June | 2024
J. Nadine Gracia, MD, MSCE, President and CEO
Welcome to TFAH's new leadership blog, Advancing Public Health and Health Equity, where we share insights into the challenges facing public health, success stories, and evidence-based solutions. There's a lot to discuss. Let's start with the issue of greatest concern: the increase in the level and duration of extreme heat and its impacts on health. In fact, last week, the National Weather Service, a federal agency within the National Oceanic and Atmospheric Administration, issued dangerous heatwave warnings for parts of Arizona, California, and Nevada.
Last month, I had the opportunity to attend the Milken Institute Global Conference 2024, “Shaping Our Shared Future.” Among the many interesting sessions, the session titled “Strengthening Global Health Systems for Climate Resilience” discussed developing multi-sector solutions, building a global consensus on climate and health action, and investing in a healthier and more equitable future. One of the speakers at the session, Dr. Githinji Gitahi, Group CEO of Amref Health Africa, passionately stated that “health is the human dimension of the climate crisis.” With this powerful statement, Dr. Gitahi put the right focus on the impacts of climate change on people and communities.
Why focus on extreme heat?
Climate scientists predict that extreme and long-lasting heat waves will become more frequent and intense. According to NASA, the summer of 2023 was the hottest summer since records began in 1880. Extreme heat is the leading cause of weather-related deaths in the United States, causing more deaths than any other type of weather event in the past 30 years. A 2021 study also found that labor productivity losses associated with extreme heat are expected to be $100 billion annually and increase over time. Additionally, extreme heat also has environmental impacts, including drought, food production, and food availability. These are not records we should be setting.
While climate change affects everyone, including the effects of extreme heat, it does not affect all people and places equally. For example, some population groups are at higher risk from extreme heat, including children, older people, pregnant women, people with disabilities, and people with chronic illnesses. Other groups at higher risk include people who work outdoors, emergency responders, and people living in urban heat islands or rural areas.
Additionally, some populations, including people of color, Indigenous people, low-income people, and homeless people, are disproportionately affected by long-standing structural and systemic inequalities. The enduring effects of inequality cannot be ignored: generational poverty, lack of access to quality health care, lack of access to quality education, limited access to safe, healthy and affordable housing, food and nutrition insecurity, and more.
What steps do I need to take?
We can and must accelerate action. Heat-related deaths and illnesses are preventable. Climate mitigation efforts aim to reduce or prevent greenhouse gas emissions. And climate adaptation efforts must strengthen public health and emergency response systems to protect health and well-being and address extreme heat.
Leadership at all levels, multisector collaboration, community engagement, sustained investments, and an unwavering commitment to advancing health equity will be key. To build a strong foundation for the nation’s preparedness and response to extreme heat, we must sustainably invest in public health infrastructure, the public health workforce, and data modernization. Congress should invest in CDC’s environmental health activities, including support for states, localities, tribes, and territories to develop climate adaptation capacity. We also need to increase investments in public health and medical preparedness and response, because these are the first line of defense for the health and well-being of our communities. It is also critical that we prioritize equity and meaningful engagement and partnerships with communities, investing in capacity to address non-medical determinants of health, such as employment, housing, education, transportation, and food and nutrition security, to create truly healthy and resilient communities.
All sectors must be involved and play a role in addressing extreme heat and the comprehensive climate crisis: policymakers, government agencies, public health, healthcare, employers, schools, housing, urban planners, businesses, and academia. We have an opportunity before us. The Infrastructure Investment and Jobs Act and the Inflation Control Act are landmark pieces of legislation in both climate mitigation and adaptation, and cities and states across the country are benefiting from these climate investments. Federal agencies are developing a variety of tools to help communities prepare for extreme heat. For example, the U.S. Department of Health and Human Services recently introduced the Heat and Health Index, the first-in-the-nation tool to provide heat health impact information at the zip code level. Additionally, Heat.gov helps local and state officials identify population groups most at risk for heat-related health damage and how to most effectively protect their health.
More cities and states are creating chief heat officer positions to provide leadership and coordination on heatwaves. Read TFAH's latest report, “Ready for 2024: Protecting Public Health from Disease, Disasters, and Bioterrorism,” which includes an interview with Marta Segura, MPH, Chief Heat Officer for the City of Los Angeles. The report and interview discuss how state and local governments can prepare for heat waves and policy opportunities to address heatwaves and other health threats.
It's 2024, and we've already experienced dangerous heat waves and fears that this year the United States will experience even more heatstroke deaths than usual. That won't be the story we tell as 2024 ends. Rather, let's record 2024 as the year the country took decisive collective action to prevent heatstroke and death, and in so doing, strengthened our nation's health security.
Learn more about the health impacts of extreme heat and the disproportionate risks for some people in this feature from TFAH's 2024 Are You Prepared: Protecting Public Health from Disasters, Disease, and Bioterrorism report.
