On Heat, Health, and Healthcare
- Ranjini Bhattacharya
Executive Summary
A new challenge that the healthcare system must prepare to face: heat. Heat claims more lives in the US than any other weather event. Since the 1950s the average temperature across the planet has been steadily increasing. Summer 2022 was one of the hottest summers in Florida- even by Florida standards! The scorching Florida heat combined with high humidity impedes the body’s natural cooling mechanisms; this makes the human body more susceptible to heat-related illnesses. Changing weather patterns has made Florida more susceptible to natural calamities like hurricanes. These natural events impose a tremendous burden on the healthcare system. This brief outlines potential policy changes that can help deal with the challenges that climate change presents to human health. In the short term, the focus needs to be on immediate relief in the form of access to water, shade, and cooling systems. In the long term, the state of Florida must cut down on its carbon footprint, invest in sustainable housing, and create a resilient healthcare system.
The Threat
On a typical morning in Florida, the temperature ranges between 88–92 ℉. 20 years ago, the temperature would have been around 81 ℉- comparable to the overnight minimums recorded this year. Humidity has also been on a steady rise. July 2022, snagged the top spot for being the hottest summer ever in Tampa, Florida. Extreme heat clubbed with high humidity poses a serious threat to humans. The human body perspires to regulate its internal temperature; high humidity makes it more difficult for sweat to evaporate from the body surface. In the absence of adequate cooling crucial organ functioning can be damaged and also prove to be fatal. Mortality is especially high in people with underlying health conditions like diabetes, respiratory disorder, and cardiovascular diseases. High temperatures have also been correlated with adverse effects on brain functioning and mental health. The most susceptible individuals in the population are children, pregnant women, construction workers, farmers, postal workers, and athletes.
Rising sea surface temperatures fuel extreme weather conditions like hurricanes and thunderstorms. When hurricane Irma struck Florida in 2017, over 6 million Floridians evacuated the state; over 70 per cent of the state had a power outage; dozens of hospitals had to be closed; nursing homes struggled to stay afloat; unimaginable damage was done to local property and landscape. Hospitals are usually hit the worst when calamity hits as doctors and staff struggle to deal with overcrowding, critical patients, flooding, electricity outage, and overall chaos.
Policymakers are aware of these challenges. The Biden administration has recently launched an inter-agency task force to tackle the problems posed by extreme heat. The task force aims to improve the working conditions of physical laborers, introduce heat inspection programs, and form a heat group to engage stakeholders with ongoing innovations. In 2017, after the death of a high school footballer due to a heat stroke the state of Florida mandated the presence of cooling tubs in high schools. After hurricane Irma, all hospitals were advised to have backup generators and facilities to maintain optimal cooling temperatures. Miami Dade county’s interim chief heat officer recognized the disparate repercussions of heat on underprivileged communities and has been working to bridge these gaps.
However, several bills related to heat resilience were also introduced in the Florida senate that became a policy. For instance, the Heat Illness Prevention Act aimed at providing employees engaged in physical labor with protection from heat illnesses ‘died’ in the Senate. Other acts aimed at reducing emissions are still under consideration. Understandably, there will always be trade-offs associated with policies. Outlined below are some measures to tackle the far-reaching effects of rising temperatures as smoothly as possible.
Possible Measures
Short-term measures involve identifying the most susceptible population, raising more awareness in the public as well as medical staff, and providing cooling and shade to all.
In the long run, the legislative and executive bodies should act together to steer the state toward climate resiliency. This needs a three-pronged approach- 1) Strengthening the Healthcare System, 2) Reducing Carbon Footprint, and 3) Improving Public Welfare.
Strengthening Healthcare System
1. Climate Centric Medical Curriculum: Most heat-related complications go unreported because neither the public nor doctors are trained to recognize heat exposure as an underlying reason for illnesses. Introducing climate change-centric dialogue and its impact on health will prepare doctors to identify these cases better.
2. Preparing for Outbreaks: Climate change fuels the proliferation and spread of invasive species that may cause diseases. Hospitals must set up plans to identify, isolate, and treat patients in the case of an outbreak.
3. Disaster Action Plan: The Centers for Medicare and Medicaid Services must require to establish an action plan in the case of a natural disaster. In the case of a disaster, the presence of backup facilities, the presence of secure rooms for existing critical patients, and streamlining the inflow and treatment of new patients are crucial.
4. Heat Preparedness: During heat waves, ER visits spike. Following the release of heat wave advisories, hospitals can prepare for this spike by providing telehealth services to non-critical patients so that they don’t have to visit the hospital; triaging patients on the level of their seriousness in the ER; setting up a swift transfer for medical records electronically; establishing efficient pipelines for healthcare delivery.
Reducing Carbon Footprint
1. Energy Efficient A.C.: The State Energy Offices and the Florida Public Service Commission can work together and invest in installing energy-efficient air conditioning in ‘all’ households. This reduces energy bills, repair bills, and carbon footprint.
2. Renewable Energy: Florida is abundantly supplied with biomass and solar energy. Furthermore, storm water collected in reservoirs after thunderstorms can also be channeled toward energy production. While the initial costs of setting up renewable energy facilities are high, in the long run, it is much more economical.
3. Carbon Capture: The fossil fuel industry continues to contribute much to the economy. To reduce their carbon footprint, industries must be encouraged to invest in carbon capture technology. This technology captures carbon dioxide released from factories and industries and converts it into a source of energy.
4. Decarbonizing Healthcare: The US healthcare system contributes to 10 per cent of national greenhouse gas emissions. Increasing funding for hospitals to invest in zero-emission buildings, vertical gardening, and renewable energy.
5. Incentives: To incentivize the move towards lower emissions, the federal government can provide incentives like tax cuts, loans, and other benefits to industries.
Improving Public Welfare
1. Workers’ Conditions: The Department of Labor and Agriculture should push for establishing regulations for physical workers exposed to heat. They must have access to drinking water, cooling, and monitored work hours.
2. Convenient Transportation: The Florida Department of Transportation can improve public transportation by increasing the frequency of transportation. All public transport must be air-conditioned.
Due to its tropical location, Florida will certainly face heat-related health challenges in the future. With the help of its natural resources and by adopting some changes the State of Florida can ensure the health and welfare of its people.
