How heat makes health inequity worse : Shots

How Climate Change Affects Public Health: The Impact of Extreme Heat

EMTs in Austin, Texas were called to aid a dehydrated patient who had passed out near the state capitol this week. This incident serves as a reminder of the dangers posed by extreme heat, particularly in cities with limited tree coverage and areas lacking shade during heat waves. Such cities experience higher temperatures, intensifying the risks associated with heat waves.

In Philadelphia, Dr. Sameed Khatana has witnessed the impact of climate change on his patients over the past five years. Each wave of record-breaking heat has had adverse effects on individuals with pre-existing conditions, such as diabetes, obesity, and heart disease. Khatana, a cardiologist at the University of Pennsylvania and the Veterans Affairs hospital in Philadelphia, emphasizes that extreme heat is not only a public health issue, but also a matter of health equity.

Heat-related risks are compounded for vulnerable communities within cities. These communities face greater exposure to heat, lack resources to cope with or escape it, and have higher rates of diseases that make heat more dangerous. Khatana, who holds a master’s in public health, explains that a significant proportion of deaths related to extreme heat can be attributed to cardiovascular conditions. Heat stroke, a life-threatening condition, occurs when the body’s core temperature rises rapidly, overloading weakened hearts and lungs as blood is redirected to dissipate heat. Conditions like obesity and diabetes impair circulation and nerve function, making it harder for the body to adapt to heat. Moreover, medications commonly used to treat heart disease, such as beta blockers and diuretics, can exacerbate heat symptoms.

The elderly, communities of color, and individuals with lower socioeconomic status face the highest risk, mirroring patterns seen in other public health concerns like obesity and COVID-19. These at-risk populations are concentrated in the Deep South and the Midwest, regions known as “the stroke belt” due to high rates of heat, older populations, and complicating diseases. Khatana expresses concern that public measures to combat heat may not effectively reach those most vulnerable.

Another challenge lies in the organization of cooling centers and accessibility for impaired individuals. Khatana questions the availability of appropriate public transportation to these centers and how people will be made aware of their locations. Historically marginalized communities, with less greenery and fewer public parks, experience temperatures up to 20 degrees higher than neighboring leafy areas. Planting trees, creating shaded spaces, and using heat-reflective roofing materials in these communities could provide protection against extreme heat, but implementing these changes requires investment and infrastructure updates.

Steven Woolf, director emeritus at the Center for Society and Health at Virginia Commonwealth University, suggests that businesses have a role to play in driving these changes. Historically marginalized communities often lack green spaces and shade, which contribute to higher temperatures. Businesses could lead the way by incorporating strategies such as tree planting and creating shaded areas. Woolf also proposes changes in roofing materials to reflect heat rather than absorb it, particularly in areas where air conditioning is less accessible. These improvements are feasible within a span of two to three years with sufficient funding.

Woolf highlights the economic incentive for businesses to make these changes. Extreme heat negatively impacts worker productivity, potentially surpassing the upfront expenses of infrastructure updates. As more parts of the country experience the health and safety repercussions of extreme heat, Woolf hopes there will be increased political will to support and invest in these necessary modifications.

 

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