nonprofit member-driven network in the heart of Asheville, NC, provided the perfect setting for the Working Group. The idea began when Arledge spoke about the intersection of climate and health at an event hosted by Runkle. The two bonded over the subject, and WNC Health Network ended up hiring Runkle to analyze their regional public health data set through a health equity lens.

The Group blossomed from there, partnering with Western Carolina University, the University of North Carolina Gillings’ School of Public Health, Appalachian State University’s Department of Geography and Planning, and Buncombe County’s Health and Human Services Department.

Started at The Collider, the WNC Health and Climate Working Group is comprised of public, academic, and private organizations.

While Asheville provided the robust public health network needed to start the Working Group, the city is also a hub for climate science. In addition to The Collider and NCICS, Asheville is home to the National Oceanic and Atmospheric Administration (NOAA) and the National Centers for Environmental Information (NCEI) — earning it the title, “Climate City.”

These organizations, coupled with a community-wide movement to address health and climate inequalities, make Buncombe County the ideal pilot for the Group.


Powell says that a primary aim of the Working Group is to effectively communicate the health impacts of climate change within a narrative that moves beyond risk communication to one that enhances resilience and self-efficacy for communities in rural America.

“We’re trying to help communities help themselves in the face of climate change, and to get local leaders on board requires moving away from doomsday scenarios,” she says.

According to Powell, the Working Group will be able to provide the macro perspective that local health care systems need. Part of this, she says, is that the Group has the capacity that local hospitals and health departments simply don’t have.

Arledge points out that the Group is in a convenient position to collect and share various counties’ stories about residents who have been most affected by climate change already. These stories — and the hard data the Group plans to collect — will connect the dots between social vulnerability and climate change.


Integrating climate change into the realm of health care has the opportunity to provide a multitude of co-benefits. For example, Powell points out that hospitals are often major contributors of carbon dioxide (CO2) emissions due to the various wastes they generate and the large amounts of electricity they use for lighting and air conditioning. Co-benefits to a hospital reducing their waste and increasing their energy efficiency include both saving money and reducing their carbon footprint.

Another co-benefit to hospitals for incorporating climate planning is reduced or avoided recovery costs following a climatic disaster. The more that health care systems can preemptively consider threats that climate change may pose to their most vulnerable populations, the less they will have to pay to rebuild their infrastructure later on.

Most importantly, prioritizing the health of a community’s most vulnerable members in the event of a landslide, flood, or extreme heat incident can save lives — which is, after all, the number one goal of health care professionals.

The Collider Blog

Where climate stories are told.

Mickey Snowdon

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Writer | Grad student | Climate warrior | Outdoor enthusiast | Bibliophile

The Collider Blog

Where climate stories are told.