Extreme heat waves will impact children and the elderly unless we design good public health interventions

With summer upon us, heat waves have the potential to affect the health and wellbeing of the most vulnerable members of our community.

Extreme heat is becoming a regular event in tropical countries such as Nigeria, India and Pakistan, with as many as 1.5 billion people experiencing temperature and humidity levels beyond which it is difficult to survive. Given the lack of consistent electricity, poor indoor climate controls and inadequate health services, coping with temperatures of over 104 deg F/40 deg C is difficult. Even in temperate countries, however, relatively moderate heat can be harmful to families.

In August 2003, France suffered one of its worst heat waves in history — temperatures reached 111 deg F/43 deg C and above average temperatures lasted for two weeks. An 15,000 additional people died during the 20 day period, with many deaths directly linked to heat, heatstroke, hyperthermia and dehydration. This was in one of the world’s richest countries with a modern health care system and abundant electricity! This kind of heat wave is becoming increasingly common due to climate change, and can hit populations with normally moderate temperatures particularly hard.

Even when heatwaves aren’t occuring, research shows that rising average temperatures can result in permanent harm to the elderly, children and mothers, with chronic malnutrition, low birthweight babies and mortality increasing.

Research has used models to connect global gridded daily temperature datasets to the number of food groups like fruits, vegetables and protein eaten by children across 19 countries. The results show that in the poorest countries, rising temperatures outweigh all other development efforts, such as investments in education, improved access to agricultural inputs or poverty reduction. The amount of food available to children declines when average temperatures rise, resulting in higher malnutrition.

When temperatures during the day are extreme, parents stay home, school closes, fields don’t get weeded, no one goes to the market and food is not cooked. Children fail to eat and thrive. Families do worse and incomes for the poorest in the community fall. These impacts are not restricted to only large tropical nations — they also affect the poorest in Europe and the United States. Even if blackouts don’t occur, poorer residents of extremely hot cities are constantly vulnerable to rising energy costs and over-reliance on aging and inefficient cooling infrastructure. We will all be affected.

There needs to be concerted government action to create a public health response to heat waves akin to poor air quality days or snow emergencies. Investment in health impact prevention and organized cooperation is the key to reducing heat-related death and malnutrition in these vulnerable groups.

When done properly, such interventions really make a difference for people’s health. Since 2003, France has cut the death toll by 90% during extreme heat events, such as the 114.8 deg F/ 46 deg C maximum that occurred in the summer of 2019. By setting out a National Heat Wave Action Plan that identified responsibilities for interventions such as cooling centers, reducing outdoor exposure, and neighborhood watch for vulnerable seniors.

As extreme events become more common, the humanitarian community and health officials need to consider high temperatures in their plans and institute interventions and setting clear responsibilities during the long, hot summers to preserve human life and wellbeing.