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Heat makes health inequity worse. People with health risks are hit harder


All over the U.S., record-breaking hot weather is bringing the danger of heatstroke. That's when the body's core temperature rises so fast and so high that it rapidly becomes lethal. And the heat is especially dangerous for those with common conditions like diabetes or heart disease. NPR consumer health correspondent Yuki Noguchi reports.

YUKI NOGUCHI, BYLINE: Just in the past five years, many of Sameed Khatana's patients have realized how climate change hurts them. They fared poorly with each wave of record heat.

SAMEED KHATANA: There's some evidence that the greatest proportion of deaths that occur related to extreme heat are likely due to cardiovascular conditions.

NOGUCHI: As a cardiologist at University of Pennsylvania, this caught Khatana's attention. The heart pumps blood away from vital organs to dissipate heat. That can overload weakened hearts or lungs. Many of his patients also have obesity or diabetes, which can affect circulation and nerve function. That also affects the ability to adapt to heat. And that's not all. Common medications his patients take - beta blockers and diuretics - can make heat symptoms worse.

KHATANA: Now, this isn't to say that people shouldn't be taking those medications. It's just to highlight the fact that some of the medications that are necessary for people with heart disease can also impair the body's response to heat exposure.

NOGUCHI: And those most vulnerable are the same ones most at risk from heat.

KHATANA: Like most public health issues in the United States, extreme heat is also a health equity issue.

NOGUCHI: Once again, the elderly, minorities and people with lower socioeconomic status bear the highest risk, just like other public health issues like obesity or COVID-19. Those most in danger live in the Deep South and across the Midwest, where heat, older populations and rates of complicating disease run highest.

KHATANA: You know, in the United States, it's oftentimes noted that there's a stroke belt.

NOGUCHI: Even within cities, many disadvantaged communities face greater exposure to heat as well as fewer resources to address it or escape it. And, Khatana says, he fears the public measures to fight heat won't reach them.

KHATANA: It's a little bit disorganized. For many places, it's unclear how people are going to get to these cooling centers. Is there appropriate public transportation? How are people going to be made aware where these centers are? Is someone going to reach out to people who perhaps are physically impaired?

NOGUCHI: Steve Woolf is director emeritus at the Center for Society and Health at Virginia Commonwealth University. He notes historically marginalized communities have less air conditioning. They also tend to have fewer trees and public parks. That means temperatures can run 15 to 20 degrees hotter in those areas, compared to leafier areas a few miles away.

STEVE WOOLF: Planting trees and creating areas of shade so that people have a way of protecting themselves from extreme heat, or changes in roofing materials can change how much heat is absorbed by buildings.

NOGUCHI: He says such changes don't have to take much time - perhaps two to three years to implement - but it also takes investment of money. Woolf says as heat affects workers and productivity, he hopes businesses will lead in making some of these investments.

WOOLF: Eventually, I'm suspecting businesses and employers will do the math and see that the payoff in terms of lost productivity more than outweigh the upfront expenses of retooling their infrastructure to deal with extreme heat.

NOGUCHI: As more parts of the country come face to face with the health and safety costs of extreme heat, he says he hopes there will be more political will to back these changes.

Yuki Noguchi, NPR News. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Yuki Noguchi is a correspondent on the Science Desk based out of NPR's headquarters in Washington, D.C. She started covering consumer health in the midst of the pandemic, reporting on everything from vaccination and racial inequities in access to health, to cancer care, obesity and mental health.

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