How Extreme Heat, Smoke, and Flooding Threaten Our Health


Columbia public health experts review the health impacts of climate change-related emergencies, and offer advice on how we can protect ourselves

By Columbia Mailman School of Public Health

The Southwest and West face a second week of extreme temperatures that have already claimed more than a dozen lives. Approximately one in three Americans received excessive heat warnings, watches or advisories last weekend, according to the National Weather Service. Globally, July was the hottest month on record, pushing the world closer to the critical 1.5-degree Celsius temperature rise threshold, the most optimistic target for limiting global warming.

Meanwhile, Canadian wildfires, preceded by doubts, continue to create smoke that carries thousands of miles, triggering air quality warmings and unhealthy conditions across wide swaths of the United States, reaching as far south as Miami, and communities across New England and the Northeast struggled to recover from recent powerful storms and flash flooding.

Environmental health scientists from Columbia University Mailman School of Public Health—home to the country’s first climate and health program in a school of public health—are working to study and address these challenges, both through original research and teaching front-line health workers and the next generation of public health leaders.

“There is no doubt that extreme weather and wildfires are happening with greater frequency because of climate change,” says Cecilia Sorensen, an emergency medicine physician and associate professor of environmental health sciences at Columbia Mailman School. Studies show that climate change has led to a 50 percent increase in the acreage burned. “We are especially concerned with vulnerable groups, including individuals with preexisting respiratory and cardiovascular conditions, the elderly, small children, and infants, people without stable housing, and those who work outside.”

Sorensen points to a slate of health risks from extreme weather. Exposure to wildfire smoke is dangerous for people with asthma and other respiratory conditions and prolonged time spent outdoors is a risk to everyone. High temperatures are most dangerous to the same vulnerable groups, including the elderly and those who work and live outside. Stormy weather introduces the risk of injury, such as from landslides and downed powerlines, and creates a breeding ground for mosquitoes and other infectious disease vectors. All these stressors disrupt lives and have a negative impact on mental health—as can the larger anxiety about climate change.

In situations of extreme weather, individuals should seek out guidance from their local authorities on cooling centers, road closures, masking guidance, and more. Air quality information is available online(link is external and opens in a new window) and offers a general framework for how safe it is to be outdoors. Sorensen adds her own advice: “Check in on your loved ones. Often our most valuable front-line responders are friends and family,” she says.

Sorensen leads the Global Consortium on Climate and Health Education (GCCHE), which is based at Columbia Mailman. With 310 medical, nursing, public health, and other health professions schools as members, GCCHE develops curricula and conducts trainings on climate and health around the world. She is a member of the Lancet Countdown on Health and Climate Change(link is external and opens in a new window) and serves on the National Academy of Medicine Action Collaborative for Decarbonization of the U.S. Health Sector(link is external and opens in a new window). She is the co-editor of the textbook Climate Change and Human Health: From Science to Practice.

In its trainings, GCCHE focuses on ways communities can protect themselves and build resiliency. These include early warning systems for extreme weather, rain gardens and other methods to mitigate flooding, cooling centers, and more.

Informing these trainings is research by Sorensen and other Columbia Mailman faculty scientists, including Darby JackMarianthi-Anna KioumourtzoglouRobbie ParksJeff ShamanLew Ziska, and others. These studies have linked elevated temperatures to injury deaths(link is external and opens in a new window), wildfire smoke to jump in ICU admissions(link is external and opens in a new window), tropical cyclones to elevated hospitalizations(link is external and opens in a new window) and death rates, including the specific illnesses involved(link is external and opens in a new window) and special risks to older adults(link is external and opens in a new window). They have also examined the effects of heat stress on kidney function of agricultural workers(link is external and opens in a new window), as well as the broader impacts of climate change on women’s health(link is external and opens in a new window) and on food security. Meanwhile, research continues to demonstrate the negative health impacts of the main driver of climate change—air pollution from fossil fuel combustion.

“Climate changing is stressing all of society, especially the most vulnerable,” says Sorensen. “It’s critical that we come together to protect ourselves as extreme weather becomes the new normal. At the same time, we need to push for a speedy transition to a green economy.”

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