Summer in our tropical paradise feels hotter than the ones I remember as a child. In fact, the last five years are the hottest ever measured. Florida’s record-smashing summers are dangerous. Experts predict more frequent, severe, and longer heat waves in our future. In Palm Beach County, the number of days with a “feels like” temperature over 100°F are predicted to quadruple from the historic average of 28 a year to 121 such days by mid-century.
Extreme heat is a public health concern. Heat is called the silent killer because it kills more people than any other extreme weather event. At least 700 people in the U.S. die each year of heat-related illnesses, and some researchers suggest this number is much higher. As the earth warms, there will be more emergency room visits, illness, and deaths. The good news is that many of these deaths can be prevented if we take steps to protect ourselves.
Some people are more vulnerable than others. Older adults, almost 40 percent of Florida’s population, are most at risk of heat-related illness or death. Seniors often live alone and their bodies are less efficient at thermoregulation, our body’s way of cooling itself down. People with pre-existing conditions like diabetes or heart disease are also more susceptible. Those who work or play outdoors and low-income residents are more likely to die or get sick when temperatures rise.
As a physician with a focus in maternal and child health, I believe we can do better to protect expectant mothers. Florida should include pregnant women in lifesaving heat warning systems. Expectant moms are as vulnerable as seniors and outdoor workers, but have often been overlooked. Practitioners caring for pregnant women should make it routine to include advice about heat illness prevention like staying cool and hydrated.
A recent review paper found a “significant association between exposure to heat during pregnancy and adverse birth outcomes,” whereby women with asthma and black mothers are most at-risk. There is considerable evidence linking heat exposure during pregnancy to higher rates of preterm birth, low birth weight, congenital heart defects, and neural tube defects like spina bifida. These are among the leading causes of infant mortality in the U.S., which is higher than most peer countries in the OECD. The increasing rates of premature birth in the U.S. are linked with immediate and lifelong poor health putting an emotional and financial burden on families and society.
Across the U.S. health professionals like myself, community organizations, and city planners are working to protect the public from extreme heat. The Palm Beach County Office of Resilience and the West Palm Beach Office of Sustainability are doing great work to build community resilience. Their work would be strengthened by closer collaboration with local public health experts. We need support from local, state, and national elected officials to communicate the dangers of extreme heat to the public. It’s time for Florida to develop a comprehensive heat action plan to coordinate statewide preparedness for deadly heat. We should use tools like the Florida BRACE program’s vulnerability assessment and the Southeast Florida Regional Climate Change Compact’s Climate Action Plan to build a state more resilient to extreme heat.
A state heat action plan must pay special attention to underserved communities suffering from hotter temperatures than affluent neighborhoods due to the urban heat island effect. As the late Sen. Paul Wellstone so succinctly put it, “We all do better, when we all do better.”
CATHERINE TOMS, TAMPA
Editor’s note: Toms is a mother, physician, and steering committee member of the Florida Clinicians for Climate Action.