Print version by Lynn Bonner
Broadcast version by Nadia Ramlagan
Reporting for The Raleigh News & Observer - North Carolina News Service collaboration with the Pulitzer Center's nationwide Connected Coastlines reporting initiative

RALEIGH, N.C. -- Pamlico County, wedged between its namesake sound and the mouth of the Neuse River, is surrounded by water on three sides and is a target for hurricanes that sweep up the North Carolina coast.

In 2011, Hurricane Irene ​made landfall near Cape Lookout and dropped more than 17 inches of rain over part of Pamlico County. Flood waters inundated Pamlico County homes, including those in Vantisha Williams' old neighborhood.

When the floodwaters receded, mold growth followed. And that, Williams believes, triggered her daughter Nazri's asthma. Nazri was then 3 years old.

"I remember making sure her nebulizer machine wasn't wet," Williams said.

Breathing problems and asthma medications are constants in the life of her family, which now includes twin 4-year-old sons Jonathan and Jeremiah. After storms, everyone starts coughing, she said.

"The humidity, the debris everywhere, the wetness, it could be making the asthma worse," Williams said from her Bayboro home. Health problems also are compounded by storm-related power outages that prevent the children from getting their breathing treatments.

In Eastern North Carolina, more people make trips to hospital emergency departments for asthma treatments than in any other part of the state, say researchers at East Carolina University. The researchers have been focusing on the connection between climate change and asthma, a chronic inflammatory disease, in the eastern counties.

A study of asthma-related emergency room visits from 2010-2014 found that, as a group, eastern counties had the highest rates of hospital emergency department visits, compared to Piedmont and western counties. More than 90% of emergency department visits were from rural counties, according to the research published in the North Carolina Medical Journal in 2018.

Asthma-related emergency department visits trended up in eastern counties over the five years, while they were largely flat in the Piedmont and trended down in the west.

Greg Kearney, an environmental health professor and one of the paper's authors, said in an interview with The News & Observer that mold growth in the aftermath of flooding is part of the problem.

"There's no doubt that is a huge asthma trigger," he said.


Climate Change Affects Mold, Asthma Patients
Housing, air quality and other environmental factors contribute to ill health. Kearney said the connection between climate change, severe hurricanes and asthma in eastern North Carolina is being discussed a lot more since Hurricane Matthew in 2016, Hurricane Florence in 2018, and Hurricane Dorian in 2019 drenched North Carolina.

"Indirectly, climate change is impacting asthma through flooded homes and creating housing problems that people can't afford to fix," he said.

"When things start to heat up, that's when the mold really takes off. People who have allergies or asthma really suffer the most."

The North Carolina Climate Science report produced last year said it is very likely that hurricanes hitting the state will bring heavier rains. All that rain, in turn, will increase the likelihood of freshwater flooding. The North Carolina climate scientists report said continued sea level rise is virtually certain. Higher sea levels and extreme hurricane rains will increase storm surge flooding.

Preparing for and picking up after hurricanes is a part of life in Pamlico. Pamlico High School sports teams are called the Hurricanes and business signs point to Hurricane Barber and Hurricane Boatyard. The Neuse River and creeks that attract boaters and recreational fishers to Pamlico are the waters that threaten homes and health in storms.

"We're surrounded by creeks," Williams said. "All of that starts to rise when the surf comes in. That's basically what floods us."

Pamlico has lots of older houses, Williams said, and even when water doesn't rise high enough to get into living spaces, it seeps in underneath. "It just kind of sits," she said.


Other Environmental Factors

But the region is also rife with other environmental factors that trigger asthma.

The North Carolina Climate Science Report says absolute humidity will increase as the climate changes. Humid air can be an asthma trigger.

Researchers from the Centers for Disease Control and Prevention and Georgia and North Carolina universities looked at connections between air quality and asthma deaths among North Carolina children. Between January 2001 and the end of 2016, 81 children from age 5 to 19 years old had asthma as their primary cause of death, researchers found. They reported a connection between high humidity and those asthma fatalities.

They also looked at percent relative humidity across three ranges. At the highest range, 81.2% to 95.9%, they found that each percentage increase in relative humidity was associated with a 16% increase in the odds of fatal asthma. Fifty-four percent of the children who died were boys, and 82% of the children who died were Black, the Georgia and North Carolina researchers found.




Kearney's research says that eastern counties with the highest asthma rates were also the poorest counties with a high proportion of Black residents.

The shock from the historically wet and destructive hurricanes of a few years ago may be fading for inland residents, but many people in coastal counties continue to live with the after-effects.

Randolph Keaton, executive director of Men and Women United for Youth and Families, said his organization is still working with families to get hurricane-damaged homes repaired. The non-profit helps people in Bladen and Columbus counties with Hurricane Florence disaster relief.

The COVID-19 pandemic has slowed home repairs.

"We still have roofs that need work," he said.

"With COVID and these houses still damp, then with weather like this that's so hot and humid, the crawl spaces in these houses are terrible," Keaton said in an interview with the N&O this summer. "It really creates for poor people a double whammy."

Keith Graham is a senior case manager at Men and Women United working with families in Bladen and Columbus on home repairs. A dozen people still have mold problems, some of them severe. A problem with getting work done is that the mold remediation costs more than half the home value.

People with respiratory problems are living in homes with visible mold, Graham said.

"It's in the attic, there's mold in the walls, under the house," he said.

In another home, a child is living in a home with a recurring mold problem, Graham said.

"They've done several things to treat it. It's still there."

Limited housing options and pandemic restrictions this spring and summer meant to encourage people to stay at home meant some families were trapped in houses that were making them sick, he said.

"Before, they were busy. Now they're stuck at home and it's even more depressing," Graham said.

'The Smell Was Unbearable'

Hurricanes Matthew and Florence drove Shalonda Regan and her family from their home in South Lumberton after Hurricane Matthew in 2016 brought historic flooding to the Lumber River. Water inundated neighborhoods that had not been flooded in previous hurricanes, including Regan's.

Regan, who works for a nonprofit after-school program, said three feet of contaminated water flooded the split-level home.

"It was like a really bad, brownish-red color," she said. "The sewage had come in. The smell was unbearable. Those were conditions I couldn't be in."

FEMA had deemed the house livable because the upper level of the split-level house wasn't flooded. Regan said she couldn't live there because the mildew triggered her asthma.

She lived in her mother's boss's unoccupied apartment for a month, she said, before she was able to move back home.


Two years later, Hurricane Florence dropped more than 22 inches of rain on parts of Lumberton, flooded the river and damaged hundreds of buildings in Robeson County.

Hurricane Florence didn't do as much damage to the family home, Regan said. About a foot of water came in, and she didn't have to stay away from the house for as long.

Regan said her asthma has improved, though she still carries an inhaler.

Months after Florence hit, Vantisha Williams' boisterous sons were still fighting back-to-back asthma flare ups. Her daughter complained of constant headaches.

You can tell by the smell when major flooding has hit Pamlico, Williams said.

"Even though the storm passes, that water is still around," she said. "It smells different around here. It's just a stench. Then you have the sewer water come up. It's just a lot. Some people lived in their houses after they were wet. They didn't want to leave their houses and they didn't have any place to go."

This story is part of the Pulitzer Center's nationwide Connected Coastlines reporting initiative. For more information, go to pulitzercenter.org/connected-coastlines.

This story was produced with original reporting from Lynn Bonner for the Raleigh News & Observer, with support from the Pulitzer Center on Crisis Reporting.

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Wet weather this spring has improved drought conditions in Minnesota and southern Canada. However, experts remain on alert for increased wildfire activity and other climate changes affecting people's health.

Poor air quality was a frequent topic last year in the upper Midwest, as smoke pushed down from Canadian wildfires. Researchers said climate change is fueling hotter and drier summers, making forests more susceptible to large fires.

Dr. Bruce Snyder, co-founder of Health Professionals for a Healthy Climate, worries about a repeat summer of thick, hazy smoke in the air creating unhealthy conditions.

"When that happens, people have more respiratory disease; people who have chronic lung disease tend to get sicker," Snyder explained. "There's a lot of downstream consequences for people all over the world, but certainly here in Minnesota."

Snyder noted the transition to cleaner energy sources is complex, but acknowledged pollution events place more emphasis on the need for less reliance on fossil fuels, due to their contributions to a warming planet. The Minnesota Pollution Control Agency said the state has had 46 air quality alerts since 2015, and 34 of those were because of wildfire smoke.

Snyder emphasized it is not just air pollution from wildfire smoke to worry about. He pointed out there are other ways a person's health can suffer from climate change.

"We've got many more dangerous insects -- ticks, mosquitoes, and so forth," Snyder stressed. "This is having a profound effect on our wildlife. But also, we're seeing a lot more progressively rising rates of Lyme disease, of West Nile virus."

Year-over-year statistics may vary, but state health officials say the median number of Lyme disease cases has risen in the past decade. Snyder added adverse health effects of climate change can be much harder for populations lacking stable housing.


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Conservationists in Maine said reinstated protections of the Endangered Species Act could help wildlife already struggling to adapt to climate change.

Economic impacts will no longer be considered when listing certain species as threatened or endangered but the threat of climate change will be a factor.

Anya Fetcher, federal policy advocate for the Natural Resources Council of Maine, said so-called "blanket rule" protections will also be revived.

"This is basically, while they are considering whether they should become endangered, they're going to continue to protect those species as if they were," Fetcher explained.

The Trump administration removed protections for threatened species along with other key aspects of the law. Fetcher acknowledged the new rules are likely to be challenged by Congress similar to other climate and environmental regulations.

Conservation powers will also be extended to federally recognized tribes, allowing them the same opportunities to protect wildlife, including some of Maine's most iconic species such as the piping plover and Canada lynx, which are losing critical habitat to development and a changing climate.

Fetcher pointed out one-third of Maine's species are vulnerable to climate change, including more than half the state's birds.

"Our wildlife is part of what makes Maine so special," Fetcher asserted. "Protecting critical habitat and the incredible wildlife that we have here is vital to our economy as well."

Fetcher added the Endangered Species Act has been helpful in protecting species such as the bald eagle, once on the brink of extinction but now a common sight in Maine. Nearly 500,000 public comments were considered in the new rule-making process.


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PacifiCorp's updated energy roadmap throws a lifeline to Wyoming's coal industry but critics said the new Integrated Resource Plan is a major setback for community health and the climate.

Rob Joyce, director of the Wyoming Chapter of the Sierra Club, said the plan would add 100 million metric tons of climate pollution by 2042. It also slashes near-term investments in cheaper wind and solar, and makes a huge bet on behalf of ratepayers to install unproven and expensive carbon capture devices on existing coal-fired power plants.

"To be increasing emissions, increasing investment in fossil fuels, and putting hundreds of millions if not billions of dollars towards carbon capture when we're not 100 % sure if that is actually even going to work is really dubious," Joyce argued.

PacifiCorp, the parent company of Rocky Mountain Power, plans to extend the life of the Jim Bridger coal-fired power plant in southwestern Wyoming until 2039. The plan also pushes back the retirements of Utah's Hunter plant by at least 10 years, and the Huntington plant by at least four years. PacifiCorp said it should deliver significant near-term cost savings to ratepayers.

The plan also added more natural gas to PacifiCorp's energy portfolio. Joyce worries Wyoming ratepayers, already tapped by state lawmakers to pay millions for a carbon capture compliance surcharge, will end up on the hook.

"We're going to have to cover the costs of the volatility of new gas resources," Joyce pointed out. "The company is saying between $500 million and $1 billion per unit that they put carbon capture on. Those are all things that they pass on to the ratepayers."

Joyce noted with a looming 2030 deadline to significantly reduce fossil fuel pollution in order to avoid the worst effects of climate change, now is the time to invest big in wind and solar. He added by delaying the expansion of clean energy resources, PacifiCorp is leaving billions of dollars in Inflation Reduction Act incentives on the table.

"Right now we know that solar and wind and even battery storage are cheap and getting cheaper," Joyce emphasized. "Those are investments that the rest of the country is making to save ratepayers money."

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