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  • Writer's pictureArch Policy Institute

The Heat in Hea(l)t(h) - Ruhee Merchant

My name is Ruhee Merchant, and I am the Arch Policy Institute's healthcare policy team lead. We aim to address healthcare inaccessibility barriers in Athens-Clarke County by boosting telehealth infrastructure and improving citizens' digital confidence, as digital preparedness is now a core social determinant of health. 


The impact of climate change on well-being takes many forms. It is a multifaceted beast; however, today, we will examine the effects of heat waves on health outcomes. 


Heat waves are defined by lengthy periods of high temperatures combined with high humidity. Georgia is at major risk from heat: record-breaking heat waves were documented in July and August of 2023. Georgia is predicted to experience a higher frequency of heat waves like this in the near future.[1]


Heat incidents dysregulate the body’s homeostasis or “steady state,” with the potential to incite heat cramps, electrolyte imbalances, heat exhaustion, or even heatstroke in extreme cases (heat strokes can damage internal organs). Heat stress is one of the most common causes of weather-related death, inflicting physiological distress, asthma, and cardiovascular disease.[2


While urban areas have cooling stations, rural areas don’t have enough of them. Rural areas, on average, experience higher rates of poverty due to isolation from resources. Hence, poorer neighborhoods are consistently more vulnerable to climate change impacts.[3] Nonetheless, it is essential to acknowledge that cooling centers are more of a band-aid solution, as they don’t address the root problem of unsustainable housing conditions. “Long-term climate resilience means that we need to ensure that everyone is living in housing where they can weather extreme heat, and they have ways to respond… that don’t require them to leave their community and go to another place temporarily,” asserts Dr. Rebecca Watts Hull, a specialist at Serve-Learn-Sustain at Georgia Tech.[4] Groups with limited access to air conditioning, abundant freshwater sources, or green spaces will disproportionately face the health risks associated with heat waves. Urban heat islands can experience disproportionate rates of heating due to greater heat absorption of the natural terrain there. Thus, policymakers should leverage modern design tools to tackle this when urban planning: this could look like installing cool roofs, sun-reflective pavements, and increased urban tree canopies.[5


While there are places disproportionately affected by rising temperatures, there are also specific groups that are more exposed. Workers with outdoor-based occupations are more susceptible to experiencing the physiological strains imposed by extreme heat. Other at-risk populations include those with limited mobility to move in and out of spaces: incarcerated individuals, nursing home residents, and individuals with disabilities.[6] Due to this, it is imperative to create more climate-resilient healthcare systems. The biotech industry is stepping up to develop preventive smart solutions such as wearable sensors for heat stress prevention. Regulating these technologies is imperative to promote proper and equitable distribution and access to these sorts of provisions. Furthermore, developing more public awareness campaigns is another key step in fomenting preparedness in the face of extreme heat.[7


Rising temperatures also allow for diseases and pathogens to be transmitted more easily. This results in the contamination of wastewater and the spread of foodborne diseases, increasing the risk of contamination from farm to fork.[8]  Pesticides are a huge risk factor for infection: increased blood flow and sweat can cause higher absorption of toxicants. This increases the proliferation and transmission of Dengue vector viruses, malaria, and other infectious diseases. Tapping into biosecurity strategies of surveillance and leveraging early warning systems increases the risk preparedness of these vulnerable populations[9


Furthermore, increasing exposure to UV light is an environmental stressor that can deplete skin of its natural substances; hence, replenishing it with skincare is vital to protect skin health, an industry slowly shifting from unrealistic expectations to focusing on personalized wellness.[10] Skin cancer is the most common cancer in the United States: one in every five Americans will be diagnosed with skin cancer in their life. There are multiple types of skin carcinoma: basal cell carcinoma, squamous cell carcinoma, and melanoma are the main types. Given the prevalence and dangerously rising exposure to UV, it is crucial to normalize skincare as healthcare. Proper access to skin care, including sunscreen, is vital to allow people to protect themselves against the development of skin-related diseases.[11] Trailblazers at Augusta University have installed automatic sunscreen dispensers on their campus: this is the first Georgia University to have such an addition.[12] There are ongoing initiatives and organizations around Georgia aiming to promote efforts to add more sunscreen stations in public spaces, which will boost accessibility to skin health as a public good rather than a luxury. 


There are constantly new learnings and findings in the realm of heat-related health outcomes. A newer, emerging concern related to temperature spikes is an increase in alcohol and drug-related hospitalizations. Research shows a correlation between higher temperatures and substance abuse disorders. The Columbia University Mailman School of Public Health examined this relationship using data from nearly 1,400,000 substance-related disorder visits over 20 years to understand this linkage. Higher hospital visits in these cases are speculated to be driven by potentially more perspiration causing dehydration or engaging in riskier activities during prolonged periods outdoors. Public health interventions such as awareness campaigns to promote proactive steps and warn individuals about risks of consumption during hot periods are the intended next steps.[13]

 

To keep up with the modern needs of the people, healthcare needs to adapt now. Diagnostic codes for patient visits undercut the underlying climate-related disease for the clinical exacerbation for which a patient is admitted.[14] This can pose a major problem and result in preventable losses. Hence, medical schools and medical institutions need to reform their educational curricula and diagnosis mechanisms to train and inform clinicians on the health impacts of climate change. University simulation centers can assist with this, and the new Medical School at the University of Georgia can be more mindful of this modern consideration while refining the framework for its new program. 


Ultimately, we all need to be more aware of the risks we face to position ourselves as taking preventative rather than curative action.

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