How climate change, heat affect health
By 1 p.m., it was 95 degrees in Norwalk on what would turn out to be the last day of the third mini-heat wave of this summer. Or maybe it was the fourth. It was hot, again. The humidity was off the charts, again. And the air quality was lousy, again.
This was not just summer in New England. Such conditions are some of the irrefutable signatures of climate change, now happening more often, more intensely and with more profound consequences. Among those consequences is their adverse, and sometimes deadly, effect on human health.
Curiously, health tends to get second-class consideration among the many ways climate change affects our lives — after the storms, floods, drought and other more instantly catastrophic and obvious events. But climate change-induced health impacts are gaining traction as a primary concern — heat chief among them, but so are air quality, water quality, disease-carrying insects and secondary impacts such as mold, loss of electricity from catastrophic events and the mental health toll from each of the above.
“Environmental professionals traditionally haven’t been trained in health, so they don’t think of it. Health professionals aren’t trained in climate change. Both of those are changing, but that’s traditionally been the case,” said Laura Bozzi, director of programs at the Center on Climate Change and Health at the Yale School of Public Health. She is the lead author on the report Climate Change and Health in Connecticut, which, inconveniently, was released in September 2020, while most health attention was focused on COVID-19, still in its pre-vaccine phase.
The report evaluated 19 indicators that reflect extreme events, from flooding to drought, heat, air quality and disease, noting the multiplier effects one factor can have on another as they impact health. It also took special notice of the disproportionate impact of climate change on the health of those in environmental justice communities and other at-risk populations. Yale also followed up with a series of issue briefs.
Since then, Connecticut has added an Office of Climate and Public Health to the state Department of Public Health, and there is now public health representation on the Governor’s Council on Climate Change. The Connecticut Equity and Environmental Justice Advisory Council is also up and running as of a few months ago, offering the possibility of better linking health and climate change because of the outsized impacts of that combination on environmental justice communities.
But it has been a balky start for all due to lack of staff, funding and other issues, including the overwhelming focus on COVID.
“There’s still catch-up to do,” Bozzi said. “They add a couple of sentences about how to fix health, but it’s like from a Google search, right?”
This summer, the New England Journal of Medicine began a more specific and in-depth focus on climate change and health in a series of monthly articles.
“I think what people need to know is that the health effects of climate change are happening now,” said Caren Solomon, the series editor and a physician at the Brigham and Women’s Hospital in Boston. “They are only going to get worse.”
Heat is a killer
“Heat is the leading weatherrelated killer in the United States,” according to the Environmental Protection Agency. The Centers for Disease Control says there are more than 700 heatrelated deaths yearly, nearly 68,000 heat-related illnesses and nearly 10,000 heat-related hospitalizations.
But these are widely considered to be low counts, as heat can also compound other health problems such as asthma and can contribute to deaths from heart attacks, strokes and other forms of cardiovascular disease, which
occur more frequently during extreme heat. That makes it difficult, if not impossible, to figure out the real causes of the death or illness, unlike with more obvious problems like heat stroke or exhaustion.
The Washington Post recently mapped 7,000 record-breaking instances of extreme heat in the U.S. this summer alone. Connecticut had some of them.
“There’s just such an increasing sense of urgency,” Solomon said. “People have asthma or their allergies are worse, and they are not linking it to the heat or the pollen and recognizing that there’s more pollen because of climate change.”
The New England Journal developed an interactive graphic that shows how organ systems and groups of people can be affected by climate change conditions, including heat. Solomon and others list concern after concern from heat alone.
Kidneys can malfunction or fail. People may get more kidney stones. Pregnant women who are exposed to extreme heat have higher rates of preterm birth and babies are smaller than they should be.
People in extreme heat, especially if it makes sleeping difficult, often have trouble concentrating. Cognition goes down; productivity goes down; their mood is lousy, along with other mental health impacts and aggressiveness — a grumpiness factor, or worse. That can mean more arguments, road rage or other violent reactions.
Heat negatively interacts with certain medications, including anti-psychotic ones. It’s not known what the cumulative effects of heat might be. It is known that the body acclimates somewhat to heat over the course of the summer so people will have more difficulty with a sudden heat wave in May than one in August.
The very old, the very young, those with other health issues and those who must work outdoors are considered high risk, but it is environmental justice communities that tend to suffer the most.
“When we look at all these health effects of climate change, heat, pregnancy complications, cardiovascular, respiratory problems, they cause greater hazards to people in low-income communities and many communities of color. And that is despite the fact that these communities contribute the least to greenhouse gas emissions and pollution,” Solomon said.
The good news, according to Bozzi at Yale, is that the environmental justice movement has been a lot better about considering health holistically, which would include its relationship to climate change.
“The traditional environmental movement has been more about protecting nature,” she said. “Maybe for climate change, it was always in the future, so you weren’t thinking about, well, how does it affect your health today? Now, we are kind of confronted with making that link because, of course, that’s what’s happening now.”