Jun 21, 2022 - Health

Extreme heat's health consequences

U.S. heat-related deaths per 100k people
Data: CDC National Center for Health Statistics; Chart: Kavya Beheraj/Axios

Extreme heat is increasingly taking a toll on children, pregnant people and other vulnerable populations, forcing authorities to roll out new strategies against an environmental threat that dwarfs floods, earthquakes and other natural disasters.

Why it matters: Summers are becoming deadlier as climate change blankets millions in heat waves whose public health consequences were until recently not fully understood.

  • “The problem with heat and drought is that until they get extreme, we don't really see the impact on the landscape that would typically trigger our risk response,” said Ashley Ward, senior policy associate at Nicholas Institute for Environmental Policy Solutions at Duke University.

Go deeper: Heat-related illness develops when the body can't sufficiently cool down or when a person’s temperature exceeds 106 degrees F — a point at which organs can shut down and people can become permanently disabled.

Between the lines: Social determinants of health like income and health literacy heavily factor in who's most at risk as heat waves increase in intensity, duration, and frequency.

  • In Miami, communities with less shade and more heat-retaining building materials that experience the worst impacts tend to have been "redlined."
  • A new CDC report detailed barriers older adults and other vulnerable residents in Maricopa and Yuma counties in Arizona faced accessing cooling centers, noting the disproportionate burden on the homeless, nonnative English speakers and communities of color.
  • Poverty also plays a role, with those unable to afford air conditioning, including mobile home residents, at increased risk of heat-related illness, researchers who mapped Miami's extreme heat map found.

What's happening: OSHA in April published new guidance that provides a framework for protecting agricultural workers and others who may experience sustained exposure to heat while on the job.

  • Federal inspectors could for the first time make unannounced visits to ensure workers are safe, per E&E News.
  • OSHA offices in parts of the Midwest that were swamped by a recent heat wave issued warnings to protect workers, including training on the hazards of heat exposure and having an emergency plan when a worker shows signs of heat-related illness.

Local response: More local health departments are preparing extreme heat plans for residential areas, targeting "heat islands" and directing messaging at the most at-risk locales.

  • "We created a whole toolkit that we're going to start alerting community organizations, talking about what we have available," Cheryl Holder, co-chair of the heat health task force in Miami, said.
  • Health officials also are enlisting local physicians and other providers in raising awareness about heat-related conditions.
  • In Los Angeles, the local health department partnered with a regional climate action collaborative to launch a social media campaign around the health risks of heat, said Elizabeth Rhoades, climate change program director at Los Angeles County Department of Public Health.
  • It's about "how to get people to think about the fact that the extreme heat their experiencing is linked to climate change," Rhoades told Axios.

Don't forget: Beyond the messaging, experts say extreme heat has consequences for local health care systems.

  • Heat-related emergency department visits in Los Angeles County have steadily increased in recent years, data from the health department show.
  • In 2015, there were 456 visits to Los Angeles County emergency departments for heat stroke, exhaustion or cramps; by 2018, there were 1,349 visits for heat-related illness.

The bottom line: Efforts to address the health impacts of extreme heat are not confined to the Sun Belt.

  • Most of the country has already experienced the first big heat wave of the summer, and things are projected to only get hotter, Axios' Andrew Freedman writes.
  • Areas unaccustomed to the threat of extreme heat like the Pacific Northwest have learned the hard way in recent years how heat waves can bring excess deaths and hospital visits.
  • "We do have to have structural change, the OSHA guidelines are a good example," Duke University's Ward said. "But there's also a role for communities and public servants to play."
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