Access to healthcare supports climate resilience everywhere, but especially in rural America

Salinas River near Greenfield, CA
© Jillian Gronnerud (2018)

Human health and environmental health are undeniably interdependent. Clean air and water, limited exposure to pollutants, a preserved natural environment, and adequate protection from occupational health and safety hazards are a few of the ways that robust environmental protection can support human health. As the effects of climate change become more visible and more severe, so too do the effects on human health and well-being. 

The World Health Organization's overview on environmental health tells us that climate change is profoundly affecting human health: natural disasters, infectious diseases, heat-related illnesses and death, effects on food production, migration, and economic instability are among the direct and indirect impacts. According to the WHO, more than 13 million people worldwide die each year due to modifiable environmental conditions. 

Zooming in on food production, climate change is already having major impacts on agricultural operations around the world. In the United States, impacts manifest directly as higher average air temperatures, changing precipitation patterns, and rising concentrations of atmospheric carbon dioxide. Indirectly, productivity is harmed by changes in disease occurrence and insect and weed populations. According to one USDA report, "research has documented cases where elevated atmospheric levels favor the growth of weeds over the growth of the crop species with which they compete." 

Taking a more nuanced look at climate change effects on the economics of US agriculture, the same USDA report notes that agricultural production is chronically vulnerable to environmental stressors (dry spells, insect damage, disease outbreak), making the added unpredictability of climate impacts unwelcome. In some cases, climate change effects render agricultural operations economically non-viable. 

In a March 2026 piece for Inside Climate News, Jordan Gass-Pooré interviewed a family farmer from upstate New York who stopped growing vegetables because "they were afraid extreme weather events would ruin their crops." Reflecting on the decision, Samantha Kemnah told ICN: "'We really enjoyed growing vegetables [. . .] [b]ut we couldn’t continue to commit to people, to raise food, and then have a hailstorm wipe it all out.'"

Photo Credit: US Department of Agriculture (2016)

A lack of formal, institutional support for farmers like Kemnah complicates the picture further. Diversified farms and smaller family farms face a lack of governmental support, in part because subsidies remain geared toward commodity crops and often come with a minimum base acre requirement. The result? Small family farms are hemmed in by stiff financial conditions and unable to access capital needed to run their business. Recent USDA research reveals that "[m]any farmers face steep hurdles to diversify their crop rotations. More diverse rotations may make management more complex and may require new equipment. Farmers may also need to learn how to grow new crops."

When farms like the Kemnah's are forced away from diversified crops and toward subsidized commodities, they are also driven away from crop rotation and other environmentally beneficial practices that could serve as part of the farm's climate change mitigation strategy. 

Cows in field near Duncan Mills, CA
© Lisa Pruitt (2025)

With a clearer picture of the impacts of climate change on US agriculture in mind, the remainder of this post will focus on one key aspect of the nexus between the environmental and human health. The basic argument goes – and research supports – that access to high quality healthcare might be one of the best preventative measures we can implement to promote climate resilience for American farmers, farmworkers, and the lands they live and work on. 

The recent Inside Climate News article by Gass-Pooré paints a picture of the current relationship between healthcare and those with agricultural livelihoods:

In the U.S., nearly half of rural residents, including farmers, are uninsured or insured by government-funded programs such as Medicaid or Medicare. Nearly one in four people under the age of 65 [...] have Medicaid coverage [...] Now, even this system is in peril as millions of Americans are expected to lose coverage as a result of pending changes and cutbacks to Medicaid [...] As a result, some farmers risk losing their lifeline and becoming uninsured. It would leave them even less prepared to do farm work and to tackle the oncoming impact of climate change. 

These dynamics suggest that healthcare access is not merely a social service for farmers, but a critical component of resilience, both at the individual and systemic level. Rates of work-related death for farmers are seven times the national average. Working in the elements, with heavy equipment, and near chemicals mean that farmers face increased rates of occupational risks, injury, and chronic illness. Demanding work, economic instability, and isolation manifests in the form of mental health challenges at rates far higher than the general population (a 2021 CDC report shows a male suicide rate of 52.1 per 100,000 among farmers and ranchers, compared to 32.0 per 100,000 among male working-aged adults across all occupations).

Despite this risk profile, farmers routinely encounter barriers to care, including provider shortages, cost, and the associated prospect of medical debt.  In a 2022 study by Florence Becot & Shoshanah Imwood, researchers reported that 20.3% of American farm households had medical debt exceeding $1,000, and that 55 percent of these households were not confident they could cover the costs of a major illness or injury.

The concurrent loss of Affordable Care Act subsidies and challenging economic conditions means that health insurance will become outright unaffordable for many farmers. The decision then becomes whether to continue working and forgo coverage – a risky proposition in such a dangerous occupation – or to leave the industry altogether in search of a job that will provide health insurance.

By contrast, Gass-Pooré's article documents describes not-for-profit health plans in Germany, which are not tied to employment and strictly limit how much patients must pay out of pocket. These plans enable farmers to work full-time and "take advantage of reliable government support" as they implement farming practices meant to improve soil health and provide other climate mitigation benefits.

The situation in America is something else entirely. Gass-Pooré summarizes the current state of affairs: 

Climate change makes it harder to maintain a productive farm, health care cuts threaten farmers’ ability to work the land and cuts to the programs that could help with both mean their lives are more uncertain than ever. 

The connections between environmental health, agricultural viability, and human well-being are increasingly difficult to ignore. Climate change places growing strain on farmers and farmworkers, while structural barriers, from limited healthcare access to outdated and failing subsidy systems, compound their vulnerability. 

As this post has explored, improving healthcare access offers a tangible pathway to support both individual resilience and broader environmental outcomes. By treating healthcare as part of the infrastructure that sustains agriculture, policymakers can better equip rural communities to withstand climate pressures while preserving the systems that feed and sustain us all.