Source: istock


Equity in Resilience: Addressing the unequal health impacts of extreme heat

This blog is part of a series on climate justice and climate hazards. Through this series we explore major climate hazards, how marginalized populations are impacted by them, and the policy solutions that could lead to more equitable, resilient communities.

Summer 2021 has seen extraordinarily hot temperatures across the United States. The season started with a massive Western heat wave in mid-June that set records in seven different states, and was followed by another record-shattering event in the Pacific Northwest in late June, where temperatures reached 116 degrees F in Portland, Oregon. While not as severely hot, coast-to-coast heat waves have continued into July and August. Extreme heat can cause serious illness, but even as global average temperatures warm, heat-related deaths are preventable. The impacts of extreme heat highlight the need for all levels of government to respond to this growing public health concern and build community resilience—especially in the most vulnerable populations.

The Intergovernmental Panel on Climate Change recently reported that “it is virtually certain that hot extremes (including heatwaves) have become more frequent and more intense across most land regions since the 1950s…with high confidence that human-induced climate change is the main driver of these changes.” Amid the trend of increasing temperatures, June 2021 was America’s hottest June on record, and July was confirmed as Earth’s hottest month ever recorded.

Higher temperatures, especially warming overnight temperatures, prevent the body from cooling, which can cause serious health impacts such as heat exhaustion and heat stroke. In the moderate climate of the Pacific Northwest and Canada, communities were unprepared for the extreme temperatures that cost hundreds of lives. Nearly 200 deaths have been officially attributed to heat in Oregon and Washington, but recent New York Times analysis suggests the true toll could be closer to 600 between the two states. Across the Canadian border, officials have reported more than 400 heat-related deaths during the week of the heat wave.

Some physiological conditions can make people more vulnerable to extreme heat. In general, older adults, infants and children, pregnant women, and people with chronic illnesses are especially sensitive to heat exposure. Additional social and economic factors can put people at a disadvantage in a warming world, especially when combined with physical risks and existing health inequities. Extreme heat and heat exposure disproportionately impacts the following groups:

  • Low-income families are more likely to live in poorly ventilated apartments or mobile homes, lack access to air conditioners, or are unable to afford the costs of cooling.
  • Outdoor workers—as well as indoor workers in facilities without air conditioning—are subject to hot and humid conditions that increase their risk of heat-related illness and workplace injury. Many of these workers are undocumented and may lack access to medical care, making them even more vulnerable.
  • People experiencing homelessness often lack adequate shelter, access to cooling, and clean drinking water to minimize heat stress.
  • Indigenous and Black populations have the two highest rates of heat-related death in the United States. Federal policies that forced Black people into underinvested urban neighborhoods made many more vulnerable to heat. Meanwhile, extreme poverty, along with inadequate housing, infrastructure, and health services in many indigenous communities has left them less able to manage growing heat.

Urban areas often experience hotter temperatures due to the heat island effect. Recent research from the University of California San Diego confirms previous findings of micro-heat islands in low-income communities of color. This trend is due to the legacy of racist redlining policies which denied housing loans to communities of color, as well as continued disinvestment in these neighborhoods, leaving low-income, non-white residents in areas with fewer trees, less green space, and heat discrepancies of up to 12.8 degrees.

Efforts to address extreme heat are typically implemented at the local level. Governments often start by identifying heat thresholds to trigger a heat emergency declaration, followed by community outreach, and providing resources such as public cooling centers. New construction in some urban areas now include cool roofs and cool pavements to reduce heat exposure. Other areas are working to increase tree canopy and urban vegetation to provide shade and cool the air. Still, extreme heat is only beginning to get the attention it deserves: Miami-Dade County just became the first in the world to hire a chief heat officer to address the issue.

Among these varied localized planning efforts, there remain challenges in getting heat resilience solutions to reach the populations that need them most. Community engagement in any decision-making process is necessary for ensuring equitable solutions to any climate hazard: Solutions must be co-created with community members to ensure they account for and address localized needs, which vary immensely.

In addition, state and local governments should take the following steps to develop an equitable response to extreme heat in their communities:

  • Identify vulnerable populations within the community, using localized demographic and temperature data (ex. CDC’s Heat & Health Tracker, EPA’s EJSCREEN).
  • Distribute public resources where they are most needed. For example, open cooling centers, implement cool pavement projects, and increase tree cover and green space, specifically in vulnerable communities.
  • Partner with local organizations that have established trust with vulnerable populations to assist with communications efforts and direct people to public resources.
  • Translate educational resources to overcome language barriers. Boston’s Department of Emergency Management created extreme heat fact sheets in the city’s ten most common languages.
  • Assist low-income households with costs of increased cooling and energy efficiency improvements.
  • Implement protective heat rules for workers. Following the devastating June heatwave in Oregon, the state’s Occupational Health and Safety Administration began requiring employers to provide shade and cool drinking water.

The federal government can support local communities on the latter two of the above points by increasing funding for weatherization programs that improve the housing conditions of vulnerable populations and putting forth health and safety guidance for workers exposed to extreme heat.

Federal government agencies can also support state and local action by providing data, guidance, and funding to make sure that historically marginalized community members are supported through climate adaptation processes. Federal agencies that house climate information should make sure their data is localized, up-to-date, and forward looking to be useful to local decision-makers. Higher resolution climate models that provide user-friendly projections of climate hazards will enable resilience planning with a focus on local equity. In addition, partnerships across federal agencies that enhance interdisciplinary, resilience-focused coordination can help advance and guide local efforts.

With global levels of carbon dioxide at an all-time high, building community resilience to extreme heat will likely need to be a priority for decades to come. Emergency heat planning needs to take place locally to ensure that community engagement is possible, but federal resources can help coordinate these responses and should encourage equity in all local approaches.