This is the first in a series of four stories about how changing weather patterns are and will affect the Black Belt.

Much of West Alabama’s rural Black Belt is beset with long-standing poverty, poor health, deteriorating infrastructure, suspect water quality and the mental and physical stresses that accompany those conditions.

Climate change is making those problems worse – or at least harder to overcome – and that effect is projected to increase in the coming decades. Increasingly higher temperatures year-round are bringing more extreme and violent storms, heavier rainfall and extended periods of drought.

The threats are clear, scientists almost universally agree. Disease-causing organisms thrive in warmer weather. Increased flooding causes already inadequate sewage treatment systems to fail as well as damaging streams and rivers with greater sediment and fertilizer run-off. Stronger tornadoes tear up the landscape and homes and terrorize the population.

What made the Black Belt different?

Almost two centuries ago, plows overturned the rich earth of the diverse, tall-grass prairies in the Alabama Black Belt to create the plantation culture based on a single crop, cotton. The act, together with the import of slaves from Africa and the Caribbean, transformed the region into an economic powerhouse for the next 150 years – until the soil was depleted and eroded. Since then the land in many cases has been given over to pine trees, cattle ranches, catfish ponds and a patchwork quilt of soy and corn fields.

When the one-crop economy disappeared and the tenant farmer system ended, much of the population migrated from the region, leaving behind a narrow range of counties across the state’s midsection that have some of the poorest health and lowest average incomes and rates of health insurance in the state and even the nation.

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“We worry a lot about the health of the very young and the very old in that kind of scenario,” said epidemiologist John Higginbotham.

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Climatologists predict the typical upper-90s summer heat in Alabama will average above 100 degrees Fahrenheit within a few decades. What will that do to a human body that labors outside in the sun or lives inside without air conditioning? Heat illness, including heat stroke, is expected to increase, a situation made worse in places that lack nearby medical services, experts say.

John Higginbotham, an epidemiologist at the University of Alabama, said, “I don’t remember growing up with so many 100-degree temperatures as we have now. That has an effect on people with heat-related illnesses and cardiovascular failure, both from the heat itself and from the poor air quality and worsening air pollution that comes with it. And the heat will negatively affect people who don’t have ways to cool their homes. We worry a lot about the health of the very young and the very old in that kind of scenario.”

Extreme weather also has a mental health impact. “We are still seeing post-traumatic stress disorder and anxiety in people who have experienced the Tuscaloosa tornado of 2013 or similar disasters,” Higginbotham said.

Higginbotham’s specialty is in health disparities, particularly in rural areas such as West Alabama. He sees multiple health problems resulting from climate change factors.

“If you’re a poor family in the country, much of your daily food and maybe your income comes from your own garden,” he said, “but some crops won’t be able to survive the hotter weather we expect, and your nutrition and finances will suffer from it.”

For those without gardens, their towns can be a food desert. Uniontown lost its Piggly Wiggly grocery and hasn’t had luck at recruiting another store. It’s about 30 miles to the closest Walmart. Thomaston (pop. 400), in Marengo County, is luckier. Dave’s Market opened in an old high school gym but is the only real grocery store for miles around.

Higginbotham pointed to access to health care as a major, seemingly intractable problem.

“We have a physician shortage in rural areas, and we have fewer hospitals, and emergency services may be farther away,” he said. “That means they don’t have ready access to the care they need to deal with the health effects of climate change.”

Black Belt counties have fewer primary care physicians, dentists and mental health providers per resident than other counties, a study by the Black Belt Action Commission shows. This makes it more difficult for someone who suffers a heat stroke, for example, to get emergency help and harder for someone with diabetes or other chronic conditions to find regular health care.

They also tend to have the highest rates of uninsured people, making it less likely they will seek health care when necessary.

In addition, more than 20% of people live in trailers or other manufactured housing vulnerable to the more severe storms expected to come with climate change. In Alabama as a whole, 13% live in such homes, compared with under 6% in the U.S.

Heavy clay blocks absorption of water and sewage. Third-world diseases may result.

The particular soil of the western Black Belt compounds the effect of flooding from storms expected to be supercharged by higher temperatures. The region’s clay-heavy topsoil over an impervious base of weathered limestone known as Selma chalk cause increased pooling of storm water in some places and heavy run-off into local waterways.

Pockets of inadequate or unrepaired sewage systems plague the area’s difficult-to-drain soil and invite the growth of pathogens and disease vectors such as mosquitos in standing water after floods.

With warmer weather, mosquito-borne diseases such as the Zika virus may emerge from the tropics into temperate zones of the United States. Zika was found in Florida in recent years and caused public health officials to be on alert in Alabama. Warmer winters and earlier springs also affect migration patterns of birds that host West Nile virus, which also is spread by mosquitoes.

The World Health Organization has reported that climate change will cause a greater frequency of infectious disease epidemics following floods and storms.

For people not connected to municipal sewer systems, the alternatives are the installation of costly septic tanks, which is problematic in the dense clay soil, or piping sewage straight into backyard gullies or nearby streams, an invitation to poor water quality and to third-world parasites such as hookworm. In Wilcox County, about 60% of homes lack adequate plumbing. A University of Alabama at Birmingham study is being conducted to determine the presence of intestinal parasites in the Black Belt.

Uniontown, in Perry County, is infamous for the woes of its lagoon-spray field wastewater sewage system, which barely has the capacity to cope with waste just from the town’s large catfish processing facility, much less what comes through broken and leaking residential sewer pipes. For years, runoff from the spray field has overflowed into local creeks and adjacent property.

Last year, emergency overflow pipes were installed and federal funding to go toward a new system was announced, but the system still awaits a permanent solution, according to Ben Eaton, president of the Black Belt Citizens Fighting for Health and Justice.

“With heavier rainfall and flooding coming with climate change, together with neglected sewer pipes, it does create a potential health problem,” said Eaton, whose group sponsors local health fairs so people can “stay ahead of the possibility of health problems.”

Higginbotham said other health problems can be brought about by warmer weather. “Armadillos used to be far west of us, but you see them now and they carry diseases, such as leprosy, which we aren’t used to dealing with,” he said.

Agreement Weather Is Changing

The weather, farmers and ranchers say, is always changing, if due only to natural cycles of 10,000 years or more. We’ve had extreme climate changes before – think of the Dust Bowl – and someday we’ll be faced again with months or even years of little precipitation, according to the state’s official climate scientist.

Virtually all climate scientists agree there is a cycle, but they attribute changes in recent decades to increased atmospheric carbon and other emissions traceable to human hands. They are alarmed by the sudden, hockey-stick-shaped, parallel trends in emissions and temperature since the heightened manufacturing activity that began with World War II.

People who live close to the land in rural Alabama, and especially those who depend on the farm, pasture and forest land for their living, are among the first to see, and eventually acknowledge, that the changing climate presents a challenge that must be dealt with.

Alabama House of Representatives Minority Leader Anthony Daniels of Huntsville wrote an op-ed last year that said people who live in the rural areas “recognize the real danger presented by climate change and support the need for practical solutions to counter the threat.”

What practical solutions lie ahead for Alabama? Most state and local government officials continue to deny that climate change exists or that humans have a hand in it. Or they do not have the political will to speak up about it.

Some pressure comes from grassroots efforts of environmental and other organizations, such as Eaton’s group, which works with the Black Warrior Riverkeeper and other health and water-quality advocates. Environmental justice nonprofits, such as the Southern Environmental Law Center, have climate-change on their agenda.

But there is no climate-change study committee in the Legislature, for example, and the big lobbying organizations that control most political activity – such as the Alabama Farmers Federation and the Business Council of Alabama – have been slow to respond to the potential danger of warming weather.

More Stories coming this week:

Monday: Audubon Study Finds Warming Climate May Be Inhospitable to Alabama State Bird

Tuesday: Wood Pellet Plants in Job-Hungry Southern Towns Prompt Environmentalists’ Warnings

Wednesday: Cattle, Catfish, and Cover Crops. Alabama Farms Play Role in Slowing Climate Change