EAST PALESTINE, Ohio — A freight train derailed in this small Ohio town in February 2023, about a quarter-mile west of the Ohio-Pennsylvania state line, sending plumes of toxic smoke and hazardous chemicals into the air. The event drew national attention and, for at least one Pennsylvania health executive, exposed a gap that had nothing to do with rail safety.
George Garrow, a medical doctor by training and CEO of Primary Health Network, Pennsylvania’s largest federally qualified health center, with a network of 46 community clinics, drove toward the scene before realizing he lacked training in environmental exposure care. “I realized I don’t know the first thing about what we were supposed to do to care for someone who may be exposed to an environmental pollutant,” Garrow said.
A gap in the system
Community health centers, also known as federally qualified health centers, aim to fill gaps in the healthcare system and provide care to underserved populations regardless of a patient’s ability to pay. A few months after the derailment, wildfires raging in Canada sent smoke billowing south into Pennsylvania, and Garrow recalled seeing people harmed by the dangerous air quality. He said the smoke was particularly impactful on under-resourced people, including those in poverty, with unstable housing, or with lower incomes.
Those two events sent Garrow on a journey. He began working with Pennsylvania State University and the Pennsylvania Department of Health to create a learning collaborative for environmental health.
The goal is to help primary care providers, particularly those serving vulnerable rural communities, create a more climate-resilient system by educating them about the impacts of weather and other environmental factors, known as environmental determinants of health.
What the data shows
As the climate warms, fueling more extreme weather, the previously hidden toll of these events is becoming more widespread. Pennsylvania is expected to continue to experience more extreme heat and flooding events, according to the state’s most recent climate assessment. Researchers are beginning to gather more data about how the uptick in extreme weather will affect people’s long-term health, sometimes in unexpected ways.
Kristina Brant, an assistant professor of rural sociology and demography at Pennsylvania State University, co-authored a paper published in July showing an increase in opioid overdose deaths following severe flooding events. She found deaths significantly increased in the one to two years following a severe flood and can persist up to a decade later.
Brant and her colleagues examined data from 2000 to 2017, looking at 11,744 overdose deaths in 219 counties across rural Appalachia, including 23 Pennsylvania counties. They estimated severe floods caused 1,368 of those overdose deaths. Brant said trauma is one of the key reasons.
“Even if someone didn’t lose their home, the flooding was a community-wide traumatic event,” said Brant. “People who work in treatment and recovery often teach people [with substance use disorder] to avoid triggers, but if a rainstorm was coming, it could make them think back to that traumatic flooding event.” Other factors also led to more opioid-related deaths.
The article originally appeared on Inside Climate News, a nonprofit, non-partisan news organization that covers climate, energy and the environment. Across the country, state officials say they’ve lost access to Forest Service grants to protect communities from wildfire, following a federal update to terms and conditions seeking to force agency partners to pledge compliance with President Donald Trump’s views on immigration, gender and DEI programs.
What to watch next: whether the learning collaborative Garrow helped build with Penn State and the Pennsylvania Department of Health expands its reach to more rural primary care providers, and how the loss of federal wildfire grants affects state-level preparedness efforts.
