Dr Tyler Evans on the Need for Better Health Equity as Climate Change Pumps Up Infectious Diseases

Dr. Tyler Evans is a physician, academician, and author who focuses on infectious diseases and how to curb them. The conversation begins with a basic question: What is health equity? It’s not equality. Instead, it is about access to health care. Dr. Evans has seen the lack of equity first hand, working in countries including Mexico and South Africa. Health equity provides the basics… care, medicine, and vaccines.

Domestically, he explains that half of the country cannot engage in effective health care. He discusses the plight of the colonias, substandard housing developments along the Texas-Mexico border, a forgotten population of two million people living on ranches without access to health care, even refrigeration. He worked with Native Americans on the Wind River Reservation in Wyoming where the average lifespan is only 53 years. He worked in Harlem and the South Bronx with brown and black populations. He worked for the AIDS Healthcare Foundation and served as the first Chief Medical Officer for New York City during Covid 19. In 2021 he co-founded the Wellness Equity Alliance to provide attention and resources to marginalized populations. He is based in Santa Cruz, California.

Dr. Evans’ academic career is impressive… beginning in earnest after earning his GED at age 17 and going to community college. He then went to University of Southern California, New York University, Columbia University, Tel Aviv University, SUNY Buffalo, and London School of Hygiene and Tropical Medicine. In the late 1990s he worked in South Africa where he witnessed the ravages of HIV and the social injustice of populations without access to health care. He was influenced by Doctors without Borders… leading to his works in Nepal, Haiti, Brazil, India, and other countries. He worked in war zones. In Uganda he was the only physician for 29,000 refugees.

His recent book, “Pandemics, Poverty, and Politics” presents the common threads at the root of health care inequities. These threads are like the trunk of a tree with branches manifesting different symptoms. Climate change is exacerbating the emergence of infection diseases that result from outbreaks of five types of bugs: bacteria, viruses, fungi, parasites, and worms. We have to live in a balance with them. The more we impact climate, “bugs get irritated” and communicable diseases emerge. Extreme heat and warming water in building cooling systems accelerates bacterial growth, notably, Legionella, a bacteria which vaporizes in AC systems. Flooding increases contamination of agricultural products with pathogens like cyclospora. Aging water and sanitation infrastructure cause higher rates of asthma and chronic disease.

While a sobering conversation indeed, Dr. Evans makes clear that he is a hard-wired optimistic. The pendulum will swing back: Inequities and poor leadership will wane. History demonstrates that civilizations will swing back in more favorable directions. We will find opportunities to work more effective with one another. And we need to: Climate change and diseases have no borders. We are all connected. Dr. Evans hopes that we come together, learn from unprecedented outbreaks to make a healthier and stronger Earth.