How heat makes health inequity worse : Shots

EMTs help a patient in Austin, Texas, this week. The man had passed out near the state capitol and was dehydrated. Cities with few trees and areas of shade are hotter during heat waves.

Brandon Bell/Getty Images

Within the past five years, Dr. Sameed Khatana says, many of his patients in Philadelphia have realized how climate change hurts them, as they fared poorly with each wave of record heat.

“Like most public health issues in the United States, extreme heat is also a health equity issue,” says Khatana, who is a cardiologist at the University of Pennsylvania and the Veterans Affairs hospital in Philadelphia.

Record heat scorching the country is especially dangerous for the many, many people with common conditions like diabetes, obesity and heart disease. And within cities, many vulnerable communities face greater exposure to heat, fewer resources to address it or escape it, and higher rates of the diseases that make heat more dangerous for people.

Risk piled upon risk

Khatana, who also has a master’s in public health, is well acquainted with how these risk factors overlap.

“There’s some evidence that the greatest proportion of deaths that occur related to extreme heat are likely due to cardiovascular conditions,” says Khatana.

Heat stroke happens when the body’s core temperature rises so fast and high it rapidly becomes lethal. 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.

In addition, common medications his patients take for heart disease — beta blockers and diuretics — can make heat symptoms worse.

…