Chelsey Kivland, Dartmouth College – Climate Change and Health Care

Gaps in healthcare access for vulnerable populations are closing around the globe.

Chelsey Kivland, assistant professor of anthropology at Dartmouth College, examines how climate change could bust them back open.

As a cultural anthropologist, I strive to understand how and why people find meaning in power and conflict. I am fascinated by the way power is both feared and desired, contested and embraced, and the culturally unique ways in which people fight for as well as against the state and sovereignty–at the local, national, and global scale.

My past major research project focused on street politics and violence in a Haitian ghetto, and attempted to uncover the multiple and contradictory ways people compete for control over an area and for linkages with broader domains of power.

My current research project explores changing notions of citizenship, statehood, and the social contract through an ethnography of the transnational regulatory regime of criminal deportation, as manifested between the United States and Haiti. I have also written about carnival bands, graffiti, community activism, and the military in urban Haiti. I teach courses in the anthropology of violence, political anthropology, and Haitian and Caribbean studies.

Climate Change and Health Care

The international exchange of technology, expertise, and aid has recently contributed to dramatic gains in health care in many low and middle-income settings, especially around infectious disease. Globally, life expectancy is on the rise and both child and maternal mortality have been halved.

Yet, climate change threatens to undermine these gains. Climate scientists argue that climate change is increasing disasters, and disasters create wide-ranging health vulnerabilities in impoverished communities.

Our research and work in Haiti has illustrated the vulnerability gap posed by climate change even at a time when gaps in healthcare access are closing. A look at the toll of Hurricane Matthew in 2016 underscores the problem.

Poor infrastructure, proximity to coastal areas, and lack of disaster preparedness left thousands vulnerable to death and injury. However, the health impacts went far beyond physical injury and disruptions to health services.

The storm triggered spikes in cholera and other waterborne diseases, especially diarrhea, the second leading cause of death among children. An estimated 800,000 people suffered food shortages as the storm decimated fishing and farming villages. Over the long-term, such environmental destruction has exacerbated the population’s dependency on nutrition-poor processed foods, which are contributing to rising rates of obesity, heart disease, and diabetes—mirroring patterns across the developing world. 

Haiti teaches us that our own health is not bound up simply in the present decisions we make about health care systems but rather more broadly situated in the changing natural environment.

Debates about health care tend to center on attempts to limit or expand access to care. The impact of unraveling environmental protections and the Paris Climate Accord has received less attention. The case of Haiti highlights the need to reframe environmental policy as health policy.