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Uncovering a Hidden Epidemic: How Postgraduate Fellows Investigated the CDC

June 17, 2020

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As Covid-19 dominates headlines, another public health hazard stands to quietly claim thousands of American lives in coming years. Extreme heat leads to 600 to 800 preventable deaths in the U.S. each year, with heat-related hospitalizations on the rise in multiple states. Federal research suggests heat-related deaths will grow to tens of thousands a year by the end of the century.

Heat is just one of many health hazards increasing as the result of climate change, including floods, fires, mosquito-borne illnesses and drought. Ten years ago, the Centers for Disease Control and Prevention launched its climate change program to address these climate-driven health risks through the targeted support of local health departments. However, a year-long investigation by Columbia Journalism Investigations published Tuesday in collaboration with the Center for Public Integrity finds that a lack of funding, limited expertise and political resistance have rendered the program largely ineffectual since its inception.

The investigation represents more than a year of work across two classes of Columbia Journalism Investigations (CJI) fellows. Here, the current fellows Elisabeth Gawthrop, ’18 M.S. Stabile; Veronica Penney, '19 M.S. Data, and Dean Russell, ’19 M.A. Science, tell how they investigated the CDC for "Hidden Epidemics."

How did the investigation originate?

EG: [Former CJI fellows] Bridget [Hickey] and Ali [Raj] started the story about 16 months ago, but the idea came from another story Kristen Lombardi had done about ticks spreading in Maine a couple of years back.

DR: Maine happens to be one of the states that receives the grant through the CDC for climate change work. One thing led to another, and she wanted to look more deeply at what the CDC program is and what other states that get money for climate-related hazards are working on. As investigations go, it then spiraled into something new.

Where did your team enter the picture?

DR: Bridget and Ali had done about six months of work off-and-on looking into the CDC. They filed FOIAs and established some of our main sources early on. Our job was to then pick up the pieces, put them all together and do some heavy lifting in the individual states, and figure out the narrative arc.

EG: We had to bolster up the reporting. We had to get it really tight and seal it, as well as add in an element of understanding what was happening more on the ground with people experiencing climate impacts and what the state health departments were doing with the federal money in more detail.

digital thermometer reading 120
As part of the investigation, CJI collaborated with environmental epidemiologist Robbie M. Parks to link an increase in heat deaths to rising temperatures in Arizona. (AP Photo/Matt York)

What did that reporting process look like?

DR: We interviewed more than 150 people, including public health experts, White House officials, former and current CDC officials, a lot of scientists, a lot of public workers and a lot of everyday people living in hot places.

What kind of data collection and analyses went into the reporting?

EG: To give one example, Ali had obtained a lot of autopsy records from Arizona of people who had died from heat. My first week, I started reading them trying to understand how the medical examiner determines that someone died from heat. You can’t get someone’s full story from an autopsy, but you can get glimpses into it. There were a lot of people who were isolated in their homes or whose air conditioning had gone out. We ended up selecting some of those to report out and selecting some to contact the families to give a human face to the story.

We also took those records and pulled out data: details about their air conditioning status and the temperatures at which they were found. I ended up creating a database with that data, which Veronica turned into a visualization in the story.

dot visualization of heat deaths
Gallery: CJI fellows used data analysis and visualization skills gained at the J-School to tell the story of their findings.
graph of heat waves
Gallery: CJI fellows used data analysis and visualization skills gained at the J-School to tell the story of their findings.
graph
Gallery: CJI fellows used data analysis and visualization skills gained at the J-School to tell the story of their findings.

How did you manage such a complex reporting project, particularly one inherited from another set of reporters?

DR: We decided pretty early on that we would focus on different aspects of the story, like the CDC and what was going on at the federal level. We also split up the states so I spent a lot of my time focused on Florida, Elisabeth focused on Arizona and Veronica focused on North Carolina.

Working on a project this size required some serious organizational skills. We have a very thorough Google drive, a master spreadsheet of quotes, summaries of all the interviews...

EG: We did a timeline. It’s something like 30 pages long. It’s a tricky balance of having enough summary documents so that you can find what you need and not spending all your time doing that.

What challenges did you encounter in the reporting process?

EG: I had a tough time finding families of people who had died from heat in Arizona. There are different populations of people who are vulnerable to heat: outdoor workers, factory workers, student athletes. In Arizona, we focused on the elderly and the homeless. In a lot of cases, these types of victims were very isolated, so there wasn’t a lot of media coverage of their death or people advocating for change. I was knocking on doors and meeting with advocates. It was much harder to find these stories than I expected.

The nice thing about when you actually get them is that they’re often stories that are underrepresented in the media. I’m glad we were able to get some of them told.

DR: One challenge about reporting on this program is that it’s very small. It's not like you're doing an investigation of a giant corporation where there are a lot of people you can try talking with. This program had such a small number of staff members if you didn't get them to talk, you might not get your story.

This was a challenge for me in Florida. The climate team there was really just like two people plus a couple of part-timers. The former program manager had had bad experiences with journalists and she wasn't keen on becoming a whistleblower, so to speak. She was crucial for understanding not just the story in Florida, but the overall story. Getting her comfortable with speaking with us took months.

Our reporting shows that climate is already impacting health. It’s not just a future problem. We don’t have a handle on it now.
Elisabeth Gawthrop, '18 M.S. Stabile

How hard was it to get the information you needed from government officials? What advice can you share with other reporters on talking to insiders?

DR: It really depended. I took a trip to Atlanta to interview people in the CDC, and the bulk of that trip was just driving around door-to-door trying to convince people to talk to me on the spot because I had already tried through emails, LinkedIn, phone calls — even handwritten letters. I got a lot of doors slammed in my face. It was a learning experience.

Sometimes it was just luck, sometimes it was just getting someone on the phone and letting them know you were there to listen to what they had to say, that you didn’t already have the story in your head and weren’t just a reporter on a deadline. A lot of it was just being as human as you can.  

EG: Ali and Bridget had done a lot of public records requests at the state level. So we had all these documents detailing the programs in the states. Having that information in hand can sometimes help in getting an interview with an official, and having those documents definitely helped us understand the programs when it was difficult to get officials on the phone.

VP: One thing I found that was helpful in proving that you’re not just there to get a story was instead of saying like, “I’ve found this…” or “Someone told me that you’re doing this wrong…” it was helpful to show that you understand the different struggles and constraints that they’re working under and that you’re willing to hear the whole story behind it.

What do you hope the impact of this story will be?

VP: Before reporting on this, when I thought about climate change, I thought about mitigation and not adaptation. That there are actual impacts happening in the United States as the result of climate change was not something I thought critically about very much. I hope to see more people thinking about the issue and how to solve it.

DR: I hope what our story shows is that there are people who care about this subject and are trying to work and just don't have the resources to prepare Americans for the impending impact. Hopefully we might see some change, we might see more investment in this issue and more awareness of the fact that climate really does have a significant impact on health, and it will continue to be the case and get progressively worse in the future.

EG: Our reporting shows that climate is already impacting health. It’s not just a future problem. We don’t have a handle on it now. Health officials like to say that every heat death is preventable, and while there may not be as many deaths as for things like the flu, not even one heat death should happen. I hope the story shows that we could be doing more now, and that action will only help us with the impacts that are expected in the future.

Read more: The full investigation and analysis on rising heat deaths in Arizona were published by the Center for Public Integrity. Versions of the story were also co-published by The Guardian and The Nation.

The Beat is an interview series with the J-School's postgraduate fellows that educates the public on how deeply reported investigations are made. Read previous installments:

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