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Extreme Heat Has Extreme Health Implications: How Cities and Policies Need to Adapt to a Warming World

By Ella Mendonsa

For many Americans, the COVID-19 pandemic meant staying home and indoors this past year. Now, in the midst of a heat wave sweeping across the country, many Americans are returning to their traditional summer activities. But just how hot will it be when we return to BBQs and pool parties? With the impacts of climate change intensifying, U.S. average temperatures have been rising each year and this year’s summer is predicted to be unseasonably hot. Last week in Texas, grid operators are urging conservation to keep the electric grid free from power outages due to the extreme heat. In February, power outages due to lack of weatherization proved fatal for 150 Texans. With a hotter summer comes more extreme heat that leads to the development of urban heat islands in cities and urban areas, where impervious surfaces absorb and reflect heat back, raising the temperature of the surrounding area and exacerbating health impacts. As the temperature rises globally, heat waves are becoming more frequent and intense, and some states are experiencing. Extreme heat has also been shown to increase risks of respiratory, neurological, and heart issues, as well as risks of cancer and death. Due to racially discriminatory housing practices from the 1930’s like redlining, communities of color in the United States bear the burden of living in hotter neighborhoods and have a higher risk of heat-related health impacts.

One SPARCC survey of public health officials found that extreme heat events were the biggest concern for more than 90% of participants. Cities have adopted various practices to combat the heat and keep residents cool, like establishing cooling centers and expanding existing urban tree canopy. In 2018 SPARCC hosted a series of Rapid Climate Vulnerability Assessments with SPARCC site and community partners to identify more strategies for beating the heat. SPARCC has been partnering with community-based organizations and practitioners in Atlanta, Chicago, Denver, San Francisco, and Los Angeles to ensure their neighborhoods are climate resilient and support their efforts to keep cool and healthy during hot summer months. 

  • In Los Angeles, the LA ROSAH collaborative adopted a more explicit focus to utilize green infrastructure and open space as a method to reduce drought, heat vulnerability, and heat islands. 
  • In Chicago, a partnership between the Center for Disease Control (CDC), the University of Illinois at Chicago School of Public Health (UIC), and the Illinois Department of Public Health (IDPH) led to an initiative to increase knowledge and awareness of how climate change impacts public health, and improving the capacity of local health departments and emergency preparedness facilities to address the health effects of climate change. They created an online heat toolkit for local health departments, and developed guidance around messaging for warning levels, mental health, social vulnerability and health data for each county. 

While these interventions have proven successful, we are still facing extreme heat events across the country— ones that could threaten the lives of the most vulnerable. In addition to these active interventions, we need new initiatives and policies, particularly for communities of color and low income communities: 

  • Many cities are addressing heat through design and adaptation of the built environment by confronting racist housing policies that can negatively impact the vulnerability of underserved communities. New infrastructure investment must address heat island impacts both to the existing built and natural environment.  Infrastructure investments must be designed to address current equity considerations and future climate impacts.
  • Support funding and capacity for state and local public health agency activities.  These can include increasing awareness of poor heat and air quality days for vulnerable populations, public cooling centers, and supporting data and analysis on heat vulnerable populations
  • Support non profit and community based organizations to advance surveillance on heat and health impacts.  In addition, support community-based organizations and local health partners in advancing projects that provide multiple benefits, including green infrastructure and shading as well as passive cooling and design, specifically for underserved areas.

Learn more about the heat risks for vulnerable populations and proposed solutions below: 

Sarofim, M.C., S. Saha, M.D. Hawkins, D.M. Mills, J. Hess, R. Horton, P. Kinney, J. Schwartz, and A. St. Juliana, 2016: Ch. 2: Temperature-Related Death and Illness. The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment. U.S. Global Change Research Program, Washington, DC, 43–68. http://dx.doi.org/10.7930/J0MG7MDX

The Interagency Working Group on Climate Change and Health. A Human Health Perspective On Climate Change. Environmental Health Perspectives And The National Institute Of Environmental Health Sciences, 2021, https://www.niehs.nih.gov/health/materials/a_human_health_perspective_on_climate_change_full_report_508.pdf. Accessed 15 May 2021

U.S. Global Change Research Program, The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment, chapter 2, “Temperature-Related Death and Illness,” 2016, https://health2016.globalchange.gov/temperature-related-death-and-illness.