Extreme Weather Can Impact Health Risks

Heat waves. Wildfires. Droughts. Floods. The Pacific Northwest isn’t immune as these extreme weather events become more common. Each incident heavily stresses the electrical grid, transportation capabilities and emergency services. But one impact frequently goes undiscussed: how these weather hazards affect patient health.

“Extreme weather conditions can create or worsen a variety of health problems; how significant those issues are depends on the population you’re talking about and the things they’re struggling with in their overall circumstances,” says Jeremy Hess, MD, MPH, a physician in the Emergency Departments at Harborview Medical Center and UW Medical Center – Montlake and director of the UW Center for Health and the Global Environment (CHanGE).

Consequently, providers need to assess how well patients are prepared for potential weather hazards.

Weather-related health impacts

Weather hazards can create a variety of health challenges, according to Hess, who also is a UW School of Public Health professor of Environmental and Occupational Health Sciences and a UW School of Medicine professor of Emergency Medicine and Global Health.

For example, in extreme heat, pregnant people can experience miscarriage in early pregnancy, pre-term labor and other pregnancy complications in late pregnancy, and are more prone to heat exhaustion and heat stroke. Kidney function can worsen in patients with renal disease, and patients with respiratory issues can struggle to breathe.

Another example is wildfires. Smoke from wildfires leads to poor air quality, and particles carried through the air can trigger asthma attacks, heart attacks and strokes. Plus, people displaced by uncontrolled flames may be forced to move farther from healthcare facilities, making access to necessary services more difficult.

Additionally, events like floods can cause drowning or lead to hypothermia, injuries, animal bites, exposure to infectious diseases and undernutrition.

It’s not just hypothetical; these are real effects of weather hazards on patients that come into our hospitals at UW Medicine and around the region.

The impact on vulnerable populations

Although extreme weather can affect anyone, social determinants of health — non-medical life factors that influence health outcomes — can put some people at greater risk for health challenges.

“There’s a lot of interaction between social and environmental determinants of health,” says Hess. Things like economic stability, where you live, and healthcare access can all influence the risk of being exposed to environmental hazards that worsen well-being.

A 2021 report by the Environmental Protection Agency (EPA) assessing the disproportionate exposure to poor environmental conditions and climate-related hazards on four groups — “low-income communities, minorities, individuals without a high school diploma and individuals 65 and older” — found that racial and ethnic minority groups are most likely to live in areas with the highest projected levels of climate change impacts, and those with low income or no high school diploma are 25% more likely to live in areas with the highest projected losses of labor hours due to increases in high temperatures.

Systemic marginalization limits access to resources, significantly reducing people’s capacity to recover from exposure to climate hazards. Long-term interventions are needed to address the effects of changing environmental conditions on health outcomes and inequities.

Assessing and addressing patient risks

Healthcare needs quickly become emergencies during extreme weather events. However, providers can mitigate these risks by proactively discussing a patient’s living situation and preparedness plans and providing helpful resources.

“It’s important for clinicians to understand that extreme weather affects health, and they must apply that understanding to patient care,” Hess says. “During patient interactions, providers need to start thinking about how important an extreme weather concern might be to their patient’s overall health. And then ask questions to assess the risks and develop a plan together.”

Whether in the emergency department, primary care setting, or during hospital discharge, Hess recommends physicians assess their patient’s risk level. Find out if they live in a flood-prone area, have access to air conditioning or are sensitive to smoke. Ask if they have a plan and resources to protect themselves during a weather event.

“If patients understand their risk, providers should do what they can to further support those efforts,” he says. “If patients don’t know their risk, offer education and information and provide resources to reduce potential harm, such as referring them to a social worker.”

The U.S. Department of Health & Human Services published a weather-hazard resources guide that can help. Providers can access information about cooling centers, strategies to decrease heat-related risks, population data related to climate hazards, planning tools and more.

Considering climate in clinical practice

In March 2024, UW School of Medicine, UW Center for Health and Global Environment, UW EarthLab and UW Sustainability held a climate and clinical practice symposium to increase awareness about these problems.

“We brought together specialties from across UW and UW Medicine to discuss what we should be doing differently in the various patient care settings,” Hess says. “How do we make sure patients get the services, information and support they need?”

The group discussed the stress of extreme weather and long-term climate changes on healthcare systems. Heat waves and wildfires alone create significant healthcare infrastructure problems. If these events create an electrical disturbance, it can amplify the impact on patients — particularly those who rely on medical equipment.

“People think they can deal with the four- or five-degree shift in temperature that is coming as our climate changes. But that will cause a dramatic shift in extreme weather and failures in our infrastructure systems,” he says. “We need to have these conversations now just to keep up with the pace of change and to understand the full implications of how extreme weather events will stress our healthcare systems.”

Another climate and clinical practice symposium is planned for 2025. Stay tuned for more information, and please contact Jeremy Hess at jjhess@uw.edu if you have questions.