Um, it’s hot out there. Heat records are breaking all across the globe this summer. I just spent a week in Texas, and one of my girls got sick really fast. So, naturally, I went down the epi rabbit hole of curiosity: if heat records are breaking, have heat-related illnesses (HRI) increased, too?
I am intrigued that the main solution here is "stay in the AC more", because I don't think it's a long term sustainable solution. The energy output required and environment affects (which then can just contribute to fossil fuel use and more greenhouse gases) seems self defeating. And then when the power is out, as you've mentioned, there is a wave of heat injuries. Also, in general terms, humans need to adapt, not depend on living in an artificial environment.
One thing I noticed living as a teenager at a US military installation in the Australian desert, is that the non-local American adults lived in extreme air conditioning at work for most of their day and then when they did come outside, they couldn't deal with the heat. A lot of town didn't have AC, and neither did my school - and the American students adapted to heat after several months and then started to feel comfortable like the locals. I know there are physiological reasons for this, although I'm not an expert in that area.
I've long thought the Americans with our willingness to spend huge energy expenditures and crank the AC super cold (hello women who freeze in offices on the regular!) do ourselves a disservice because we just never adapt to outside temperatures. I have no idea how you could actually have an intervention on this, but do you think there could be merit in getting people outside MORE, dressing more appropriately, hydrating more appropriately, and importantly, designing our built structures to cool interiors WITHOUT the use of AC?
Of course, as mentioned the homeless population are the hardest hit and those with AC are currently doing better, as you've shown. But I think there are better answers than "get in the AC", including for the homeless population- better access to water, shade, clothing etc
Hi, Kelsie: I have been thinking about your comment here since you wrote, as I agree with you we cannot air condition our way out of this, for the very reasons you state. I do think your thoughts about acclimatizing have a good bit of merit. One hesitation I have been pondering is age-related, and I have now run across an article that speaks to why there is increased hazard to older people, and therefore why acclimatizing may work less well for us as we age. To me, what this speaks to, once again, is the need to have public-facing communications that do more than simply state the dos and don’ts, but also explain in understandable terms the science that lies behind them. For example, I didn’t have any idea that as an older person, I sweat less or don’t feel as thirsty! Anyway, for what it’s worth, here’s a link to the article, and thanks again for spurring my thinking about this: https://www.nytimes.com/2023/07/20/well/live/heat-illness-safety-older-people.html
It is worth mentioning that cold extremes kill ~10 times as many people as warm extremes both globally and in Europe. So warming, which reduces cold extremes, will result in a reduction in deaths from extreme temperatures. Apparently 500,000 fewer lives were lost in the UK from 2001 to 2019 because of milder winters.
We can protect from temperature extremes by ensuring that electricity is cheap and reliable and domestic heating and cooling are readily available. This requires economic growth and cheaper energy.
We're on the verge of a collapse in the Atlantic oceanic current that moderates the weather in northern Europe. It's probably oing to get much colder in the UK when this happens
You are absolutely right that this is a major concern. Indeed the possible collapse of what I call the 'Gulf Stream' is actually once of the biggest risks of climate change. There is some debate as to how likely it is and in what time frame it will happen. The IPCC consensus is that risk is fairly low, at least for this century. It will mainly impact Northern Europe, which is fortunately well-equipped to cope because of its good infrastructure and experience with cold weather. This is why we need to continue to reduce emissions, but only in a way that ensures that energy remains reliable and affordable. Affordable reliable energy is essential to protect us from the impacts of climate change, as well as from extreme weather events that will continue to happen whatever happens to the climate.
Recent measurements suggest that the North Atlantic is warming faster than accounted for in the models the IPCC is relying on. Current thinking (pun intended) is that breakdown of the AMOC is likely by mid-century, with a statistical possibility that serious effects will be observed as early as 2025 (https://www.nature.com/articles/s41467-023-39810-w). I find your lack of urgency... disturbing.
IMO we're at least two decades behind the rapid expansion of nuclear technology -- in the form of micro-reactors and local grids -- necessary to ensure reliable and affordable clean energy, especially in the global south.
And while extreme weather events will still occur after we reach net zero, they will become less likely and less frequent. Instead of every kind of extreme happening everywhere all at once -- where we are heading today, unless we get very busy -- perhaps our children will be able to fully recover from each extreme event before the next one happens.
I thought we were discussing cooling. You have switched to extreme weather. Fortunately the news here is not as alarming as you might think.
Despite warming of ~1.2 C already there has been no detectable increase in storms of any sorts or floods, according to the IPCC. The mid-range prediction is a further warming of around 1 C. It seems implausible that this further increase will result in much more extreme weather events than the past warming of 1.2 C.
Even better is the fact that the actual impact of extreme weather has dropped dramatically in the past century as a result of increased resilience that comes from economic growth. The rest of the world is catching up with the developed world and this will increase their resilience whatever happens with extreme weather.
Yes I know that extreme heat events have increased and are killing more people. But often forgotten is the fact that extreme cold events kill ~10 fold more people, especially in poorer countries without affordable reliable energy. A dirty little secret of climate research is that deaths from extreme temperatures have actually dropped because of global warming! In the U.K. 500,000 fewer deaths were estimates from 2001-2019.
The collapse of the AMOC is likely to bring very cold climate back to Great Britain and the North Sea. It seems to me that you're overly sanguine about the effects of extreme weather caused by anthropogenic climate change, be it hot or cold. Cold weather events may directly kill more individuals, but the shift to a warmer climate will lead to mass starvation and war. I'm thankful that fossil fuel apologists are starting to lose the information war.
I am pleased you acknowledge that you see it as an information war that you are participating in. You clearly recognise that you are biased and more concerned with winning the argument than solving a real problem. Reality does not care about information.
I am not a fossil fuel apologist. It is simply irrational to think we can rapidly switch from fossil fuels to 100% clean energy without catastrophic effects on economic growth and energy poverty.
That INEVITABLE effect has to be balanced against the the POSSIBILITY of the effects you are discussing.
A rational approach is to replace fossil fuels with reliable affordable clean energy as fast as possible. Nuclear energy can easily do this if we remove unnecessary regulatory constraints.
Sadly most of this who are concerned about reducing fossil fuels are woefully ignorant of the limitations of solar and wind.
When this is combined with exaggerated fear of climate change the result is really dangerous for humanity.
Instead of educating themselves about this people like you dismiss these issues by questioning the motives of those raising them. It really is something to be ashamed of.
"Like many things in public health, the HRI surveillance is a suboptimal patchwork of data, and only some states are reporting, creating a fragmented picture." For the far right, this is a feature rather than a bug. If our data on a problem for which they have no solution are incomplete or non-existent, it's easier to pretend the problem doesn't exist.
Thank you for this summary and for the data. I'm so sorry to hear about your little girl. I hope that she is fully recovered and that all of you can stay cool. I also hope that we as a country and a world can get it together to more rapidly and effectively address climate change.
At least we now have, from gov't funded atmosphere/ocean researchers, frequent global measurements of air temperature. This is part of the broad weather, climate, air-quality data flow, from orbiting satellites to deep diving ocean probes. It can aid our response, and especially, warns of the spread of UNinhabitable regions. For example, google NASA WorldView..... https://worldview.earthdata.nasa.gov
What do you consider to be the Midwest? Illinois, Wisconsin, Iowa, etc are midwest to me, yet I see no charts with these states in them.
"While state data is lagged (last update was 2021), data by region is impressively available in almost real-time. 2023 is shaping up to be unique in the Midwest, with higher rates of HRI than in previous years."
Perhaps because some of those state neither collect nor report data that would make them look bad? That's certainly how the extremists here in Missouri operate.
Good job. What IVD-10 diagnostic codes are being used to find heat related illnesses? As a physician myself, I was especially interested in this statement, “Reporting behavior. If more physicians are aware of HRI, they are more likely to categorize it as such in a patient’s chart. Over time, it will look like more HRI when, in reality, it’s a product of increased reporting.”
Comment on a different subject: I suggest looking at a paper in Nature, 20 July 2023. Title is: How Many Clinical Trials Can't be Trusted?", by Richard Van Noorden. Sounds like the magnitude of faked clinical trials and faked or altered data is significant.
Agreed. You can't tell 8 million people to crank up their AC without straining the power grid, and if that goes, we're all buggered.
Considering how incensed people got about the minor nuisance of wearing a mask, I'm not optimistic that people are going to behave altruistically (certainly not voluntarily) when we start having to ration air conditioning to people who are deemed to need it the most.
But....to be fair, I don't think our heroine here is prescribing anything normative here, just presenting objective facts about what impacts the risk of HRI's.
This is so good to increase understanding of what’s going on. Applause to Dr. Jetelina for once again doing comes naturally, as in “So, naturally, I went down the epi rabbit hole of curiosity.” 💕👏💕👏💕
First thank you for addressing the impact of environmental determinants on health (EDOH). As I've read and heard, HRI are severely underreported. The impact of extreme heat on overdose, respiratory illness, cardiovascular events, etc. are generally not included in these stats. How can we present this data when what I've read is that Heat Related mortality is probably 10X what is reported?
I am intrigued that the main solution here is "stay in the AC more", because I don't think it's a long term sustainable solution. The energy output required and environment affects (which then can just contribute to fossil fuel use and more greenhouse gases) seems self defeating. And then when the power is out, as you've mentioned, there is a wave of heat injuries. Also, in general terms, humans need to adapt, not depend on living in an artificial environment.
One thing I noticed living as a teenager at a US military installation in the Australian desert, is that the non-local American adults lived in extreme air conditioning at work for most of their day and then when they did come outside, they couldn't deal with the heat. A lot of town didn't have AC, and neither did my school - and the American students adapted to heat after several months and then started to feel comfortable like the locals. I know there are physiological reasons for this, although I'm not an expert in that area.
I've long thought the Americans with our willingness to spend huge energy expenditures and crank the AC super cold (hello women who freeze in offices on the regular!) do ourselves a disservice because we just never adapt to outside temperatures. I have no idea how you could actually have an intervention on this, but do you think there could be merit in getting people outside MORE, dressing more appropriately, hydrating more appropriately, and importantly, designing our built structures to cool interiors WITHOUT the use of AC?
Of course, as mentioned the homeless population are the hardest hit and those with AC are currently doing better, as you've shown. But I think there are better answers than "get in the AC", including for the homeless population- better access to water, shade, clothing etc
You now have me on high alert on non-A/C approaches. This is really interesting, and right to your general point: https://www.nytimes.com/2023/07/28/world/europe/europe-heat-buildings-air-conditioning.html
Hi, Kelsie: I have been thinking about your comment here since you wrote, as I agree with you we cannot air condition our way out of this, for the very reasons you state. I do think your thoughts about acclimatizing have a good bit of merit. One hesitation I have been pondering is age-related, and I have now run across an article that speaks to why there is increased hazard to older people, and therefore why acclimatizing may work less well for us as we age. To me, what this speaks to, once again, is the need to have public-facing communications that do more than simply state the dos and don’ts, but also explain in understandable terms the science that lies behind them. For example, I didn’t have any idea that as an older person, I sweat less or don’t feel as thirsty! Anyway, for what it’s worth, here’s a link to the article, and thanks again for spurring my thinking about this: https://www.nytimes.com/2023/07/20/well/live/heat-illness-safety-older-people.html
It is worth mentioning that cold extremes kill ~10 times as many people as warm extremes both globally and in Europe. So warming, which reduces cold extremes, will result in a reduction in deaths from extreme temperatures. Apparently 500,000 fewer lives were lost in the UK from 2001 to 2019 because of milder winters.
We can protect from temperature extremes by ensuring that electricity is cheap and reliable and domestic heating and cooling are readily available. This requires economic growth and cheaper energy.
We're on the verge of a collapse in the Atlantic oceanic current that moderates the weather in northern Europe. It's probably oing to get much colder in the UK when this happens
You are absolutely right that this is a major concern. Indeed the possible collapse of what I call the 'Gulf Stream' is actually once of the biggest risks of climate change. There is some debate as to how likely it is and in what time frame it will happen. The IPCC consensus is that risk is fairly low, at least for this century. It will mainly impact Northern Europe, which is fortunately well-equipped to cope because of its good infrastructure and experience with cold weather. This is why we need to continue to reduce emissions, but only in a way that ensures that energy remains reliable and affordable. Affordable reliable energy is essential to protect us from the impacts of climate change, as well as from extreme weather events that will continue to happen whatever happens to the climate.
Recent measurements suggest that the North Atlantic is warming faster than accounted for in the models the IPCC is relying on. Current thinking (pun intended) is that breakdown of the AMOC is likely by mid-century, with a statistical possibility that serious effects will be observed as early as 2025 (https://www.nature.com/articles/s41467-023-39810-w). I find your lack of urgency... disturbing.
IMO we're at least two decades behind the rapid expansion of nuclear technology -- in the form of micro-reactors and local grids -- necessary to ensure reliable and affordable clean energy, especially in the global south.
And while extreme weather events will still occur after we reach net zero, they will become less likely and less frequent. Instead of every kind of extreme happening everywhere all at once -- where we are heading today, unless we get very busy -- perhaps our children will be able to fully recover from each extreme event before the next one happens.
I thought we were discussing cooling. You have switched to extreme weather. Fortunately the news here is not as alarming as you might think.
Despite warming of ~1.2 C already there has been no detectable increase in storms of any sorts or floods, according to the IPCC. The mid-range prediction is a further warming of around 1 C. It seems implausible that this further increase will result in much more extreme weather events than the past warming of 1.2 C.
Even better is the fact that the actual impact of extreme weather has dropped dramatically in the past century as a result of increased resilience that comes from economic growth. The rest of the world is catching up with the developed world and this will increase their resilience whatever happens with extreme weather.
Yes I know that extreme heat events have increased and are killing more people. But often forgotten is the fact that extreme cold events kill ~10 fold more people, especially in poorer countries without affordable reliable energy. A dirty little secret of climate research is that deaths from extreme temperatures have actually dropped because of global warming! In the U.K. 500,000 fewer deaths were estimates from 2001-2019.
The collapse of the AMOC is likely to bring very cold climate back to Great Britain and the North Sea. It seems to me that you're overly sanguine about the effects of extreme weather caused by anthropogenic climate change, be it hot or cold. Cold weather events may directly kill more individuals, but the shift to a warmer climate will lead to mass starvation and war. I'm thankful that fossil fuel apologists are starting to lose the information war.
I am pleased you acknowledge that you see it as an information war that you are participating in. You clearly recognise that you are biased and more concerned with winning the argument than solving a real problem. Reality does not care about information.
I am not a fossil fuel apologist. It is simply irrational to think we can rapidly switch from fossil fuels to 100% clean energy without catastrophic effects on economic growth and energy poverty.
That INEVITABLE effect has to be balanced against the the POSSIBILITY of the effects you are discussing.
A rational approach is to replace fossil fuels with reliable affordable clean energy as fast as possible. Nuclear energy can easily do this if we remove unnecessary regulatory constraints.
Sadly most of this who are concerned about reducing fossil fuels are woefully ignorant of the limitations of solar and wind.
When this is combined with exaggerated fear of climate change the result is really dangerous for humanity.
Instead of educating themselves about this people like you dismiss these issues by questioning the motives of those raising them. It really is something to be ashamed of.
"Like many things in public health, the HRI surveillance is a suboptimal patchwork of data, and only some states are reporting, creating a fragmented picture." For the far right, this is a feature rather than a bug. If our data on a problem for which they have no solution are incomplete or non-existent, it's easier to pretend the problem doesn't exist.
Thank you for this summary and for the data. I'm so sorry to hear about your little girl. I hope that she is fully recovered and that all of you can stay cool. I also hope that we as a country and a world can get it together to more rapidly and effectively address climate change.
At least we now have, from gov't funded atmosphere/ocean researchers, frequent global measurements of air temperature. This is part of the broad weather, climate, air-quality data flow, from orbiting satellites to deep diving ocean probes. It can aid our response, and especially, warns of the spread of UNinhabitable regions. For example, google NASA WorldView..... https://worldview.earthdata.nasa.gov
What do you consider to be the Midwest? Illinois, Wisconsin, Iowa, etc are midwest to me, yet I see no charts with these states in them.
"While state data is lagged (last update was 2021), data by region is impressively available in almost real-time. 2023 is shaping up to be unique in the Midwest, with higher rates of HRI than in previous years."
Perhaps because some of those state neither collect nor report data that would make them look bad? That's certainly how the extremists here in Missouri operate.
Good job. What IVD-10 diagnostic codes are being used to find heat related illnesses? As a physician myself, I was especially interested in this statement, “Reporting behavior. If more physicians are aware of HRI, they are more likely to categorize it as such in a patient’s chart. Over time, it will look like more HRI when, in reality, it’s a product of increased reporting.”
ooops ICD-10
Comment on a different subject: I suggest looking at a paper in Nature, 20 July 2023. Title is: How Many Clinical Trials Can't be Trusted?", by Richard Van Noorden. Sounds like the magnitude of faked clinical trials and faked or altered data is significant.
Agreed. You can't tell 8 million people to crank up their AC without straining the power grid, and if that goes, we're all buggered.
Considering how incensed people got about the minor nuisance of wearing a mask, I'm not optimistic that people are going to behave altruistically (certainly not voluntarily) when we start having to ration air conditioning to people who are deemed to need it the most.
But....to be fair, I don't think our heroine here is prescribing anything normative here, just presenting objective facts about what impacts the risk of HRI's.
This is so good to increase understanding of what’s going on. Applause to Dr. Jetelina for once again doing comes naturally, as in “So, naturally, I went down the epi rabbit hole of curiosity.” 💕👏💕👏💕
PS, I hope your daughter is now ok!
First thank you for addressing the impact of environmental determinants on health (EDOH). As I've read and heard, HRI are severely underreported. The impact of extreme heat on overdose, respiratory illness, cardiovascular events, etc. are generally not included in these stats. How can we present this data when what I've read is that Heat Related mortality is probably 10X what is reported?
I'm very concerned about a covid vs excessive heat/poor air quality "rock and a hard place" effect emerging this summer.
Glad you wrote about this Katelyn, I think it's a worthy topic to follow, along with other climate change related issues that impact health.