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Tick bites are rising. What to know about Lyme disease and alpha-gal syndrome.

2026-05-06T11:00:00+00:00

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Hello and welcome to Healthbeat’s weekly report on stories shaping public health in the United States.

This week, I’m highlighting the news that tick season has begun, with cases rising three-fold in the past month. We have good news about one of the most feared infections transmitted by ticks, Lyme disease, and not so good news about a non-infectious disease caused by ticks, alpha-gal syndrome.

I am Dr. Jay K. Varma, a physician, epidemiologist, and public health expert currently serving as chief medical officer at Fedcap, a global nonprofit focused on economic mobility and well-being for vulnerable communities. Views expressed here are my own.

Tick season has arrived early and aggressively

The Centers for Disease Control and Prevention reported last week that emergency department visits for tick bites have risen roughly three-fold since March, from 34 per 100,000 visits to 96 per 100,000. That is the highest rate for this point in the year since 2017. The Northeast and Midwest have the highest rates of tick bites, with the Northeast already at nearly 50 tick-bite ER visits per 100,000.

What we call “tick season” in the United States is the stretch from roughly April through September, when warming weather draws ticks out of leaf litter and into the grassy, brushy edges of yards, parks, hiking trails, and gardens.

Ticks are often present at the tips of grass blades and low shrubs, then grab onto deer, dogs, or humans as they brush past. Tick bites and diseases transmitted by them are rising because of climate change. Warmer temperatures are allowing tick populations to survive further north and to extend their activity for longer periods of the year.

The two ticks of greatest public health concern in the United States right now are the blacklegged tick (also known as the deer tick) and the lone star tick. The blacklegged tick transmits Borrelia burgdorferi, the bacteria that cause Lyme disease, as well as less common infections such as babesiosis and anaplasmosis.

Another type, the lone star tick, is driving the rapid rise of alpha-gal syndrome, a delayed allergy to red meat. The lone star tick is identifiable by the white spot on the back of adult females and is notable for actively crawling toward people, rather than simply lying in wait to bite.

Lyme disease is, by far, the most common tick-borne illness in the country, with about 476,000 people diagnosed and treated each year. Alpha-gal is rarer, but causes substantial difficulty for patients and may be increasing. Both conditions are the focus of important news in the past month, so let’s take them in turn.

Will we soon have a vaccine for Lyme disease?

A vaccine for Lyme disease is important, because many initial infections are missed. Untreated Lyme can cause arthritis, heart problems, and neurologic complications, and, even when infection is caught early and treated, some patients report long-lasting fatigue and pain. A vaccine could potentially prevent or reduce these conditions.

What’s less well known is that we had a Lyme vaccine in the 1990s. In 1998, the Food and Drug Administration approved LYMErix, a vaccine that was about 76% effective in preventing infection. Although the scientific data for the vaccine was strong, demand for it plummeted after people began reporting arthritis-like symptoms after receiving the vaccine.

Researchers warn of threats – to humans and native plants – from little-known ant

It turns out that the rate of arthritis-like symptoms was similar in the general population and that symptoms did not correlate with the second or third dose, as a true immune-driven side effect should. Nevertheless, a class-action lawsuit was filed, and GlaxoSmithKline pulled the vaccine from the market in 2002.

Now, more than two decades later, Pfizer and Valneva have announced phase 3 results for a new Lyme vaccine candidate, PF-07307405. The vaccine works through an unusual and elegant mechanism: It generates antibodies in your bloodstream that the tick ingests when it bites you. Those antibodies disable the bacteria inside the tick before they can be transmitted into your body.

In the VALOR trial, Vaccine Against Lyme for Outdoor Recreationists, the vaccine was 73% effective at preventing confirmed Lyme disease 28 days after a fourth dose and about 75% effective one day after the fourth dose.

Although these numbers are promising and Pfizer says it will submit for regulatory approval, there are some important concerns.

First, fewer Lyme cases occurred during the trial than expected, so the primary statistical endpoint was not technically met, even though the secondary analysis was.
Second, this is a four-dose vaccine (three shots in the first year, then a booster before the next tick season). In my experience as both a physician and leader for large-scale vaccine programs, it is extremely difficult to get adults to complete a four-dose vaccine series.
Finally, in the current anti-vaccine environment, I worry whether the FDA will consider this vaccine, whether the CDC would promote it even if FDA approves it, and whether the public will actually accept it. It would be deeply unfortunate if we relived the LYMErix story a second time.

Alpha-gal is rising, but is it more widespread than we realize?

If you have not heard of alpha-gal syndrome yet, it’s likely you will in the near future. It is a delayed allergic reaction to red meat (e.g., beef, pork, lamb, sometimes dairy and gelatin) caused by a sugar molecule called galactose-alpha-1,3-galactose, abbreviated as “alpha-gal.”

The lone star tick carries this molecule in its saliva. When the tick bites you, it can trigger your immune system to make antibodies against alpha-gal. After that, eating a hamburger may cause hives, vomiting, stomach cramps, or, in some cases, life-threatening anaphylaxis several hours later. It has been called “the midnight allergy,” because patients often eat dinner, fall asleep, and wake in the night to a full-body reaction.

The foundation of any public health response to a disease is to count it. You cannot prevent what you cannot see. Yet alpha-gal surveillance in this country is patchwork, as described in a recent article.

Arkansas became the first state to make alpha-gal a reportable condition in 2023, and more than 15 states track cases to some degree. New York, which is home to one of the country’s most concentrated hot spots in Suffolk County, does not track cases statewide. New York City does — and has documented 280 suspected cases since 2024 — even though the lone star tick is not common in the five boroughs.

The CDC has documented more than 110,000 suspected cases since 2009 and estimates the true number could be three to four times higher.

Without comprehensive surveillance, public health agencies cannot warn their communities about how common it is and who is likely to get it. Clinicians are less likely to consider it, and patients spend time bouncing between specialists before they are diagnosed.

Where to look for advice on tick bite prevention

Although changes to its website have been problematic, the CDC does remain an excellent resource for information on how to prevent tick bites. The single best protection is a combination of applying Environmental Protection Agency-registered repellents on your skin, treating shoes and clothes in permethrin, walking the center of trails, and conducting full-body tick checks within two hours of coming inside.

If you are bitten, consider using the CDC’s Tick Bite Bot that walks you through what to do.

Until next week,

Jay

Dr. Jay K. Varma, who is recognized globally for his leadership in the prevention and control of infectious disease, writes about public health for Healthbeat. He has guided epidemic responses, developed policies, and implemented programs that have saved lives across Asia, Africa, and the United States. He is based in New York. Contact Jay at jvarma@healthbeat.org.

Researchers warn of threats – to humans and native plants – from little-known ant

2026-05-01T18:32:46+00:00

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Researchers in the South want people to know about an invasive ant species whose painful sting can cause fatal anaphylaxis in some people – and disrupt local ecologies as well.

Asian needle ants are not widely known and often meander outdoors individually, so it’s easy to miss them and get stung. As temperatures grow warmer in the spring, the ants become more active and people spend more time outside.

Dan Suiter, an entomologist with the University of Georgia’s extension service, received calls from three people in 2024 reporting being stung by Asian needle ants and requiring hospitalization for anaphylaxis, an allergic reaction that can be fatal.

Suiter said he wants to make sure people know about the Asian needle ant so they can avoid stings. Since he began putting out press alerts over the past few years, he’s received many more reports from people who were stung and needed serious medical treatment.

@healthbeatnews
Researchers in the South want people to know about an invasive ant species whose painful sting can cause fatal anaphylaxis in some people – and disrupt local ecologies as well. #AsianNeedleAnts are not widely known and often meander outdoors individually, so it’s easy to miss them and get stung. As temperatures grow warmer in the spring, the ants become more active and people spend more time outside. Learn more about the Asian needle ant and how to minimize risk at healthbeat.org. #ants #insects #georgia #south
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The species, discovered in Decatur, Georgia about a century ago, likely arrived in the United States through international trade.

The ant has been reported in more than 20 states east of the Mississippi River, from Florida to Wisconsin, according to data from the Global Ant Biodiversity Informatics project at the University of Hong Kong.

One study published last year found the ants thriving in a community mulch pile in Watkinsville, Georgia. Gardeners taking mulch from the pile could be contributing to the ant’s local spread, the authors wrote.

The species has a 100-year head start on researchers, and they lack good historical data as to how the ant has spread in the United States, said Christopher Hayes, an entomologist at North Carolina State University.

How invasive ants can affect the environment

As with other invasive species – like kudzu – it’s too embedded in the environment to successfully remove it, Hayes said.

In the Southeast, fire ants and Joro spiders are well-known invasive species.

Scientists are seeking to better understand the Asian needle ant: where it is, its habitat, and its environmental impact. That’s important, Hayes said, because the ant can harm ecological systems.

“On a daily basis, you have these multiple species that they’re always competing with one another,” Suiter said. Asian needle ants “out-compete” other ant species for food, driving those species to “local extinction.”

That’s a problem because those species are often responsible for seed dispersal that allows native plant species to reproduce, he said.

Hayes said he would like to figure out how to preserve native species and mitigate the Asian needle ant’s environmental impact.

Painful sting can prompt anaphylaxis, phantom pain

Allergic reactions to stings by honeybees, wasps, and ants account for up to 43% of anaphylaxis cases and about 20% anaphylaxis-related fatalities. That makes them an important, if sometimes underrecognized, public health issue, according to a 2022 study.

Suiter said people who are allergic to bees and wasps and those who carry EpiPens should know what the Asian needle ant looks like so they can avoid a potentially serious allergic reaction.

Asian needle ants crawl along decaying wood and leaves.

As temperatures warm and summers grow longer, Hayes said, the Asian needle ant will have longer active seasons. While the ants typically “hunker down” over the winter, they become more active in warmer weather, meaning people will have more chances of being exposed to them.

The ants don’t come indoors, instead preferring moist environments, like downed logs, Suiter said.

The ants, whose scientific name is Brachyponera chinensis, are brownish, measure 3/16-inch long, and often live in logs and leaf litter and under rocks and stones.

“One of the ways to minimize the numbers of needle ants in your yard would be simply to clean up all that,” Suiter said.

Asian needle ants are less aggressive than fire ants, Hayes said. They are “stealthier” and more likely to be hidden in piles of wood than the fire ant mounds that Southerners are used to seeing.

And while fire ants are more likely to come pouring out of a mound and bite people multiple times, Asian needle ants will “meander around on your arms” or other body parts until they get squeezed, such as in a gardener’s glove, prompting them to bite, Hayes said.

In contrast to most other ant species that form long trails, Asian needle ants tend to go it alone.

“When you see them in your yard or on the concrete, they’re just kind of meandering around as a single ant, and they don’t really garner your attention” the way ants in long trails might, Suiter said.

“With the Asian needle ant, their rate of triggering anaphylaxis from a single sting is much higher than the rate of a fire ant individual sting triggering anaphylaxis,” Hayes said. “The sting of an Asian needle ant is more dangerous on the individual ant level.”

(Colloquially most people say they were “bitten” by an ant, Hayes said. In reality, most ants first bite people and then either sting with venom or spray an acid.)

The sting looks different than a fire ant sting, which looks like a small zit with a white pustule, Suiter said. Asian needle ant stings have small red dot surrounded by swelling, similar to a yellow jacket sting.

People who are allergic to other insects like bees and wasps are most at risk of anaphylaxis, Hayes said, because the venom is similar.

But there are reports of people with no history of allergies or anaphylaxis also having severe reactions to the Asian needle ant, Hayes and Suiter said.

If you do think you’ve been stung, keep an eye on the site and mark any swelling or redness with a marker on your skin so you can tell if it spreads. If it does spread, or you have difficulty breathing, seek medical advice right away, Hayes said.

He has been stung before – “for science” – and said the sting felt like fiberglass underneath his skin, different from how a fire ant’s sting feels. He keeps an EpiPen and Benadryl on hand to help manage allergic reactions.

The Asian needle ant has an unusual feature: It can cause pain hours after the initial sting, even up to 24 or 48 hours later.

Hayes said his young son was stung last summer and woke up hours later screaming in pain.

Suiter also reported the pain returning hours later after a sting. “It’s got kind of a bizarre response,” he said.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

NYC food aid groups take stock after rough winter for hungry seniors

2026-04-30T14:52:32+00:00

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As New York City emerges from one of the coldest winters in years, those who serve the growing population of seniors facing food insecurity are reflecting on what more can be done – before summer, when extreme heat could bring another barrier to aid distribution.

“They have to think: Do we want to be hungry or do we want to freeze?” said Tyler Efferon, executive director of EV Loves NYC, a food pantry in the East Village. He noticed seniors were missing from food distribution sites this winter.

“We usually do 384 meals, and this past week we only did 240 meals,” he said in February.

In 2023, 1 in 10 New Yorkers ages 65 and older experienced food insecurity – a 3% increase from 2021, according to Feeding America, a nationwide network of food banks, food pantries, and soup kitchens.

Since the pandemic, the city’s total population has declined – but the senior population has continued to grow, according to a 2025 report by the state comptroller’s office. The city’s 65-and-older population grew 53% from 2000 to 2023 – 17 times faster than the total population.

Many seniors in need don’t have the mobility to get to food distribution sites, especially when sidewalks are slippery with snow and ice, said Alexina Cather, former deputy director of the NYC Food Policy Center at Hunter College.

“When it’s 5 degrees outside, you cannot come,” Julie, 63, told Healthbeat as she braved a frigid evening in February to pick up free groceries from a City Harvest truck on Manhattan’s Upper East Side. She declined to give her last name. “One Monday I came, but it was too cold, so I went home.”

It can be hard during summer heatwaves, too.

City Council Member Elsie Encarnacion, whose district includes part of the Bronx and the Upper East Side, introduced a bill on April 10 at the Committee on Aging to require the city Department for the Aging to develop a protocol for conducting in-person and phone wellness checks during extreme hot or cold weather.

People line up to receive food distributions from City Harvest in New York City in February.

For older people, exposure to the cold poses a higher risk of hypothermia, as the human body’s ability to regulate temperature deteriorates with age.

Chris Jay, a 61-year-old unemployed man who lives in an apartment in Sunset Park, said he defied the cold every Monday this winter to get food at the Gotham Food Pantry, where he received a hot meal at 6 p.m.: chicken, rice, vegetables, and lemon cake.

Afterward, he spent an hour and a half in 23-degree weather on the steps of All Souls NYC Church, waiting for a truck from City Harvest, which redistributes surplus food that would otherwise go to waste.

“A lot of people just come for the meal, and then they leave,” Jay said. “They don’t want to wait around for the truck because we never know when the truck’s going to be here.”

Delivering food directly to seniors’ homes would require more resources, trucks, drivers, and other workers. Gotham Food Pantry operates with only four employees and 100 volunteers, making personalized home delivery out of reach, Executive Director Douglas Silver said.

“I would need to have all the addresses of all those people,” he said. “I don’t have this.”

Advocates say more funding for local food pantries, not just big food banks, could make a difference.

“Right now, a few core companies get all the funding for food access,” Efferon said.

Cather said the city mainly funds the Food Bank for NYC but should be investing in neighborhood food pantries. With more money, she said, local food pantries could schedule delivery to some senior centers, giving food to 100 people at the same location.

“The food pantries are at the front line,” Cather said. “They understand the nuance of their clientele and can meet people where they’re at.”

Meals on Wheels delivers a wellness check

The city Department for the Aging provides one meal every weekday through its Meals On Wheels program. It is dedicated to seniors who cannot cook, travel to food pantries, or stand waiting for hours. The program serves 24,000 of the city’s 1.43 million seniors, according to the comptroller’s report.

Meals on Wheels was created by the Older Americans Act of 1965, when the senior population was only 9% of the whole U.S. population. In 2025, the Census Bureau estimated this same population to be at 61.2 million, or 17% of the total population.

The meals are delivered door to door, providing human contact for older adults, said Susan Zhuang, chair of City Council’s Committee on Aging. ”Meals on Wheels is not only just a meal delivered to their home. It is also a check-in with them.”

Meals are not delivered on weekends. Zhuang said many nonprofits have told her that seniors often fall and cannot reach the phone. Deliverers from Meals on Wheels knock on the door and find them on the floor.

“If it happened Friday night and then the whole weekend passed and no one checked on them, the people are going to die,” Zhuang said. “It’s not only just a meal issue. It’s a meal issue plus isolation issue plus health health issue plus caregiver issue.”

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City Council Member Linda Lee, whose district in eastern Queens includes the Douglaston and Bayside neighborhoods, has introduced a bill to extend Meals On Wheels to seven days a week.

Meanwhile, Citymeals on Wheels, created in 1981, distributes weekend meals to 16,000 to 20,000 people every year. About 2,000 senior New Yorkers get a monthly breakfast box containing the equivalent of 30 breakfasts with perishable and non-perishable items, and the program delivers groceries to 700 seniors a year.

Fear of ICE keeps people from food distribution sites

Fear of being detained by Immigration and Customs Enforcement agents are also hindering seniors from going out for food, advocates say.

Council Member Alexa Aviles, whose district covers Red Hook and parts of Park Slope, Sunset Park, Borough Park, Dyker Heights, Bensonhurst, and Bath Beach where 46% of the residents were born in another country, said she has noticed this fear among her constituents.

“Now that ICE is in the community,” she said, “people are afraid and don’t want to stand in long lines where they feel vulnerable.”

Aviles, whose office participated in food distribution, said that fear of ICE “concerns everyone who does food distributions and any activity where now you have a mass of people.”

“The first question we are now asking is not ‘Do we have enough?’ Now it’s ‘What are we going to do if ICE shows up? How are we going to keep community members safe? Will people come out if we do this?’ ”

NYC Department for the Aging’s budget, which the Committee on Aging oversees, is less than 1% of the city’s budget. Zhuang is negotiating for more.

Rachel Sherrow, COO of Citymeals on Wheels, said society is too focused on youth and doesn’t take enough care of seniors.

“We are talking about universal pre-K, universal child care, universal all of that,” she said. “What about universal older adults, universal meals? An older adult should be getting at least three meals a day.”

Apolline Lamy is a freelance journalist in New York.

Smoke from South Georgia wildfires drives poor air quality, ER visits in Atlanta

2026-04-24T15:29:08+00:00

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Wildfires burning hundreds of miles away created a visible haze and poor air quality this week in Atlanta, with some emergency rooms and clinics reporting calls and visits for respiratory conditions exacerbated by the smoke.

A statewide drought that started in mid-September has created ideal conditions for more than 75 wildfires that have burned more than 35,000 acres in the past week. Gov. Brian Kemp has declared a state of emergency in 91 of Georgia’s 159 counties.

The biggest fires are in Southeast Georgia – Brantley County, where homes have been evacuated, and Clinch County – sending smoke into the northern part of the state at times, as winds shifted.

Up to 90% of wildfire smoke contains PM 2.5: particulate matter that is smaller than 2.5 micrometers. The particles are so small that they don’t fall to the ground, which means people can breathe them in, said Colleen Reid, a professor at the University of Colorado Boulder who studies wildfires.

That particulate matter can lodge in the lungs’ small airways (the bronchioles) and even make their way to the bloodstream, said Emory University pulmonologist Dr. Colin Swenson. That can cause health problems, especially for certain at-risk groups.

Atlanta and many other areas of the state have had moderately concerning or worse air quality since Tuesday, according to Airnow.gov, which reports on local air quality conditions. That has driven an uptick in emergency room and clinic visits within the Emory system in Atlanta, Dr. Colin Swenson told Healthbeat.

Wildfires are uncommon in Georgia, where typically high humidity and rainfall protect forests from sparks and allows groundwater and soil to recharge. That didn’t happen this winter, with Atlanta, for example, only getting 54% of the rainfall it normally gets since the start of the year, according to the National Weather Service.

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The last time the state faced such drastically dry conditions was in December 2016, said Elliot Wickham, the community lead for drought at the National Water Center, a division of the National Oceanic and Atmospheric Administration.

Drought conditions are forecast at least until the end of July, according to the National Weather Service.

Dry vegetation can be ignited in many ways – by power lines, a dropped cigarette, lightning, or even a spark from a broken-down car on the side of the road, said Reid, who offered some advice for Georgians who are not used to dealing with wildfires:

When the air clears, check your home air filters. They may have picked up more pollution than usual.

Here are some other things to know to protect your health amid poor air quality.

Who is most at risk of illness from air pollution?

People with respiratory conditions like asthma, chronic obstructive pulmonary disease, and bronchiectasis, are especially at risk, Swenson and Reid said.
People with cardiovascular diseases like coronary artery disease and heart failure can also be affected, Swenson said.
Pregnant people are vulnerable as well, Reid said. Wildfire smoke can increase the risk of low birth weight or preterm birth.
Children are more prone to asthmatic flare-ups because their airways are smaller than adults’. Schools and sports groups may cancel outdoor activities or move them inside.
The unhoused, people who work outdoors, and those who lack air conditioning will also face more smoke exposure, Reid said.
People who are in lower-risk groups might experience effects like chest tightening when exercising outdoors.

What can people do to alleviate effects of poor air quality?

Monitor air quality. Swenson and Reid recommend checking airnow.gov for information on the air quality index. The AQI is a good indicator of whether it’s safe to spend time outdoors. If it is yellow (moderate) or above, at-risk people should stay indoors. If it is red or above, then everyone should stay indoors, Reid said.
- Reid recommended checking frequently and getting as local perspective as possible.
- “The smoke plume [can] really change the air quality over short periods of time, depending on how the wind blows and and the intensity of the fire,” Reid said.
Run the air conditioning system and use HEPA air filters, Swenson said. That can help clean indoor air. People who don’t have those should try to find indoor spaces to spend time, Reid said.
Keep windows and doors closed.
Wear a mask. Those who are at risk who must go outside should use an N95 mask, Swenson said. That can help protect against the inhalation of the very fine particulates.
Exercise indoors. If you really want to exercise outdoors, early morning and after dusk are best, Swenson said.
Check your air filters after the fires and change them if needed, Reid said. Make sure building managers at large buildings are doing the same.

How long will health impacts last?

There are short- and long-term impacts, Swenson said. The smoke can set off COPD or asthma exacerbations in near-term. Those can last days to weeks, he said. It can also increase the risk of heart attack or cardiac injury for people with underlying conditions.

Over the long term, the smoke can set off “systemic inflammation that can linger for weeks or even up to a month,” Swenson said.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

To fight heat, NYC sets 2040 tree canopy deadline, with riskiest areas first

2026-04-21T13:24:07+00:00

This story was originally published by THE CITY. Sign up to get the latest New York City news delivered to you each morning. Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

On a breezy Monday morning on a quiet corner of Queens, 11 leafy new neighbors arrived on a truck, fresh from a nursery in Kansas City.

Elm, red maple, and cherry trees — some with pink blossoms — would be planted next to the sidewalks across a few blocks of Cambria Heights, a suburban-style neighborhood of homes with grassy front lawns.

As workers hoisted a tree out of a bag surrounding its roots, a woman with a phone to her ear leaving a nearby house called out to ask what kind of tree the workers were planting: an elm that would grow to be up to 70 feet tall over the next three to four decades.

“Adding to the family!” she exclaimed, grinning, before getting into a car.

Cambria Heights is among the neighborhoods with the highest risks of extreme heat, where temperatures are hotter than the city’s average and where some blocks lack any trees.

Monday’s tree-planting session came as part of a strategy in its second year that prioritizes putting new trees in the neighborhoods most vulnerable to extreme heat, rather than in response to ad hoc 311 requests, as had been done in years past.

And planting those trees took on a particular significance as the Mamdani administration on Tuesday released a plan to expand the tree canopy to cover 30% of the city by 2040.

“To reach this 30% goal, it’s going to take work from every actor in the entire city,” said Jessica Einhorn, chief of forestry programs at the Department of Parks and Recreation. “This program planting trees, especially in the high [heat vulnerable] neighborhoods, is really critical towards that equity angle.”

In those riskier areas, the tree canopy — or the area of the city currently covered by trees and their leaves — stands at 19%, compared to about 26% in others, city Chief Climate Officer Louise Yeung told the City Council in March. (Overall, tree canopy covers just over 23% of the boroughs, according to the last count in 2021. That was after a net increase of 1.2% since 2017.)

Trees across the city serve more than an aesthetic purpose — they add to the health and resiliency of a neighborhood. Areas with a robust tree canopy and vegetation have shown to be slightly to significantly cooler compared to places where green space is scarce and pavement is plentiful. Trees also help to purify air and can reduce water runoff to mitigate flooding.

And their value as heat-regulators will only increase in the near future.

By the 2040s — the due date for the 30% canopy goal — New York City’s temperatures could be between nearly 3 and 6 degrees hotter due to the effects of climate change, according to the New York City Panel on Climate Change. Heat is dangerous: It contributes to the deaths of over 500 New Yorkers on average each year, with Black New Yorkers twice as likely to die compared to white residents.

The city experiences the urban heat island effect, meaning it’s hotter because of the density, pavement, and tall buildings than elsewhere. But some areas are significantly greener and cooler than others, while other neighborhoods are more vulnerable to heat based on a combination of physical factors — like existing trees — and social considerations, like residents’ income and access to air conditioning.

Cherry blossoms bloom in eastern Queens on Monday.

The Parks Department’s tree-planting strategy, announced in 2024, does away with the system where anyone can call 311 to ask for a new tree — except for the loophole New Yorkers can make a $1,800 donation to do so, as previously reported by THE CITY.

The new system instead divides the city into more than 400 zones, planting trees in every viable place within a zone while removing stumps and dying trees.

Each community board district will have a zone serviced every three years, and Parks plans to hit all zones every nine years. (Here’s a tentative schedule of tree-planting locations.) The most heat-vulnerable neighborhoods are on track to be completed by the end of 2027, Yeung said.

Money grows trees

Mayor Zohran Mamdani’s plan is the first time the city has set a target date for the goal of a 30% canopy. But critically, the money to pay for it has not been committed.

“Many of the actions in the plan rely on existing program budgets and aim to ensure that we are spending smarter,” City Hall spokesperson Jessica Woolford said in a statement. “We are creatively leveraging funds from government and private sources to advance our shared goals.”

City Hall did not offer its own estimate for the cost. But according to a 2022 estimate from a local environmental advocacy group, it would cost about $500 million to plant a million trees and achieve its canopy goal.

“The plan is great, but what comes after is the most critical part,” said Shravanthi Kanekal, a resiliency planner at the New York City Environmental Justice Alliance. “It’s going to signal a whole lot to see how much they dedicate funding to the plan.”

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Though as a candidate, Mamdani promised to dedicate 1% of the budget to the Department of Parks and Recreation, his preliminary budget this year proposed spending just half of that — cutting nearly $34 million from the department’s budget in the current fiscal year.

“I’m really glad to see the city set a goal of 2040, and I think what we’ve been looking to is how to further accelerate achieving that goal,” said Tami Lin-Moges, director of the cities program at the Nature Conservancy. “But obviously that really relies on increased investments. … Investing in parks and the urban forest is an investment in livability in New York City.”

Greening the city so almost a third of it has tree canopy will require money, manpower, and shoring up interest from New Yorkers, said Simon Skinner, chief of programs and operations at the New York Restoration Project.

He pointed to the successful initiative to plant a million trees that the Bloomberg administration launched in 2007. It took eight years, short of the decade expected.

“It shows it’s possible,” Skinner said. “Everyone was pulling in the same direction because it was such a big initiative coming from City Hall.”

Skinner said several agencies coordinated to prioritize the goal as private landowners got involved, and the government and its partners educated kids and adults on tree planting and stewardship.

Not everyone is happy with new plantings

In Cambria Heights on Monday, interactions with neighbors showed some of the challenges the city may face as it reaches for the goal; not everyone was happy about the newly rooted neighbors.

Derrick Simmons, a long-time resident of a nearby block, stopped by to talk to the Parks workers about the problems he’s had with trees.

“The trees have fallen on different people’s cars. They broke up the sidewalks,” he said. “I know they said that this is supposed to make the neighborhood more beautiful, and I get that. But of course we got 26 trees. We don’t need any more trees.”

A bit later, another neighbor walked by and said the tree roots were messing with his home’s sewer pipes: “I live on the next block. We got tree-lined streets. It sucks!”

Navé Strauss, Parks’ director of tree planting, said, “Our mandate is to plant every available location.”

Einhorn said Simmons and his neighbor’s complaints indicated there was a lot that could be done to “increase the connection between people and their trees.”

“We do as much as we can to care for the trees, but really it’s those blocks where like a property owner or a neighbor will come out and water the tree or maybe plant flowers around that the data shows that those trees are better off than the others,” she said.

To reach the 30% canopy goal, trees will need to be planted on privately owned property, not just in public parks and on streets, Einhorn said — “and more than anything else is preserving our existing tree canopy.”

That maintenance — pruning, watering, cleaning tree beds and removing invasive vines — is important for trees to thrive and for the canopy to expand. All of those tasks require people to do them, which costs money.

“Obviously, it’s sexy and nice to plant a bunch of new trees, but we have to also look after what we already have,” Skinner said. “They have an outsized effect on things like reducing heat and absorbing pollution.”

Samantha Maldonado is a senior reporter for THE CITY, where she covers climate, resiliency, housing and development.

How a medical student is helping the CDC alert doctors to heat’s effects on medications

2026-04-14T22:25:40+00:00

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Medical student Riya Goel’s life has been shaped by climate change. She spent part of her childhood in Bangalore, India, where she experienced frequent asthma attacks, often requiring hospitalization, due to poor air quality.

Other stints living in California and Colorado exposed her to wildfire smoke. She learned firsthand about Atlanta’s extreme heat when she started medical school at Emory University, where she will graduate in May.

Those experiences sparked an interest in understanding the interaction between climate change and health. Goel has developed a resource for the Centers for Disease Control and Prevention that helps clinicians understand how heat could affect patients on commonly prescribed medications, from aspirin to antidepressants.

Many drugs can reduce patients’ ability to withstand higher temperatures. Some drugs increase sun sensitivity, and high heat can reduce the efficacy of some drugs.

Providers need to be aware of the heat risks of drugs so they can educate patients and help offset those, Goel said.

The resource provides information for clinicians about how heat impacts the body along with tips for educating patients. It then provides a list of more than 20 commonly prescribed drug classes and indicates how high heat can impact them.

For example, some common selective serotonin reuptake inhibitors, often prescribed for anxiety and depression, can increase sweating. Aspirin can make it harder for the body to release heat.

Diuretics, which are commonly prescribed for conditions like heart failure and high blood pressure, can cause dehydration, increasing the risk for falls in extreme heat. But the drugs are designed to remove fluid from the body, so increasing water intake isn’t necessarily a good solution. Ideally, people on diuretics would have access to cool environments, Goel said.

“We can be conferring risk even just by very basic prescriptions that we write for our patients,” Goel said.

She’d like to see more medications added to the CDC list, and she wants more clinicians to be aware of the potential interactions.

“A lot of current efforts, including CDC guidance, are focused on building that awareness,” she said.

The tool recommends that clinicians make a plan with their patients for days when the HeatRisk is orange, red, or magenta. HeatRisk is a National Weather Service tool that measures temperature, humidity, and other factors for locations across the United States to help people plan for high heat.

Goel created the medication list working with Dr. Laura Seeff at the CDC. The CDC provided Goel with an initial list of medications to research, and she started with a literature review before diving deeper into how heat can impact each drug.

“I remember just spending hours every day, researching and adding things to the Excel doc,” Goel said. She identified additional medications for the list through her research.

Despite her long interest in climate change and medicine, Goel said her research for the project revealed some facts she hadn’t known before. For example, inhalers like the one she uses for asthma can lose their potency if stored in high heat. They should be kept at room temperature.

Dr. Randall Tackett, a professor at the University of Georgia’s College of Pharmacy, said that kind of information is important for patients. He pointed out that many people get their prescriptions delivered by mail, and sitting outside on a porch or a driveway in hot weather could degrade some medications.

The CDC tool Goel created can be used anywhere but will be especially relevant in cities like Atlanta that have many high-temperature days.

“During the summers [in Atlanta], it’s extreme heat every single day, and there’s so many people on antihypertensives, anti-epileptics, anti-depressants, and they all kind of alter our physiology in ways that are really important to recognize,” Goel said.

The city experiences about two more weeks of high heat days than it did in 1970, Dr. Kristina Dahl, vice president for science at nonprofit Climate Central, told Healthbeat last year.

The effects can vary widely, depending on where people live in the city and their access to cooling. For example, citywide about 96% of homes have central air conditioning, but in some westside neighborhoods, that drops to 80%, a 2023 analysis by Georgia Tech Professor Brian Stone found.

Along with people who lack air conditioning, there are many other vulnerable groups, Goel said. They include:

Children
Elderly people
Unhoused people
People who work outdoors
People with certain mental illnesses or cognitive deficits
People who are immunocompromised
Pregnant people

Goel is especially passionate about that last group because she will start her OB-GYN residency at the University of California in Los Angeles in June.

Pregnant people have “decreased sweating abilities, because there’s just more fluid that’s needed to make sure the circulation is adequate, and they tend to put more fluid towards their extremities,” Goel said. “The way that they expel heat or absorb it is also different.”

Older people are also especially vulnerable, Tackett said, because age impacts the body’s ability to regulate heat. That can increase the risk of people fainting or falling, he said.

“There is always the chance of someone getting out into hot weather and developing heat prostration or fainting,” Tackett said.

Pharmacists want to counsel their patients about the medications they are dispensing, Tackett said, but often people are in a hurry and decline counseling. Patients who start taking a medication during the winter may not be aware that a medication could increase heat sensitivity, he said.

He encouraged patients to take the time to check in with their pharmacist or clinician to learn more about how their medications are impacted by heat.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

How to climate-proof the world’s health systems: Brazil offers a roadmap.

2025-11-20T12:00:00+00:00

Public health, explained: Sign up to receive Healthbeat’s Global Checkup in your inbox a day early.

Hello from Nairobi.

The approach of the Thanksgiving holiday is a delightful reminder of just how wildly enterprising Kenyans are. Cranberry sauce and pecans? On the supermarket shelves! Orange pumpkins? Sweet potatoes? A close-enough local fowl called the kienyeji turkey? All at the market right now!

(If you don’t understand my excitement, you may need to endure a few chicken-and-potato holidays before you really appreciate these things.)

My name is William Herkewitz, and I’m a journalist based in Nairobi, Kenya. This is the Global Health Checkup, where I highlight five of the week’s most important stories on outbreaks, medicine, science, and survival from around the world.

With that, as we say in Swahili: karibu katika habari — welcome to the news.

Global climate talks meet health crises

The United Nation’s Climate Change Conference is wrapping up this week in Belém, Brazil, a city at the mouth of the Amazon. Last year was the hottest in our species’ recorded history (again!), so as you might imagine… there is plenty to discuss.

Which is why it’s especially striking that global health policy (generally) and the surge of yellow fever and dengue cases across Amazon-adjacent countries (specifically) found its way onto the main agenda. In fact, the organizers designated Nov. 13 as the conference’s first ever “Health Day.”

As a rule, I try to steer clear of stories that amount to “UN bureaucrats invent a theme day to juice visibility.” But I am making an exception here, because this wasn’t just theater.

As The Guardian reports, the conference and the government of Brazil released an action plan to “help countries … deal with climate-fueled health issues” and a 100+ page roadmap on how to implement that plan. This marks the most serious the international community has ever been about proactively addressing climate change as a force that scrambles global health systems.

The authors (including leading researchers from eight universities) spell out the scale of the issue in a way that’s impossible to ignore. “Climate change is one of the most urgent global health challenges of the 21st century,” they write. “Nearly half the world’s population … live in highly climate-vulnerable contexts, and about 1 in 12 of the world’s 200,000 hospitals faces the risk of total shutdown from extreme weather under high-emissions scenarios.”

What does this mean in practice … and how should we read these recommendations during a moment when global health investments are retracting at their fastest pace in a century? I reached out to Dr. Kristie Ebi at the University of Washington, one of the world’s foremost experts on the health risks of climate change, to help break it down.

The heart of the roadmap is not a list of shiny new, expensive programs. Instead, it is a dramatically unsexy push to make health systems more flexible and more anticipatory.

For example, the authors outline for countries how to structurally reinforce their hospitals and overhaul the power, water, and other systems that keep them running, so they don’t buckle during heat waves or floods. They also spell out how to link climate and health data and train a workforce that can catch climate-driven risks before they spiral. As Ebi noted, “climate change remains relatively new for most ministries of health, with limited internal expertise,” which makes even the basic work of adding climate data to surveillance harder than it looks.

The most difficult part of the plan, Ebi noted, is the future-facing analysis it demands. Plenty of countries have reviewed how climate change could hurt their health systems, but many still don’t have the tools to actually predict what those risks will look like in the years ahead. And that gap is not academic. If a given country’s ministry/department of health cannot anticipate how heat, rainfall, supply chains, or migration will shift over the next decade, they are basically driving without headlights. The roadmap is trying to force a shift away from emergency response and toward planning for the risks that are already coming into view.

And then, of course, there is the money question. Yes, this work is coming at an inopportune financial moment. But the report is blunt that costs will rise sharply the longer countries wait. And Ebi is clear that this is not optional.

“Nearly everywhere experienced extreme weather ... often with devastating consequences. Increasing preparedness to these events will save lives,” she said.

A second cholera vaccine?

Some good news this week: South Africa has begun clinical trials for the first cholera vaccine to be manufactured on the continent, South Africa’s Sunday Times reports.

Disease breakdown: Cholera is a bacterial infection that infects up to 4 million people each year. Because it largely spreads through water contaminated with feces, it thrives in humanitarian disasters or anywhere else that basic sanitation has broken down. (Think conflict or flooding.) Cholera’s horror is its speed. It causes sudden, violent diarrhea that can empty the body so quickly that stools turn a pale, milky white. Without treatment, cholera can kill in a matter of hours.

The trials are a joint effort between Biovac, a local pharma firm, and the South African government. To be clear, this is not the first vaccine of its kind. A firm called EuBiologics in South Korea makes the only other cholera vaccine. Two doses of that vaccine protect about 70% of recipients for about two years, but … there’s not enough of the vaccine to meet demand.

This shortfall comes as cases rise globally, fueled by overlapping climate shocks and conflicts. It’s a squeeze that Health Policy Watch says “has severely constrained the global supply of cholera vaccines, leading to rationing and global shortages.”

Africa is the hardest hit. The continent is going through the worst cholera outbreak in a quarter-century, with cases surging in countries as disparate as Sudan, Burundi, and Angola, Al Jazeera reports. So this new vaccine is timely.

That said, let me be a realist/downer for a moment. Clinical trials usually move through three phases, and this is only the first one. (Phase 1 is where researchers check basic safety, not even whether the vaccine, uh, stops cholera.) Only about 10% of vaccines make it out of this early stage, but because this is not some brand-new medical advancement, the odds here are likely much higher. Still, there is a long, unsure road ahead.

But the upside is real. Even just myopically, shoring up the cholera vaccine supply will save tens of thousands of lives. But what South Africa is doing here is bigger than one product. During (and immediately after) the pandemic, many multinational pharma companies announced various expansion plans to manufacture drugs or tests on the Africa continent, with many of those plans scaled back since.

Today’s news shows that, just maybe, durable manufacturing gains will come from homegrown institutions.

Marburg virus in humanity’s cradle

Ethiopia has just confirmed its first ever outbreak of Marburg virus after nine suspected hemorrhagic fever cases in the country’s southwest were sent for testing this week, Bloomberg reports.

Disease breakdown: Marburg virus is functionally Ebola’s first cousin. A very similar high-fatality fever that often leads to hemorrhaging and organ failure. Untreated, about 9 in 10 people who contract the disease will die. The disease exists endemically in bats, allowing it to spread and occasionally spill over into humans. While this is Ethiopia’s first record of the disease, the World Health Organization says the strain matches those seen in past regional flare-ups. There is, unfortunately, no vaccine.

The epicenter of this new outbreak is a town called Jinka, which I last visited in 2022. It is one of the most fascinating places I have ever been. It sits in a region where some of the earliest hominid fossils have been unearthed, and where dozens of strikingly unique Indigenous communities live in close proximity. The town itself is the gateway to the Mago and Omo National Parks, themselves part of a wider UNESCO World Heritage Site because of the extraordinary cultural and ecological diversity. Most relevantly here, I remember the Indigenous peoples’ access to even basic government services being shockingly poor.

The latest news is that containment is underway, and that Ethiopia is reportedly “moving rapidly.” (Although it’s worth noting that the Ethiopian government has its hands full with various other conflicts and crises … some of them directly of Prime Minister Abiy’s own making.)

Here are my biggest questions right now:

Will the outbreak stay limited to this initial cluster, or spiral? As with the Ebola outbreak still wrapping up in the Democratic Republic of the Congo, will emergency appeals for funding be enough? Finally, without a vaccine to provide a robust buffer, how effective will contact tracing and containment be in such an underdeveloped area?

Mind the funding gap, part 2

A month ago, we followed some UK political drama about British donations to the Global Fund: the massive, 23-year-old organization that collects donations from wealthy governments and funnels them into programs that fight AIDS, tuberculosis, and malaria in more than 100 countries.

Back then, the rumor was that the UK, under Prime Minister Keir Starmer, was mulling a 20% cut in the country’s £1 billion pledge. Now it’s been announced that the UK will instead commit £850 million (over $1.1 billion) for the next funding cycle, representing a roughly 15% reduction, The Guardian reports.

While not as bad as the rumors, this is a bit of a gut punch for a few reasons.

First, Starmer’s party is ostensibly the pro-foreign aid face of the UK. (The opposition Conservative Party has promised to further reduce all foreign aid by another two-thirds when next in power.) The fear is that this reduction eases the geopolitical pressure on other leaders. “There is a danger that this drop in its pledge will lead to reductions in other donor commitments, with real risks for people’s lives,” says John Plastow, executive director at Frontline Aids, a global partnership.

Secondly, while the £850 million pledge is still enormous by any standard, the impact of any cut will be directly measured in lives. Per the Guardian article: A previous study showed that “a 20% cut to the overall Global Fund would result in 330,000 additional deaths by 2040 from malaria alone,” let alone the impact on HIV and tuberculosis cases, as the “fund provides 59% of international financing for malaria.” And with malaria cases now surging again in places like Myanmar, after years of decline, the risks of even a modest funding pullback look even starker, the Financial Times reports. (Sorry, paywall.)

It’s still too early to say how this will impact the total funding picture. I’ll be following up next month after the Global Fund closes its “replenishment conference,” the part telethon, part diplomatic speed-date that decides how much money the fund will actually have to work with.

Tuberculosis declined in 2024. Good thing nothing has happened since.

In the fight against tuberculosis, we finally brought a reversal of the pandemic-era spike that interrupted decades of steady declines. New cases fell by about 2%, Euronews reports .

(Why the rise in the first place? The tuberculosis researchers and modelers I’ve spoken with largely blame that Covid-era spike on people increasingly staying indoors — where tuberculosis spreads more easily — and on a diagnostic choke point. Basically: During the pandemic, if you had a bad cough, you got tested for Covid, and if the test came back negative, you were basically told congratulations rather than being screened for something else.)

Unfortunately I can’t, in good conscience, appreciate this as the good news story it should be. Blame the WHO’s reporting bureaucracy or the glacial pace at which governments release their health data, but our global tuberculosis picture is always about 12 months out of date. And this year was a doozy!

Tuberculosis is especially exposed to this year’s global funding crunch, and today’s report warns that “cuts from wealthy countries could lead to up to 2 million additional deaths from [tuberculosis] and 10 million new illnesses over the next decade.”

My read: In all likelihood, the progress we’re seeing in last year’s data has already slipped away in the year since.

We’re off next week, so see you in December!

William Herkewitz is a reporter covering global public health for Healthbeat. He is based in Nairobi. Contact William at wherkewitz@healthbeat.org.

Breastfeeding by candlelight: My ‘aha’ moment for improving maternal and child health in emergencies

2025-11-17T19:22:08+00:00

This story was part of Healthbeat’s live storytelling event, “Aha Moments in Public Health,” held Nov. 3 at Manuel’s Tavern in Atlanta. Watch the full show here. Sign up to receive Healthbeat’s free Atlanta newsletter here.

While this story could be named “Why I almost named my son after a hurricane,” instead it tells the story of what inspired me to spend my public health career addressing vulnerabilities in maternal and child health.

On Sept. 16, 2004, two days after delivering my first child, I was discharged from an Atlanta area hospital into the aftermath of Hurricane Ivan. In my post-partum haze, I had no idea what havoc this storm was about to unleash in our lives. At that time, Hurricane Ivan was one of the largest, most devastating hurricanes to hit Georgia, producing tornados, flooding, and power outages throughout the state.

What should have been a 20-minute drive home, took 2 1/2 hours. At one point, we had to pull off the highway so I could feed my son in the car. When we finally arrived at our house, we learned that we had no power and no air conditioning, which even in early fall in Atlanta can create relentless humidity.

This next part may be TMI, but it is important to share that my infant weighed 10 pounds, 14 ounces. Yes, I gave birth to an almost 11-pound baby! What this meant was that he was hungry ALL THE TIME. As the downpour continued, amidst the darkness and heat, we hurried to get settled. For the first hour or so, I tried to breastfeed my new son by candlelight, but through tears, sweat and frustration, I just could not function. I needed my husband’s help to get out of the house and to a hotel, where safety and electricity comforted us through our first night out of the hospital.

This “aha” moment of breastfeeding by candlelight turned into a career inspired to address disparities in maternal and child health.

Unfortunately, being a new mother going through the nightmare of a natural disaster is not a unique or unusual experience, but it is in fact, a dangerous one.

History has shown that pregnant and postpartum women are particularly vulnerable during emergencies. They have functional needs that require additional social and health care-related support, including prenatal and postpartum care and lactation support. Evidence has demonstrated that emergencies can cause heightened stress among this population, often leading to adverse maternal and health outcomes including miscarriage, premature delivery, low birthweight, and mental health challenges.

These were experiences of many women who were pregnant or delivered during several national disasters, including Hurricane Katrina in Louisiana, Hurricane Harvey in Texas, and most recently Hurricane Helene in North Carolina.

Sarah Blake with her newborn son after Hurricane Ivan in 2004.

There are other types of emergencies that mothers experience that are both harmful and preventable. For instance, extreme heat during pregnancy has been shown to increase women’s risk for severe maternal morbidity and adverse infant health outcomes. The Covid-19 pandemic shed light on the importance of maternal immunization to protect women from complications of infectious disease during and after pregnancy. Even human-caused disasters (such as those caused by bioterrorism) have shown to have long-lasting effects on mothers and their infants.

Through my work, I partner with public health agencies and community organizations to create strategies that improve maternal and child health public health emergency preparedness planning and response. Just recently, I worked with my collaborators from the Morehouse School of Medicine’s Center for Maternal Health Equity and Healthy Mothers, Healthy Babies Coalition of Georgia to complete Project Prepare, a Centers for Disease Control and Prevention-funded study of preparedness and readiness for emergency planning among pregnant and postpartum women in Georgia.

Our findings revealed that mothers in Georgia are often disconnected from their health care providers for essential information and support before, during, and after emergencies. They also lack essential financial and social services during emergencies that are needed to ensure healthy outcomes. These findings are important, especially in Georgia, where women experience among the highest rates of maternal mortality.

As both a women’s health advocate and health services researcher, it is my mission to address the vulnerabilities that women experience, particularly during the perinatal period. It is both my purpose and a call to action that I take on willingly and, in these challenging times, with unwavering resolve.

I dedicate this story to my firstborn son, Will – or Ivan as he is fondly sometimes called.

Dr. Sarah Blake, PhD, is an associate professor at Emory University’s Rollins School of Public Health and serves as director of Emory’s Maternal and Child Health Center of Excellence. A health services researcher, she applies a health equity lens to address women’s health care.

Why mpox is persisting around the world

2025-11-06T12:00:00+00:00

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Hello from Nairobi.

The short rainy season has settled over the Kenyan highlands, and the orchids and vanilla vines in my back yard are fully in bloom. (After a decade, I think I’m finally used to “seasons” being marked by precipitation, rather than temperature.)

A little warning here: This week’s report doesn’t shy away from the heavy stuff — a virus on the move, a heating planet, and a worsening war — but it ends with two hopeful breakthroughs in the fight against drug-resistant disease. So stick around.

With that, as we say in Swahili: karibu katika habari — welcome to the news.

Mpox’s next act

The World Health Organization has announced a new tangle of worrying trends for the viral infection mpox. First up, cases are on the rise with over 44,000 detected infections this year. And a new, faster-spreading strain has just been discovered in locations including Malaysia, Namibia, Italy, the Netherlands, Portugal, Spain, and my home state of California, The Guardian reports.

To complicate things, all this comes as we are exiting a major outbreak of the disease, which crested and broke in 2022 and 2023. So what exactly do all these new reports mean? Are we moving backward, or seeing something else entirely?

Disease breakdown: Mpox (formerly known as monkeypox) is a virus first detected in the 1950s in lab monkeys in Denmark. The first known human case occurred in the 1970s in central Africa, and for about 50 years the virus quietly circulated on the continent through contact with infected animals. That changed in this decade, when in 2022 a strain of the virus made an evolutionary leap, and started spreading through physical and sexual contact between people. The mpox illness can cause flu-like symptoms and pus-filled lesions, and in a minority of cases, death. Luckily, an effective vaccine exists!

I reached out to Dr. Michael Marks, a researcher at the London School of Hygiene & Tropical Medicine to understand how to digest this news.

The first thing Marks explained is that the appearance of mpox in new places or new countries isn’t all that unexpected, even with a brand-new strain in the mix. This is partly because close-contact transmission thrives especially well in “sexual networks where there are multiple partners and rapid partner change,” he said. In practice, that’s meant mpox will continue to spread in fits and starts, erupting when it leaps to a new network. (Especially among networks of gay and bisexual men, who remain most at risk purely from behavioral factors.)

While the 2022–23 outbreak largely subsided due to vaccinations and community awareness, Marks says the virus never really went away, and “mpox continued to be transmitted at low levels.” Moving forward, “we’ll likely have ongoing transmission in many countries, with periodic outbreaks when mpox reaches a new susceptible community,” Marks explains.

What should you know about the newest strain?

As Healthbeat has reported, it’s called clade 1b, and it’s a potentially deadlier branch of the virus, which has independently evolved the same trick as the 2022 strain, spreading efficiently from person to person. Scientists say the risk of that combination (higher severity and better transmission) is what has them worried.

The takeaway? For most people, the risk remains low. But if you’re in networks where hookups are frequent and partners change often, there is an increasing risk of catching and spreading the virus.

Looking forward, Marks was blunt about our long-term outlook. “Elimination isn’t meaningfully on the cards,” he said. The virus survives in wild animals, and there’s little appetite or funding for the mass vaccination it would take to entirely stop it. “Mpox isn’t going away [so] we need to move from a mindset of ‘there’s an outbreak’ to ‘this is an ongoing, persistent issue that needs a sustained response.’”

That response, he said, will hinge on vaccination, the best tool by far.

Planet with a fever

The world just logged its first year above 1.5 °C of warming, and the health toll is catching up. That is, according to TIME magazine’s report on The Lancet Countdown, an annual global assessment that tracks how climate change is affecting human health.

How bad is it?

Not great. “Twelve of the 20 indicators for the health risks and impacts of climate change in the report set concerning new records.” For example, last year the average human being experienced 16 more dangerously hot days than would have occurred without climate change.

Most stark: That heat is now driving a 63% rise in annual heat deaths since the 1990s, killing roughly 546,000 people each year. That’s more than one person every minute. “The health impacts caused by our changing climate have reached unprecedented levels that cannot be ignored.”

The research team also warns that the world is tracking toward “2.7°C of heating by the end of the century — if not more — and emissions keep rising,” which would be a catastrophe well past what human systems can adapt to.

But there are bright spots. “One thing that’s often overlooked is just how much progress even limited climate action has already achieved in terms of saving lives,” the report’s lead author, Dr. Marina Romanello, told me. For example, “the shift away from coal in high-income countries between 2010 and 2022 is estimated to have prevented around 160,000 premature deaths each year from air pollution.”

“These stories of success and solutions deserve more attention,” she adds. “They show that climate action is not only possible, but already underway — with enormous health benefits.”

Hospital falls under attack in Sudan’s overlooked war

I’ll level with you, readers. I’m flagging this next story not just for its health angle, but because it deserves far more international attention than it’s getting.

As background: Sudan’s civil war, well into its second year, is pitting the country’s armed forces against a powerful paramilitary group called the Rapid Support Forces. Throughout the conflict, the fighting has been marked by mass displacement, starvation, and widespread civilian killings and human rights abuses. All of this is happening with no end in sight, and zero international appetite to forcefully intervene on behalf of civilians. But while the conflict has been ongoing for years, several foreign correspondents who cover Sudan have told me this week that even they’re alarmed at how fast things are unraveling, and how sharply the death toll is rising.

This leads us to our story: On Thursday, the WHO announced that “the last functioning hospital in the Sudanese city of al-Fashir was raided, and hundreds are feared to have been killed there after a paramilitary force overran the city,” Reuters reports. The death toll for the hospital has been reported as high as 430 people, with additional medical workers being held for ransom. The destruction has effectively obliterated the region’s final lifeline for trauma care. On Monday, the International Criminal Court announced it is probing these reports.

It’s a horrifying report. If this story leaves you with anything, let it be a reason to pay attention. Sudan’s crisis is deepening while the world effectively looks away. Maybe awareness alone will not be enough, but it’s the smallest act that still matters.

This virus is on our side

On to decidedly cheerier news.

A research team led by Dr. Loren Miller of Harbor-UCLA Medical Center has just shown that bacteria-hunting viruses (known as bacteriophages) can help treat deadly bloodstream infections caused by Staphylococcus aureus, an organism notoriously resistant to antibiotics, Reuters reports.

The trial was on 42 patients, all of whom were given antibiotics. Two-thirds were also “treated intravenously with a ‘cocktail’ of [bacteriophage] viruses.” The study showed that the virally infected patients had fewer relapses, shorter stays in intensive care, and quicker recovery. While this is not the first time bacteriophages have been used in clinical trials, Miller says the trial serves as a “potential paradigm shift in how we treat antibiotic-resistant infections.”

(It’s worth noting that the study was a “phase II clinical trial,” which means it’s still early in the testing process. Phase II trials usually involve a relatively small group of patients and are designed to see if a treatment seems to work and is safe enough to keep studying. It’s a crucial step, but not final proof.)

Still, if this approach succeeds in larger trials, it could meaningfully extend the lifespan of our current antibiotic arsenal and provide a new weapon in the fight against multidrug‐resistant bacteria.

For once, I’m on team virus.

Antibiotics in the dirt

In even stranger multidrug‐resistant bacteria news: Scientists just dug up a new, powerful antibiotic … quite literally.

The journal Nature reports that a research team at the University of Warwick in the UK discovered a breakthrough while studying a soil bacteria called Streptomyces coelicolor (which is famous for churning out a well-known antibiotic.)

When the scientists looked at one of the bacteria’s unfinished chemicals, which is produced midway through making its usual antibiotic, they found something shocking: That new compound obliterated otherwise drug-resistant bacteria at microscopic doses.

The scientists (who could have conceivably unearthed a better name) are calling this novel compound “premethylenomycin C lactone.”

For now, the researchers don’t even know how this stuff works, only that it does. “We still don’t really know where it targets. We think it targets the cell wall in some way,” says Lona Alkhalaf, a chemical biologist with the research team. Next up is tests to see whether it’s safe for human cells and continuing research for how to make it in bulk.

Who knew? The next great medicine might not come from good old-fashioned mud.

See you next week!

William Herkewitz is a reporter covering global public health for Healthbeat. He is based in Nairobi. Contact William at wherkewitz@healthbeat.org.

Climate-proofing: How a Coney Island hospital rebuilt after Superstorm Sandy

2025-09-15T14:39:32+00:00

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On the night Superstorm Sandy hit New York in October 2012, seawater from the Atlantic Ocean surged into the emergency room of what was then known as Coney Island Hospital. Staff scrambled to evacuate 28 patients to higher floors, wading through knee-deep water and holding flashlights to navigate dark hallways.

“The damage was extensive. The hospital was fully evacuated. We lost all power in the campus. It was multiple months before [the hospital] can be utilized again,” Svetlana Lipyanskaya, CEO of NYC Health + Hospitals/South Brooklyn Health, said in an interview. (Lipyanskaya, who was not at Coney Island Hospital in 2012, worked at Weill Cornell at the time.)

Today, the site, now called South Brooklyn Health, is fortified by a four-foot flood wall. A new hospital building, named after the late Supreme Court Justice Ruth Bader Ginsburg, features hurricane-resistant glass, and power and water systems designed to withstand future storms that could have once crippled the facility.

As climate change accelerates, South Brooklyn Health’s transformation reflects a growing recognition of the vulnerability of health care facilities to extreme weather events and the need for resilient infrastructure to maintain essential services. Michele Baker, policy coordinator of The Global Climate and Health Alliance, said many health facilities “were not built with these kinds of weather events in mind.”

“We learned what our vulnerabilities are,” Lipyanskaya said. “And so when we rebuilt, we rebuilt with that in mind.”

Crucial services moved to higher floors

In May 2023, the $923 million Ruth Bader Ginsburg Hospital opened, offering services to nearly 875,000 residents of South Brooklyn and nearby neighborhoods, many of whom are immigrants and low-income individuals. The Federal Emergency Management Agency funded the construction of the new hospital.

Flooding is NYC’s most pressing public health threat, new city report says

One of the key features of the hospital is its emergency department located on the second floor to ensure continuity of care during floods.

“Our new building is built so that, post-event, we could be up and running very quickly because there’s literally nothing of any key importance on the first floor,” Lipyanskaya said. The hospital’s first floor houses just the lobby and a seven-foot bronze statue of Ginsburg.

Clinical services, along with power, heating, cooling, and water systems are located on higher floors. Aside from the flood wall surrounding the hospital campus, flood barriers are installed within the building. A wind-resistant envelope further protects the structure against severe storms. During Sandy, seawater from the Atlantic, just a mile away from the hospital, easily breached the facility, even over sandbags. Violent winds blew open the windows.

In addition to infrastructure upgrades, South Brooklyn Health has also trained staff to respond to disaster situations, and the hospital has implemented a robust supply chain system to ensure uninterrupted patient care during emergencies.

“We have backups of everything, and we’re able to replenish very quickly and move forward very quickly,” Lipyanskaya said, adding that the supply chain efficiencies were more a result of the Covid-19 pandemic than Sandy.

South Brooklyn Health is not alone in bolstering its defenses against climate impacts in the city. With a grant from FEMA, NYC Health + Hospitals Bellevue, Metropolitan and Coler, which were also devastated by Sandy, have installed flood walls to protect against storm surge, elevated electrical equipment and alarm systems, and put in place backup generators to ensure operations can continue for at least 72 hours during a power outage.

Atlanta hospital flooded during extreme cold

Many hospitals across the United States remain ill-equipped to withstand the increasing severity and frequency of climate-related disasters.

About 515 hospitals in North America could face high risk of a total or partial shutdown due to extreme weather events if global emissions continue to rise at a rapid pace, according to a December 2023 report by climate-risk data analysis company XDI. Large corporations, financial institutions, insurance companies, real estate developers, and governments rely on XDI’s data to assess the climate risks faced by their properties, infrastructure, and operations.

By 2100, Florida is expected to have the highest number of hospitals at high risk under a high emissions scenario, followed by Louisiana, California, Texas, and New York, according to the report.

Climate change is delaying the arrival of spring in NYC parks, researchers find

Last year, Hurricanes Helene and Milton paralyzed health care facilities in Florida, Georgia, Tennessee, and other Southern states, and led to shortages of IV solutions.

In 2022, Grady Memorial Hospital, a public hospital that primarily serves low-income patients in Atlanta, was crippled after an HVAC system failure triggered by extreme cold led to widespread flooding. Dr. Jamaji Nwanaji-Enwerem, an emergency medicine physician, recalled how it damaged the burn unit and knocked out several CT scanners.

“These cascading failures revealed how aging infrastructure in safety-net hospitals, which already face financial and operational challenges, is especially vulnerable to climate-related events,” Nwanaji-Enwerem said.

Safety-net hospitals may lack funding for climate-proofing

While FEMA grants provide critical funding for disaster resilience, other programs often rely on tax-related incentives, such as credits, which require upfront capital investments, said Winslow Dresser, associate director of regional climate solutions at Health Care Without Harm, a nonprofit advocating for sustainable health care practices. Wealthier institutions with strong credit ratings and better access to capital are more likely to benefit from these programs, Dresser said.

“Many safety-net hospitals lack the financial flexibility to make these changes alone,” Nwanaji-Enwerem said. “Broader federal, regional, and state policies are needed to provide funding, technical support, and incentives for climate-resilient upgrades.”

Nwanaji-Enwerem added that strengthening partnerships with local governments and community organizations can also improve hospitals’ readiness and response.

For some hospitals, bolstering defenses against climate disasters can be especially challenging if they have not experienced a major storm or wildfire. In those cases, Dresser said, the hospital leader “does not have those kinds of risks top of mind.”

While South Brooklyn Health’s infrastructure upgrades were designed to ride out the challenges of a changing climate, its CEO stressed that resilience is about more than just disaster-proof buildings.

“We really need to focus on providing care to patients where they are and think much more broadly about what happens outside the walls of the hospitals,” Lipyanskaya said, adding the improvements have also allowed the hospital to expand its services to better support the surrounding community.

Gaea Cabico is a freelance reporter in New York.

Climate activists cite health hazards in bid to stop Trump from ‘unleashing’ fossil fuels

2025-09-11T15:51:31+00:00

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HELENA, Mont. — In 2023, a group of 16 young Montanans won a much-heralded climate change case that said the state had deprived them of a “clean and healthful environment,” a right enshrined in Montana’s constitution.

Their victory in Held v. Montana, later upheld by the state Supreme Court, resounded across the country, showing that young people have a stake in the issue of climate change, advocates say. Yet, state policies to address the causes of climate change in Montana — home to large coal, oil, and natural gas deposits — haven’t changed in the wake of the case.

On Wednesday, some of those plaintiffs are scheduled to appear in federal court to request that U.S. District Judge Dana Christensen block a series of President Donald Trump’s executive orders on energy issues. They argue the orders violate their Fifth Amendment rights and will cause nearly 200,000 additional deaths over the next 25 years and lead to more heart, respiratory, and other health problems. They are joined by other plaintiffs ages 7 to 24 from California, Florida, Hawaii, and Oregon, and are backed by the climate-focused nonprofit Our Children’s Trust.

How an Atlanta pediatrician deals with climate anxiety – and finds joy in action

“Trump’s fossil fuel orders are a death sentence for my generation,” Eva Lighthiser, a 19-year-old resident of Livingston, Montana, wrote in the complaint filed on May 29. “I am not suing because I want to, I am suing because I have to. My health, my future and my right to speak the truth are all on the line.”

She added that a warming climate has led to an increase in summer wildfire smoke and contributed to the flooding of the Yellowstone River (a warmer atmosphere holds more precipitation). At the heart of the case, Lighthiser v. Trump, is the claim that young people are being denied their Fifth Amendment rights under the U.S. Constitution — life, liberty, and the pursuit of happiness — because of the health effects of fossil fuel development and climate change. And they say the Montana Supreme Court’s decision in December to uphold their right to a clean and healthful environment buttresses their claim.

Montana Attorney General Austin Knudsen, a Republican, along with 18 other states and Guam, a U.S. territory, have sided with the Trump administration, filing a motion supporting the government’s request to dismiss the case. They argue the plaintiffs do not have standing to file the lawsuit, and that there is no constitutional right to a specific energy policy. “The state of Montana has an interest in this case because it will directly impact the business done in the energy sector within its borders,” Knudsen argued in his motion.

A hearing on the motion to dismiss, as well as the plaintiffs’ call for a stay of the executive orders, is scheduled for next week in federal court in Missoula.

Olivia Vesovich, 21, one of the plaintiffs, who is in her senior year at the University of Montana in Missoula, told KFF Health News she struggles with severe spring pollen allergies, which research shows are exacerbated by climate warming and will likely worsen.

“My eyes were swollen shut every single day, every single night,” Vesovich said. “When I wake up in the morning, I couldn’t open my eyes for 10 minutes. It’s not fun at all, and it’s exacerbated by climate change and by the fossil fuel industry.”

She also has exercise-induced asthma as well as feelings of suffocation from the smoke-filled skies during wildfire season — the intensity and frequency of which are magnified by climate change. And Trump’s executive orders are already being implemented and causing harm, Vesovich said.

“We are making an argument that Olivia’s state constitutional right to a safe climate system should also be protected under the federal Fifth Amendment as part of her liberty right,” said Andrea Rodgers, a senior attorney for Our Children’s Trust.

Our Children’s Trust was also behind the climate change case Juliana v. the United States, filed in 2015 by 21 young plaintiffs who argued their rights had been violated. In 2024, the 9th U.S. Circuit Court of Appeals ordered the federal district court to dismiss the case, ruling that the courts were not the appropriate venue for climate policy.

Climate change is delaying the arrival of spring in NYC parks, researchers find

They believe the victory in Held v. Montana gives American youth more standing this time. If they prevail, the result would be more far-reaching than the Montana case, creating a national precedent.

The plaintiffs are asking the court to declare Trump’s three related executive orders — “Unleashing American Energy,” “Declaring a National Energy Emergency,” and “Reinvigorating America’s Beautiful Clean Coal Industry” — unconstitutional and to block their implementation. They also claim that Trump has overstepped his authority by attempting to undo laws such as the Clean Air Act. A coalition of 14 states’ attorneys general has also filed a lawsuit against the order that declares an energy emergency.

Trump came into office in January primed to support traditional energy sources and to back off efforts to usher in an era of renewable energy, which he claims are not viable. He has also issued orders rolling back environmental regulations. “We are driving a dagger into the heart of the climate change religion to drive down the cost of living for American families, unleash American energy, bring auto jobs back to the U.S., and more,” Environmental Protection Agency Administrator Lee Zeldin said in a March news release.

In July, the EPA proposed repealing its 2009 “endangerment finding” that concluded climate-warming gases “endanger both the public health and the public welfare of current and future generations.”

The finding established that greenhouse gases are a pollutant and create adverse effects, such as extreme weather and risks to human health and ecosystems. And it created a foundation to regulate automobiles and the energy sector to address climate change.

Zeldin said that eliminating the rule would save Americans “$1 trillion or more in hidden taxes.”

Unleashing fossil fuels will come with costs, as well. The health effects of a warming world are thoroughly established in scientific literature, said Kristie Ebi, a University of Washington professor of global health and an expert in the health risks of climate variability. Mosquito-borne diseases such as dengue, chikungunya, and malaria are spreading, and flooding, droughts, and wildfire, exacerbated by climate change, pose threats. And research has shown an increase in deaths.

“There’s a long list of adverse health outcomes” from a warming world, she said. “The data are clear.”

This story originally published at KFF Health News, Healthbeat’s national reporting partner.

Climate change is delaying the arrival of spring in NYC parks, researchers find

2025-08-26T14:53:23+00:00

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As climate change drives warmer winters, environmental scientists have long expected to see spring arrive earlier. But Yale University researchers analyzing satellite imagery of New York City parks found the opposite: Spring is starting later.

“This is completely a flip, and also contrary to our expectations, because you would think that if it’s warmer, the leaf-out would be earlier,” said Dr. Karen Seto, the Frederick C. Hixon Professor of Geography and Urbanization Science at the Yale School of the Environment.

In the study, published July 30 in Environmental Research Letters, Seto and other researchers analyzed the start of the growing season at 379 parks across New York City, comparing trends between 2000 to 2009 and 2013 to 2022. Researchers focused on how the impacts of climate change and the urban heat island effect — how a city’s heat-absorbing buildings, roads and infrastructure increase its overall temperature — shape the temperature of green spaces.

Access to parks is linked to positive public health effects, including reductions in blood pressure, heart rate, and all-cause mortality, as well as decreases in psychological stress. And in cities like New York, parks have a key role to play in cooling streets and absorbing atmospheric CO2.

How connecting with nature helps Black women have healthier pregnancies

When it comes to mitigating the effects of climate change, Yale researchers found that the size of the park matters. They analyzed parks ranging from large green spaces like Central Park and Prospect Park, to medium-sized ones like Bryant Park and Madison Square Park, to even smaller, playground-sized spaces.

In the smallest parks, temperatures inside and outside the green spaces are similar, said Dr. Juwon Kong, a postdoctoral associate and the study’s lead author. Big, sprawling parks, which are more protected against the urban heat island effect, are not only cooler internally, but can also cool the surrounding area, he said.

“Larger parks’ cooling effects can be extended at least one or two blocks,” Kong said.

Medium-sized parks are most vulnerable to the impacts of the urban heat island effect, researchers found, since they have less of a buffer between their interiors and surrounding infrastructure.

Analyzing detailed satellite imagery of the parks, researchers found that the delayed onset of spring was most significant in medium-sized parks. For those parks — ranging in size from one hectare (about 2.5 acres) to 18 hectares (about 45 acres) — the average start of spring was delayed by 2.62 to 4.43 days.

In smaller parks, of less than one hectare, researchers recorded an average delay of spring of 0.90 days. And in the biggest parks, of more than 18 hectares, researchers recorded that the average arrival of spring was delayed by about 1.41 days.

The delay of spring reflects a disruption of the precise physiological mechanisms that govern a tree’s transition from bare branches to new growth, Kong said. Trees in temperate regions typically require sufficient winter chilling to transition from dormancy to leaf growth, but warmer winters shift that balance, pushing back the arrival of spring.

Seto said that it is not clear if delayed springs will continue in coming years, or what their long-term consequences could be.

“Having the shorter and shorter growing season means less time for leaf-out, less shade, less cooling, less habitat,” Seto said. “I think there’s unknown questions about what the domino effects are on the composition of different vegetation and the health of trees.”

In the near term, though, the findings have implications for the management of green spaces in New York City, and perhaps other cities, she said. For instance, the findings might help inform tree-planting strategies that maximize cooling benefits.

The research, Seto said, “helps us think about ways in which we can better manage the green space in cities so that they can thrive in a hotter and hotter climate and be more resilient.”

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

How an Atlanta pediatrician deals with climate anxiety – and finds joy in action

2025-07-11T14:12:31+00:00

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Dr. Preeti Jaggi remembers clearly the moment she became concerned about the environment. Robin Williams was there – on the television.

Jaggi was a teenager in Ohio in 1990 when Williams and other celebrities landed in her living room to talk about pollution and other environmental problems as part of “The Earth Day Special.”

“I remember they talked about climate and how we depend on a stable Earth to thrive. … I remember being concerned about it,” she said.

Jaggi, 52, went on to become a pediatrician specializing in infectious diseases. She works at Children’s Healthcare of Atlanta and as a professor at Emory University, blending her workplace focus on protecting patients with a role as an environmental advocate.

She chairs the advocacy group Georgia Clinicians for Climate Action, where she argues for more renewable energy before the state’s Public Service Commission, collaborates to electrify Georgia’s school buses so kids have cleaner air, and finds ways for the health care industry to be more environmentally sustainable.

Her “everything, everywhere, all at once” presence is driven by her belief that pediatricians have a duty to protect the Earth’s future for their young patients.

Summer heat is felt unevenly across metro Atlanta. Experts say more data is needed to address the public health threat.

“It’s becoming more and more obvious that the environment is affecting health … We just had this huge deluge flood in Texas, and all these kids in a camp were either displaced or died from that,” said Jaggi, who lives in Decatur.

Closer to home, she often talks about the death of 1-year-old twins and their mother in Thomson, Georgia, last year after a tree fell on their home during Hurricane Helene.

Rising temperatures also drive more hot days, which lead to more emergency room visits, Jaggi said.

Excess heat days increase the risk of heatstroke, and longer warm periods mean ticks, mosquitoes, and other vectors of disease are moving to new areas, bringing infections like Lyme disease, malaria, and dengue fever.

Air pollution also has a range of impacts, Jaggi said, including driving up rates of premature births, cancer, autism, and especially asthma.

Jaggi said that during the 1996 Atlanta Olympics, when there was significantly less driving, air pollutants fell, and so did the number of children going to the hospital for asthma – by 40%.

“We need to have strong air pollution standards because we know that it makes us sick,” Jaggi said.

“Our new reality” can make it tough for kids to play outdoors and connect with nature, Jaggi said, something that’s always been a key source of pleasure for her.

“There are going to be days where kids cannot go outside as much as they would otherwise do, which is really sad for them, right? We want them to be outside and be playing in that unstructured time,” she said.

While her medical training did not include much of a focus on climate change, she has enrolled in programs like the Climate Health Organizing fellowship through the Cambridge Health Alliance.

Children are tapped into the impact of climate change, and they’re worried about it, Jaggi said.

“I’ve heard a kid say, ‘I feel that adults take no initiatives into protecting the climate, and they put all the burden on future generations. .. And I don’t know if we can do that without you’,” Jaggi said.

“In Georgia, about 23% of 16- to 25-year-olds are extremely worried about climate, and 75% are worried,” Jaggi said, referring to a study published in The Lancet last year. She can relate to the concerns, since she felt them many years ago as a high school student.

Jaggi also spends a lot of time thinking about vaccines in the face of increasing hesitancy among parents. She sees a parallel with her climate work: “We want to prevent a problem. … This is why, as a mom, you would tell your child, ‘Don’t stay close to that hot stove. Don’t put your hand on that hot stove.’ …. We do things to prevent a problem.”

Jaggi said she has had patients who suffered from vaccine-preventable illnesses. For example, one child was not vaccinated for chickenpox, and suffered a bacterial infection.

“It really ate away at their muscle, and they had to be in hospital for three weeks with six or seven surgeries. The parents said to me, ‘If we would have known, we would have gotten this vaccination’,” Jaggi said. “I just listened to them, and I empathized with their suffering also, because they, I believe, had some regret.

“Giving good information to people about the safety of vaccinations is our responsibility,” Jaggi said.

Vaccination and protecting the environment are driven by a community ethos: “Your community protects you, and you protect your community. It’s similar – we want to protect our environment so that our kids can thrive.”

“The best thing that I can say to people to convince them that I love my children more than anything in this world, and I vaccinated them because I want them to be healthy,” said Jaggi, the mother of two college students.

Even as she reels off a host of climate concerns, Jaggi has found that her advocacy brings her “joy,” inspired by the marine biologist and climate activist Ayana Elizabeth Johnson.

“There are so many things that I view with confusion and bewilderment, but I can still do something, and … even small actions are important,” Jaggi said. “I find a lot of joy in at least just remembering that I can do something.”

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

NYC buildings trap heat. ‘Cool roofs’ program aims to lower temperature inside.

2025-06-25T11:00:00+00:00

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Mehdi Heris, a professor at CUNY’s Hunter College, has dedicated his research to bridging the gaps between science and urban planning. As New York City enters another scorching summer, he wants more people to know about a way to lower indoor temperatures by up to 5.9°F: “cool roofs.”

The practice, which involves covering rooftops in a light-reflective coating, had been implemented on at least 36% of the city’s roofs, according to Heris’ research. He has been tracking the efforts of NYC CoolRoofs and The HOPE Program, a job training non-profit focused on sustainability, to cool more of the city’s 1.6 billion square feet of rooftops.

“It is basically low-hanging fruit for communities to start with cool roofs for heat mitigation,” Heris said, citing the free or low-cost program that would allow many buildings to do it. “This is something that can benefit you. This is something that will benefit your energy bill and your health and livelihood.”

Extreme heat is becoming more common in the U.S. Here’s how to stay safe.

Extreme heat is a public health challenge as one of the deadliest effects of climate change, with an estimated 580 New Yorkers dying prematurely last year related to hot weather, according to the 2024 NYC Heat-Related Mortality Report. Last summer, the city saw over 20 days with temperatures over 90°F, a number that is projected to triple by the 2050s, according to the New York City Panel on Climate Change.

Last month, the city launched a dashboard to help New Yorkers and city officials assess heat risks and guide the local response to heat waves.

Heris says reflective roofs are a fast, easy, and cheap (or even free) way to cool buildings. Studies show that in non-air-conditioned residential buildings, the coated roofs can lower maximum indoor temperatures by 2.2 to 5.9°F.

How reflective coating mitigates urban heat island effect

A cool roof is able to lower building temperatures due to its ability to reflect sunlight. It can be installed by either painting on a reflective coating, installing a reflective membrane, or installing cool shingles. Cool shingles are made of either asphalt, wood or polymer, and work best on pitched roofs.

The NYC CoolRoofs program only offers to paint reflective coating on flat roofs. Coating dark roofs requires maintenance over time due to wear from weather. But installing a cool roof in the first place will help it last.

The reflective coating helps combat the urban heat island effect, where air temperature is hotter in cities than surrounding suburban and rural areas.

“The things that we have constructed our cities out of often absorb and retain and then re-radiate more heat … things like asphalt building roofs, or particularly, dark, tar-based building roofs,” said Travis Flohr, assistant professor of landscape architecture at Penn State and co-researcher with Heris of “Cool Roofs in a Warm City.”

With dark roofs, heat is absorbed by the building, said Mike Treglia, lead scientist for the New York Cities Program at The Nature Conservancy.

“One of the biggest issues of the urban heat island effect is that cities don’t really cool down as much at night as other areas,” Treglia said. “It’s not just the daytime heat stress that people face, but also not being able to cool down in their un-air-conditioned apartments at night.”

New York is getting hotter. A new state dashboard aims to anticipate health risks.

This is even more difficult for people with underlying conditions such as asthma, heart disease, and diabetes, according to the World Health Organization. People who have chronic health issues are more vulnerable to heat because they retain more body heat or due to medications they take.

The city has a program to help New Yorkers buy and install an air conditioner. But about 21%, or 493,000 rental households across the city, don’t run their AC because of the cost, a 2023 housing and vacancy survey found.

A cool roof can lower energy bills. According to the study by Heris and Flohr, installing a cool roof can cut cooling costs by 7%-15%. This also lowers carbon emissions and helps the city reach its goal of carbon neutrality by 2050. Every 2,500 square feet of roof that is coated can reduce the city’s carbon footprint by 1 ton of CO2.

To reach this goal, the city passed Local Law 97 to lower greenhouse gas emissions from buildings, the source of two-thirds of the emissions in the city, according to NYC Buildings. Buildings originally were required to send in data on their emissions starting at the end of this month, but the department recently gave property owners more time to comply.

NYC program offers free roof coating for many buildings

The NYC CoolRoofs program, which is run in partnership with the city’s Department of Small Business Services, the Mayor’s Office of Climate and Environmental Justice, and The HOPE Program, has covered over 12 million square feet of roofs since 2009 with reflective coating.

The HOPE Program is hoping to partner with non-profit organizations around the five boroughs to get more buildings to install cool roofs – especially in neighborhoods that have a higher heat vulnerability, like the South Bronx and parts of Brooklyn. These boroughs are more vulnerable to the heat due to the lack of trees and other green space that provide shade.

Heris has worked with groups like South Bronx Unite and El Puente in his research. They are “important groups, because they are really connected to their community. If we can provide some knowledge for them that becomes good material, to go to the community and take these numbers and see just this is how it’s gonna happen.”

Thirty percent of flat, dark roofs across the city could have a cool roof installed, Heris said. For eligible buildings, the service is free. To qualify, roofs must be flat, in good condition, accessible to workers, and made of certain materials, like asphalt and bitumen.

The expense of needed repairs is a major barrier for keeping buildings out of the program, especially in disadvantaged areas, said Kendra Jones, director of HOPE’s Bronx programs.

“The repairs that we would need to be on the roof is a higher priority than the actual coating itself,” she said.

HOPE has mostly been working on residential buildings, but is planning more outreach to larger commercial buildings.

“The return is so good, you don’t really need to think about whether [you] should do it or not,” Heris said.

This story was produced in partnership with the Health & Science Reporting Program at the Craig Newmark Graduate School of Journalism at CUNY.

New York City mayoral primary voters cast ballots in extreme heat

2025-06-24T21:23:39+00:00

Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

New York City’s highly anticipated mayoral primary election collided on Tuesday with the first heat wave of the summer.

In the Flatlands neighborhood of Brooklyn, temperatures that climbed into the 90s hadn’t deterred Stephanie Ferdinand, 64, from casting her ballot. A supporter of Andrew Cuomo, the former Democratic governor, Ferdinand said she wanted to see the next mayor defend the city against federal incursions, including cuts to public health insurance programs.

“We have to vote, no matter how hot it is,” she said.

An extreme heat warning was in effect for New York City through Tuesday evening, with dangerously hot conditions and heat index values expected to reach up to 106°F. The combination of extreme heat and humidity would significantly increase the risk of heat-related illnesses, the National Weather Service said. High temperatures were expected to continue through Wednesday.

A sign direct voters toward the polls in the New York City mayoral primary election in the Flatlands neighborhood of Brooklyn on Tuesday.

Elected officials, including Gov. Kathy Hochul, urged residents to take precautions while voting, including by limiting time outdoors, hydrating, and seeking out cool spaces.

As New York’s summers get hotter, extreme heat is an increasingly pressing public health threat. People 65 years old or older, those with asthma or heart disease, outdoor workers, and people without access to cool shelter are particularly vulnerable to the impacts of extreme heat.

In New York City, an estimated 580 people, on average, die prematurely each summer due to hot weather, typically when heat aggravates underlying illness, according to city data. Visits to the emergency department for heat-related illnesses increased over the weekend and spiked early this week as temperatures climbed, according to city data.

Extreme heat is becoming more common in the U.S. Here’s how to stay safe.

In Flatbush, Emma Eriksson, 35, turned out in the hot weather to rank Zohran Mamdani, a New York state assemblyman and Queens Democrat, first on her ballot. She’d taken precautions against the heat, voting in the morning before the temperature spiked and planning to stay hydrated and replenish salts throughout the day.

“Heat sickness is real — it’s so brutal,” she said.

Emma Eriksson, 35, and Jack Drury, 40, beat the heat in Flatbush, Brooklyn to vote in New York City's mayoral primary election on Tuesday.

In East Flatbush, poll workers at St. Augustine’s Episcopal Church cooled themselves with fans that read “Vote NYC.” The neighborhood is among those in New York City most vulnerable to heat mortality, as determined by the city’s heat vulnerability index. The index identifies areas where residents are at the highest risk of dying during and immediately following extreme heat, based on factors like daytime summer surface temperature, access to air conditioning, the availability of green space, and median income.

For Virginia Pierre, 79, the heat hadn’t stopped her from getting to the polls. Pierre had ranked Cuomo first and said she wanted to see more support for seniors and for New Yorkers who rely on food pantries.

“I didn’t want to come out, that’s the truth,” she said, leaning on her cane.

“But I want to vote,” she added. “We need help.”

With her civic duty fulfilled, Pierre said she planned to get her nails done for her granddaughter’s high school graduation — and then retreat into the air conditioning at home.

“I’m not coming out,” she said.

In another heat vulnerable area, the Arverne neighborhood of The Rockaways, in Queens, Carlene Hamilton, 70, left the polls feeling hopeful.

Hamilton said she wanted to see a change for the city, and had been energized by Mamdani’s youthful, progressive campaign. But she was concerned that the heat wave would deter voters, particularly those among her area’s elderly population.

While Hamilton has air conditioning at home, she said she doesn’t use it much. After voting, she planned to go to the boardwalk, to walk along the water.

“We’re fortunate to have a breeze out here,” she said.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

Hot — and humid — summer days are on New York’s horizon. How to keep cool.

2025-06-20T13:31:00+00:00

This article originally appeared at Your Local Epidemiologist New York. Sign up for the YLE NY newsletter here. Public health, explained: Sign up to receive Healthbeat’s free New York City newsletter here.

We’ll dive into the warm temperatures on New York’s radar, but first …

Me at the WNYC studio.

Have you voted yet? Last week, I shared a health voter guide for the NYC mayoral election. This week, I sat down with WNYC’s Brian Lehrer to discuss it. You can listen to our conversation here.

Okay, back to our scheduled programming …

Last weekend, I joined 9,999 other women to run a loop through Central Park for the Women’s Mini 10K. It was empowering and energizing, but wow was I struggling with the heat. I assumed the temperature must be in the 90s. The reality? Just 75°F.

The problem wasn’t the heat alone, it was the humidity. When moisture in the air is high, your body can’t cool itself as effectively. Sweat just sits on your skin instead of evaporating, making it feel much hotter than it is.

Next week, parts of New York could see high temps reach 100°F — the hottest day of the year so far. Because our bodies gradually adapt to heat as the summer progresses, we’re especially vulnerable in June. Early-season heat hits harder. There’s also truth to the old saying: It’s not the heat, it’s the humidity.

Let’s break down why heat and humidity matter — and what you can do to stay safe.

⚠️[Increasing Heat and Humidity!]: For early next week, we are looking at our first stretch of prolonged hot, humid weather beginning Sunday and lasting through at least the middle of next week. Stay tuned for forecast updates as we get closer at https://t.co/wTqdsomHTB pic.twitter.com/F7gU29rkQZ
— NWS New York NY (@NWSNewYorkNY) June 17, 2025

Back up: Why humidity feels so brutal

When it’s hot outside and/or we’re exerting ourselves, the body tries to cool itself down by sweating. But it’s not sweat alone that cools you down. The sweat needs to evaporate off your skin. The evaporation of a teaspoon of sweat could cool your entire bloodstream by 2 degrees F.

This is where humidity comes in. When there’s a lot of moisture already in the air, sweat can’t evaporate as effectively because the air can’t absorb more moisture, making it harder to cool down. The body’s cooling processes become less effective, and heat and humidity can become dangerous. Older people are more vulnerable to humid conditions because the body produces less sweat as we age.

Humidity and dew point describe how muggy it feels, but they measure different things:

Relative humidity — the percentage in your weather app — tells us how full the air is with water vapor relative to its capacity. But warm air holds more water, meaning 60% humidity on a hot day feels much stickier than 60% on a cool day.
Dew point is more precise. It measures the actual amount of moisture in the air. Technically, it’s the temperature at which air becomes saturated and dew forms. The higher the dew point, the more moisture is in the air, and the muggier it feels.

In short: The dew point is a better indicator. A dew point above 65°F feels sticky. Above 70°F, it becomes more uncomfortable and risky during a heat wave.

When I was running my race last weekend, the humidity hovered around 80%, with a dew point of 70°F.

Heat-related illness in New York

Every year, thousands of people across New York visit the emergency department for heat-related illness. In 2024, there were 3,213 heat-related emergency department visits in New York state, excluding New York City. From May 1, 2025, through Thursday, there have been 556 ED visits for heat in New York state (excluding New York City).

Emergency department visits for heat-related illness in New York state, 2025. The heat index is a combination of temperature and humidity, and is similar to the “feels like” temperature.

Heat illness can be severe. In New York City last year, seven people died directly because of heat, and 570 died because heat exacerbated underlying conditions, like heart disease. Those age 60 and over are most susceptible to heat-related illness.

New York is getting hotter. A new state dashboard aims to anticipate health risks.

Counterintuitively, people in New York who died from heat stress were most often exposed to dangerous heat inside their homes, not outside. Without air conditioning, indoor temperatures can be much higher than outdoors, especially at night, and can continue for days after a heat wave.

New York families with low incomes can apply for free AC units or fans through the Home Energy Assistance Program. In 2024, more than 25,000 households in New York state got access to cooling units through HEAP.

What you can do

The best thing to do is to try to stay cool and check in on neighbors who may not have air conditioning.

Know your risks. The Centers for Disease Control and National Oceanic and Atmospheric Administration dashboard tracks local heat risk scores that takes into account temperature, humidity, and other metrics that impact health. The risk score ranges daily from “No risk” to “Extreme” heat risk. Enter your ZIP code here.
Apply to get a free air conditioner or fan through HEAP, if you qualify. However, the future of HEAP’s program is uncertain. In April, all federal employees overseeing the national program that funds state-level HEAPs were laid off, and funds were frozen due to cuts at the Department of Health and Human Services. Applications will remain open only as long as state funds last — once they run out, no more households will receive cooling assistance.
Use a cooling space. Cooling centers can be found in New York City here and across the rest of the state here. Libraries, museums, or coffee shops are great options.
Keep your pets cool. They’re susceptible to heatstroke, too. Here are hot-weather safety tips for pets.
Watch out for hot playgrounds. Metal, turf, and black asphalt can cause burns on hot days.
Know what symptoms to look out for. Confusion, dizziness, and unconsciousness are serious signs of heatstroke that warrant calling 911.

Bottom line

It’s going to be a hot one. Stay hydrated, check on your neighbors, and don’t underestimate June heat — it can hit harder than we expect.

Love,

Your NY Epi

Dr. Marisa Donnelly, PhD, is an epidemiologist, science communicator, and public health advocate. She specializes in infectious diseases, outbreak response, and emerging health threats. She has led multiple outbreak investigations at the California Department of Public Health and served as an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention. Donnelly is also an epidemiologist at Biobot Analytics, where she works at the forefront of wastewater-based disease surveillance.

Tick populations have surged in the Northeast. Here’s how to keep you and your pets safe this summer.

2025-06-18T11:00:00+00:00

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As climate change brings longer summers and milder winters, tick populations have surged across the Northeast. And while New York City isn’t a hot spot for ticks, it’s surrounded by regions where the risk of encountering an infected tick is high.

In the city, transmission of tick-borne diseases tends to occur on Staten Island and in parts of the Bronx. But most of the local cases of tick-borne disease come from visits to upstate New York, Long Island, Connecticut, New Jersey, Pennsylvania, and Massachusetts. The New York City Department of Health and Mental Hygiene recently warned local health care providers to be vigilant for tick-borne diseases, particularly in patients who have traveled outside of the city.

On Long Island, Dr. Sandeep Gandhi sees patients with suspected tick-borne diseases at Stony Brook Southampton Hospital’s Regional Tick-Borne Disease Resource Center Clinic in Hampton Bays.

“We are seeing a huge uptick in tick-related infections, particularly Lyme disease,” he said of cases on Long Island.

While your risk of encountering an infected tick is far higher on Long Island than in the five boroughs, the regions are closely connected, Gandhi noted.

“There’s a lot of exchanges, travel, between Manhattan and Long Island, and the pets travel with them,” he said. “That is an increasing factor.”

Here’s what to know about tick-borne diseases, and how to stay safe this summer.

How should you protect against tick bites?

Reducing your risk of tick-borne disease transmission comes down to awareness, prevention, and monitoring, Gandhi said.

If walking in wooded areas, wear long pants, tuck them into your socks and stay on paths, experts advise. Ticks tend to climb tall grasses and shrubs, wait for animals or humans to brush up against them, and then attach to feed. Wearing light-colored clothing can make it easier to spot ticks.

Insect repellant that contains the permethrin can be sprayed directly onto clothing and last for multiple washes, but should not be used on the skin. Insect repellants containing DEET and picaridin, formulated to work against ticks, should be sprayed on the skin.

Dr. Sandeep Gandhi, an infectious disease specialist, sees patients with suspected tick-borne disease at Stony Brook Southampton Hospital’s Regional Tick-Borne Disease Resource Center Clinic in Hampton Bays.

When returning home, check yourself for ticks as soon as possible, Gandhi said, paying close attention to your hairline areas, armpits, and groin. If you find a tick on yourself, remove it with fine-tipped tweezers, grabbing the tick close to its head, and pulling it out in one smooth motion.

The city Health Department also recommends bathing or showering within two hours of coming indoors and drying clothing on high heat for at least 10 minutes to kill ticks.

Dog owners should also carefully check their pets for ticks, Gandhi said.

“When dogs sleep in the bed with the patient, that’s one of the greatest risk factors for getting tick-related infections,” he said.

What kinds of ticks are there, and what diseases do they carry?

Tick surveillance conducted by the Health Department has found the blacklegged tick to be widely established in Staten Island and parts of the Bronx, including Pelham Bay Park and Hunter Island. The Health Department has detected pathogens that can cause Lyme disease, anaplasmosis, babesiosis, Borrelia miyamotoi disease, and Powassan virus disease, in a small number of those ticks.

Lone star ticks, often associated with ehrlichiosis, have been detected in Staten Island and the Bronx, and Gulf Coast ticks have been found on Staten Island. American dog ticks have been detected in all five boroughs, but the Health Department has not found any of them testing positive for Rocky Mountain spotted fever in recent years.

Extreme heat is becoming more common in the U.S. Here’s how to stay safe.

Lyme disease is the most common tick-borne disease found in the New York City region, accounting for 2,952 cases among New Yorkers in 2024 (including 1,900 newly diagnosed cases and 1,052 new positive results for cases from prior years), according to the Health Department’s preliminary data.

Lyme disease is spread through the bite of an infected blacklegged tick, and in most cases has to be attached to a person for 24 to 36 hours before it can transmit the disease.

“There are other tick-related infections that have a shorter period of time,” Gandhi said. “The shortest period of time is the Powassan virus, which can transmit within 15 minutes.”

The Powassan virus disease is dangerous but exceedingly rare in New York City. The Health Department noted that it has been reported in one resident who was infected in the Hudson Valley in 2018.

Last year, the Health Department also reported 78 cases of babesiosis and 65 cases of anaplasmosis, 24 cases of ehrlichiosis, two cases of Rocky Mountain spotted fever, and one case of rickettsialpox.

How do you know if you have Lyme disease?

When it comes to Lyme disease, in Gandhi’s experience, a bruise-like lesion is more common than the classic “bull’s eye” rash people might be prepared to look for. Other symptoms can include fever, cold or flu-like symptoms, body aches, joint pain, and, in rare cases, a shooting nerve pain.

If you have a lesion of more than 5 centimeters and a tick bite, or live in an area like Long Island where ticks are endemic, you should be treated proactively for Lyme disease, Gandhi said.

“Lyme disease is very, very treatable,” he said. “The antibiotic most commonly used is doxycycline.”

Early symptoms of Lyme disease typically begin three to 30 days after a tick bite; late symptoms can occur months later. If caught early and treated with prescription antibiotics, recovery can occur within weeks.

In rare cases, symptoms can persist even when Lyme disease is detected and treated early, as is the case with Post Treatment Lyme Disease. With that condition, people can continue to experience symptoms like severe fatigue, body pain, and cognitive challenges six months or more after the end of treatment.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org .

Flooding is NYC’s most pressing public health threat, new city report says

2025-06-16T11:00:00+00:00

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New York City could face a wide range of public health calamities in the coming years. There could be an infectious disease outbreak or another pandemic. It’s possible the city could see a mass casualty incident or accidentally released hazardous materials. But it’s flooding that the New York City Department of Health and Mental Hygiene is most concerned about.

A new report, a five-year risk assessment required by the Centers for Disease Control and Prevention, presents flooding as the city’s most pressing public health threat. That’s a result of rising sea levels and intensifying storms, which threaten the city’s coastlines and low-lying neighborhoods.

The last time the report was released, in 2018, using a different methodology, the Health Department identified a respiratory virus with pandemic potential as the city’s most severe threat, and excessive heat as the most likely threat. The new report warns that another pandemic remains the most severe and highest risk public health threat, but flooding — a category distinct from coastal surges — is the most probable one.

Flooding has become an increasing concern in New York City in recent years. In the fall of 2021, heavy rainfall and floodwaters from Hurricane Ida killed 13 residents, including 11 who drowned in basement homes. In 2023, flash floods generated chaos across the city, leading to multiple rescue operations for people stuck in cars and in flooded apartments.

Extreme heat is becoming more common in the U.S. Here’s how to stay safe.

“Nationally, we’re vulnerable to more frequent and intense floods because of atmospheric warming,” said Dr. Victoria Lynch, a postdoctoral research fellow in the Department of Environmental Health Sciences at Columbia University Mailman School of Public Health.

Warmer air temperatures lead to more water vapor in the atmosphere, which can quickly condense and unleash very intense rainfalls, Lynch said. And New York City, like other coastal regions in the United States, is also vulnerable to sea level rise.

Tidal flooding in the 2020s in New York City will likely affect Brooklyn Bridge Park, the Coney Island boardwalk, and other coastal strips of the city, according to the report, which draws on projections from the National Oceanic and Atmospheric Administration. By the 2080s, the flood risk will worsen, making low-lying areas like the Rockaways and LaGuardia Airport vulnerable to frequent high tide flooding. If a coastal storm hit in the 2080s, the flooding impact on the city would be significant, inundating much of southeast Brooklyn, large parts of downtown Manhattan, and areas of Staten Island, Queens, and the Bronx.

Flooding poses a significant risk to human life. A study published earlier this year in Nature Medicine, led by Lynch and other Columbia University researchers, explored the full scope of flood-related mortality in the United States from 2001 to 2018. Researchers found that floods were associated with higher death rates for most causes of death — in some cases for months after the flood event.

Severe rain-related floods were associated with increased death rates for cardiovascular disease and infectious diseases during the month of a flood. In the month following a flood, researchers noted increases in injury-related and infectious disease-related death rates. Two months after a severe flood, researchers found an increase in respiratory disease death rates. For tropical cyclones, researchers found a pronounced increase in injury death rates during the month of a severe flood, and an increase in injury and infectious disease death rates in the following month.

“They’re these massive shocks to the system that can affect you as an individual, but then also your family and your community,” Lynch said of floods. “In every way that a person’s health and livelihood can be affected, it is when you have these really devastating flood events.”

In its report, the Health Department also identified parts of the city that would particularly struggle to recover from a major coastal storm. That determination was based on geographic vulnerability to flooding, as well as on the ability of a local community to avoid harm, maintain access to basic services, and return to previous levels of access to employment, housing, food, and health care. The neighborhoods least prepared to bounce back from a significant coastal storm include Sheepshead Bay, Rockaway Beach, East Harlem, Soundview, and Throgs Neck, according to the report.

To mitigate the risks of flooding, the report recommends using backwater valves to prevent sewer backups, creating rain gardens to absorb stormwater and reduce runoff, and promoting green space stewardship for stormwater management.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org .

Extreme heat is becoming more common in the U.S. Here’s how to stay safe.

2025-06-12T11:00:00+00:00

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Summer brings heat waves — and the risk of heat-related illnesses.

Extreme heat is the primary cause of weather-related mortality in the United States, posing a significant threat to public health. Periods of unusually hot weather are especially dangerous for elderly people and those with chronic conditions. But anyone working or exercising outside, or those without access to cool shelters, can be vulnerable to health effects during heat waves.

And it’s only getting hotter. With climate change, extreme heat events are expected to become more frequent and intense. Globally, nearly half of the world’s population experienced at least 30 extra days of extreme heat between May 2024 and May 2025, a result of human-driven climate change, according to a new report from scientists at Climate Central, Red Cross Red Crescent Climate Centre, and World Weather Attribution.

Here’s what to know about extreme heat and how to stay safe this summer.

What is extreme heat, and how deadly is it?

Extreme heat is generally considered to be a prolonged period of hot, and sometimes humid, weather that is unusual for a certain location and time of year.

But there is no standard nationwide definition of extreme heat across the United States, given the country’s highly varied climates, said Dr. Jaime Madrigano, an associate professor of American health in the Department of Environmental Health and Engineering at the Johns Hopkins Bloomberg School of Public Health.

“We have a big country, and it’s not uniform,” she said.

As a result, there are varying thresholds for heat advisories, as well as differences in how heat-related mortality is recorded, she said.

New York is getting hotter. A new state dashboard aims to anticipate health risks.

The Centers for Disease Control and Prevention reports that more than 700 people die from extreme heat every year across the country. But the full scope of mortality is likely much higher, because heat-related deaths can occur even without temperatures reaching extreme levels. A JAMA study published last year recorded 2,325 heat-related deaths in the United States in 2023, the highest annual total — and a 117% increase — since 1999.

In New York City alone, an estimated 580 people, on average, die prematurely each summer due to hot weather, typically when heat aggravates underlying illness, according to city data. The city’s 2024 Heat-Related Mortality Report noted that heat-exacerbated deaths have increased over the past decade because of summers that are hotter overall, with more “non-extreme hot days” of temperatures between 82°F and the city’s extreme heat threshold of 95°F.

What are heat-related illnesses?

Extreme heat can have a wide range of effects on our bodies. Heat cramps — muscle cramps and spasms that occur after intense exercise and sweating in high heat — can be the first sign of heat-related illness. Heat exhaustion, which occurs when the body loses water and salt, is characterized by dizziness, thirst, heavy sweating, nausea, and weakness, and can lead to heatstroke.

The most common heat-related illnesses that Dr. Christopher Tedeschi, an associate professor of emergency medicine at Columbia University Medical Center, sees in the summer are respiratory or cardiac illnesses exacerbated by intense heat.

“It doesn’t need to be in the middle of a heat wave,” he said. “Someone with asthma or emphysema, in the setting of a day where the heat index is high, certainly is more at risk of having an exacerbation of their chronic illness.”

Heatstroke is more rare, but requires an emergency response, he said. That condition occurs when a person’s body temperature rises rapidly — to 106°F or higher within 10 to 15 minutes — and cannot cool down. Symptoms of heatstroke include confusion and slurred speech, loss of consciousness, hot skin, seizures, and very high body temperature. Heatstroke can lead to permanent disability or death.

The condition can occur in older people who can’t easily cool their bodies down, Tedeschi said, but also in younger people who exert themselves on hot days, like an athlete who collapses during preseason training. In those cases, ER teams will work to quickly cool people down, including by immersing them in ice water.

“When people have heatstroke, cooling them quickly is really the key to reducing their mortality,” he said.

Who is most vulnerable to extreme heat?

People who are particularly vulnerable to heat-related illness include those with asthma or heart disease, pregnant women, those 65 years or older, infants, young children, those working or exercising outside, and those who are unhoused, according to the CDC.

Socioeconomic status and access to green spaces can significantly shape one’s vulnerability to extreme heat, and some cities have made efforts to map out areas where those factors are particularly pronounced. New York City’s heat vulnerability index details which neighborhoods are most at risk for death during and after extreme heat, based on factors like daytime summer surface temperature, access to air conditioning, median income, and the availability of green space. Philadelphia offers a similar tool that identifies heat vulnerability on a block-by-block basis, as well as identifying local pools, libraries, parks, and health centers.

Summer heat is felt unevenly across metro Atlanta. Experts say more data is needed to address the public health threat.

Madrigano, the Johns Hopkins expert, is researching heat vulnerability in New Orleans. The city’s hot, humid weather and high poverty rate makes it particularly susceptible to heat-related morbidity and mortality, she said, pointing to factors like whether residents can afford to keep their air conditioning running.

“From a public health perspective, we know the most effective strategy for keeping people safe during extreme heat is air conditioning,” she said.

In some states, new tools aim to help residents and officials identify who is most at risk during heat waves. In California, the newly released CalHeatScore offers daily rankings of forecast heat impacts in ZIP codes across the state. New York state recently launched a similar tool, which combines weather forecasting with data on heat-related emergency department visits and emergency medical services calls.

How can I protect myself against extreme heat?

There are ways to mitigate health impacts during periods of hot weather.

“At the end of the day, it’s about protecting yourself from heat, taking frequent breaks, staying hydrated, staying in cool areas if you can, adjusting your work hours, if you can, to avoid those hottest parts of the day,” Tedeschi said.

When venturing outside, wear loose, lightweight, light-colored clothing and sunscreen, and try to stay in the shade if possible, the CDC advises. During periods of elevated temperatures, never leave children or pets in cars.

Other standard recommendations include staying in air-conditioned indoor locations. People who lack air conditioning at home are advised to seek out cool public spaces like libraries. The National Center for Healthy Housing offers a list of each state’s cooling center resources.

What does a warming climate mean for cities and hospitals?

Some states and cities have rolled out heat response and climate mitigation plans, ranging from heat and health forecasts to initiatives to paint reflective roofs and plant more trees. But a federal effort to develop heat mitigation strategies across the country was recently defunded by the Trump administration.

Meanwhile, cities continue to heat up. In Atlanta, compared to 1970, there are now almost two more weeks of extreme heat per year. And New York City is projected to see the number of days each year with temperatures higher than 90 degrees rise from 17 to as many as 54 by the 2030s — and as many as 108 by the 2080s.

The warming climate also poses challenges for health systems. In a 2022 NEJM Catalyst article, researchers noted that New York City can expect the number of heat waves to increase from an average of two per year to seven per year by 2050, and urged hospital systems to create response plans.

Tedeschi, the New York City emergency room physician, worries about what increasingly long and intense heat waves will mean for the patients he cares for — and health systems. A heat wave can become a “mass casualty event” if multiple patients arrive with heatstroke, which requires a robust team response, he said.

“I expect we’ll see more patients in the ER with heat-exacerbated illness over the next few years,” he said.

What questions and concerns do you have about how rising temperatures affect health? Email us at nyc.tips@healthbeat.org.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

Degraded air quality continues in New York City, posing health risks

2025-06-05T14:56:32+00:00

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Poor air quality continued in New York City and surrounding regions on Thursday, posing health risks to sensitive groups.

The New York State Department of Environmental Conservation extended an air quality health advisory into Thursday, for New York City, Long Island, and nearby counties from 11 a.m. to 11 p.m.

Young children, elderly people, and those with respiratory diseases like asthma are advised to avoid strenuous activities in the afternoon and early evening. New Yorkers can check up-to-date air quality at AirNow.

The city’s degraded air quality is a result of ground-level ozone, a pollutant, although on Wednesday smoke from Canadian wildfires also created hazy skies, said Dave Radell, a National Weather Service meteorologist.

“The air quality alerts that are in effect through tonight are because of ozone, which is a pollutant that we often see this time of year, once we start getting into the warmer weather and some pretty stagnant like conditions,” he said Thursday.

Ozone can be particularly dangerous for people with asthma, children, older adults,and those who are active outdoors, according to the U.S. Environmental Protection Agency. Ozone can cause coughing or a scratchy throat, make it more difficult to breathe, and aggravate lung diseases.

In 2023, smoke from Canadian wildfires posed significant health risks for New York City residents, shrouding the city in smoky orange clouds. Public health and environmental researchers later identified an association with the degraded air quality and a spike in emergency department visits in the city for asthma.

Wildfire smoke poses a risk to respiratory health because it is a mixture of water vapor and pollutants like particle pollution — tiny droplets of soot, acids, metals, and other compounds — which can easily seep into homes, according to the EPA. Inhaling particle pollution can result in minor health effects like eye and respiratory tract infections, or more severe ones, like the exacerbation of asthma, or heart failure.

To limit detrimental health effects from wildfire smoke, the New York City Department of Health and Mental Hygiene recommends staying indoors with windows and doors closed, if temperatures allow. If the outdoor temperature is higher than 85 degrees, the Health Department recommends using an air conditioner, with the fresh air intake closed to prevent pulling polluted air inside. Those without air conditioners can seek out libraries, public buildings and other cool indoor spaces.

The agency also recommends using a portable air cleaner to filter the air, and wearing a well-fitting N95 or KN95 mask if you need to go outdoors.

The story has been updated with Thursday’s air quality alert and to specify that the ground-level ozone resulted in the region’s degraded air quality.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

New York is getting hotter. A new state dashboard aims to anticipate health risks.

2025-05-30T17:15:25+00:00

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As climate change drives up temperatures and the risk of heat-related illnesses in New York, public health leaders and researchers are paying more attention to heat surveillance.

This week, the New York State Department of Health launched a dashboard that aims to help New Yorkers assess heat exposure and health risks — and guide local responses to heat waves.

“This is a new tool that will help us understand the risk hot weather presents to us,” State Health Commissioner Dr. James McDonald said in a statement. “We have moved beyond, ‘it’s not the heat, it’s the humidity’; it’s much more complicated than that, and this dashboard offers better insight into your risk.”

Since 1901, average temperatures in New York state have increased by almost 2.6°F, and since 2000, they’ve remained higher than in any period in recorded history, according to the New York State Climate Impacts Assessment. And it’s only going to get hotter from here: Average temperatures in the state are projected to rise between 5° and 11°F by the end of the century.

As rising temperatures increase the risk of heat-related illnesses, McDonald said that the dashboard will “help communities and decisionmakers — like school officials and employers – make informed choices, such as adjusting outdoor activities or opening cooling centers.”

What’s the link between extreme heat and public health?

Scientific research shows that as climate change makes summers hotter — and heat waves longer — the risk of heat-related illness rises. Extreme heat can be especially dangerous for children, elderly adults, people with chronic conditions, anyone who works outside, and those who are unhoused.

More than 700 people die from extreme heat every year in the United States, according to the Centers for Disease Control and Prevention.

The most serious heat-related illness, heat stroke, occurs when a person’s body temperature rises rapidly and cannot cool down. Heat stroke can drive body temperature up to 106°F or higher within 10 to 15 minutes, and without emergency treatment can result in permanent disability or death, according to the CDC.

Symptoms of heat stroke include confusion and slurred speech, loss of consciousness, hot skin, seizures and very high body temperature. Signs of heat exhaustion — the body’s response to excessive loss of water and salt — include headache, nausea, dizziness, weakness, thirst, heavy sweating and elevated body temperature.

Extreme heat can also worsen the effects of air pollution and exacerbate respiratory conditions. A 2012 study of extreme heat and respiratory hospitalizations in New York state estimated that from 2080 to 2099, extreme heat could lead to two to six times the number of hospital admissions for respiratory conditions than had occurred from 1991 to 2004.

Research published last year in the CDC’s Morbidity and Mortality Weekly Report found that from May to September 2023, daily rates of emergency department visits due to heat-related illnesses peaked in a number of regions during warm-weather months and remained elevated for an extended period afterward.

“Heat-related illness will continue to be a significant public health concern as climate change results in longer, hotter, and more frequent episodes of extreme heat,” the study’s authors noted. “By monitoring heat-related health impacts, public health agencies can detect trends in health care utilization rates, identify subpopulations at increased risk, and guide public health actions tailored to specific heat exposure levels.”

How does the dashboard work?

The New York State Heat Risk and Illness Dashboard uses weather data from the National Weather Service and the state’s own early warning weather detection system. It also publishes recent data on heat-related emergency department visits and emergency medical services calls, drawn from statewide syndromic surveillance system reports. The dashboard grew out of HeatRisk, a NWS tool that launched nationwide last spring and combines weekly weather forecasts with predictions for the risk of heat-related health impacts.

New York’s dashboard shows a county-by-county map colored to show heat risk, ranging from “little to no” risk of heat-related illnesses to “extreme” risk. Each risk category offers corresponding recommendations for the public. At the level of “minor” risk, people who are extremely sensitive to heat, like older adults with underlying health conditions, are urged to take breaks and drink fluids; at “moderate” risk, those sensitive to heat and healthy individuals working or playing outdoors should take more frequent breaks and drink plenty of fluids; at “major” risk, everyone should take breaks and drink fluids, and those sensitive to heat should adjust activities; and at “extreme” risk, conditions are dangerous for everyone, meaning that activities should be adjusted, health symptoms monitored, and more time spent in air conditioning.

As of Friday, every county in the state was deemed to be at “little to no” risk of heat-related illnesses, with only Richmond County (Staten Island), deemed at “minor” risk. But by Wednesday, the forecast showed, all of the state could fall under a “minor” risk category, with some counties in Western New York under a “moderate” risk for heat-related illnesses.

How can this tool help us understand heat risk?

State health officials and researchers hope that the dashboard will help inform New Yorkers of their health risks during periods of elevated temperatures and guide local responses to heat waves.

While there is annual variation in weather, longer-term climate trends suggest that New York is getting warmer, said Dr. Neil A. Muscatiello, director of the Bureau of Environmental and Occupational Epidemiology at the Health Department’s Center for Environmental Health.

“In terms of long-term trends, we expect to see more days forecasted in the red and magenta categories — the major and extreme risk categories,” he said.

The launch of the state’s dashboard coincided with the publication of a study in the CDC’s MMWR, which assessed the value of HeatRisk forecasts for New York state.

The study, led by Muscatiello and other Health Department staffers, tracked HeatRisk forecasts for 57 New York counties — excluding those in New York City — from May to September 2024. Researchers found that for New York state and for six of seven state regions, a higher risk forecast was associated with higher rates of heat-related illnesses.

Muscatiello, the study’s lead author, said the findings helped establish that when the HeatRisk forecast suggested higher heat risks, that was reflected in actual emergency department data the next day.

“The forecast could provide a basis for developing heat emergency plans at the local levels,” he said.

What about heat surveillance for New York City?

The state’s new dashboard focuses on counties outside of New York City for health-related data, because when it comes to heat-related illnesses, New York City has its own databases to rely on.

The city tracks real-time heat-related illnesses using syndromic surveillance reports from hospitals in the city, and publishes data on temperatures and ED visits for heat-related illnesses. The city also maintains a “heat vulnerability index,” which shows neighborhoods where residents have heightened risk of dying during and immediately following extreme heat, based on factors like daytime summer surface temperature, access to air conditioning, the availability of green space, and residents’ median income.

The city is particularly vulnerable to the health effects of extreme heat because of the urban heat island effect, which describes how a city’s buildings, roads and infrastructure drive up its overall temperature. Even within New York City, there can be micro heat islands, where temperatures are even higher in neighborhoods with histories of disinvestment and less green space, experts told Healthbeat last year.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org.

Summer heat is felt unevenly across metro Atlanta. Experts say more data is needed to address the public health threat.

2025-05-14T20:53:19+00:00

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There’s no question that the coming summer in Atlanta will be a scorcher. But exactly how hot it will get can vary greatly in pockets across the metro area, creating uneven health risks.

Experts don’t have the data from the many places where people live, work, and play outdoors to track those extreme temperatures. Atlanta has only one “class 1” weather station that can provide high-quality data over a long historical period, and it’s at Hartsfield-Jackson Atlanta International Airport, though there are more weather stations across the metro region.

“The heat risk in one neighborhood is actually dramatically different than the heat risk in another neighborhood, and we have almost no information on that,” said Brian Stone, a professor who runs the Urban Climate Lab at Georgia Tech.

The lack of temperature data across the metro area makes it difficult for leaders to address the decades of rising temperatures, which pose a public health threat.

“Atlanta now experiences nearly two weeks worth of extreme heat days per year than it did in 1970 — part of a broader trend in which nearly every U.S. city is heating up,” said Dr. Kristina Dahl, vice president for science at nonprofit Climate Central.

A 2021 study found that Atlanta had 19 heat-related deaths each year attributable to human-induced climate change between 1991 and 2006.

Air temperature and humidity combine to affect health

Stone said there are many sources of heat data, but each has limitations.

Satellites capture surface temperature – how a street would feel if you touch it – but not the combination of temperature and humidity that drive health impacts from heat.

The Atlanta metro area should develop a more robust monitoring system, he said.

He pointed to Philadelphia, which developed a map that shows detailed heat risk by census tract, as well as where people can access cooling stations and other services to help with heat.

Stone’s lab uses climate models to help cities understand which neighborhoods have higher temperatures and how measures like adding trees or cool roofing to buildings could lower those temperatures.

One study Stone conducted for the City of Atlanta in 2023 found different neighborhoods face wide differences in heat risks. Areas with higher density had higher summer temperatures, while those with more tree canopy had lower temperatures.

While the English Avenue neighborhood had a heat vulnerability score of 10 — the highest in the city — nearby Georgia Tech had a score of 4. Neighborhoods to the west and south of the city center showed the highest total levels of heat vulnerability, on average.

That study also found that the prevalence of central air conditioning across the city was 96% but as low as 80% in some westside neighborhoods.

An Atlanta-based project called GEM, for Greenlink Equity Map, created by nonprofit Greenlink Analytics, measures urban heat using a nighttime temperature and converts it into a heat index for different neighborhoods in many cities.

The map presents data about the entire metro region and can show data about health and climate-related variables like utility burden – how much of a person’s income goes to energy costs – and tree canopy in different neighborhoods, said Matt Cox, CEO and executive director of Greenlink.

Some neighborhoods in Atlanta have a lot of tree canopy but still experience a high energy burden, which means people may not be able to afford air conditioning or must make choices between food and medicine or utilities.

It’s important to record nighttime temperatures that reflect accumulated heat over the day, but many models use morning or daytime measures, which tend to be lower. The Greenlink map uses nighttime temperature measures from satellites coupled with machine learning to produce its data.

The City of Atlanta is updating its climate resilience plan, which will include recommendations to address extreme heat, spokesperson Rayna Plummer said.

The city is planning several community engagement events related to climate resilience this summer.

Citizen scientists help collect temperature data

In Gwinnett County one day last August, 20 volunteers drove around a 27-square-mile area with thermometers to track the temperature at different times of day, part of a federal effort to enlist local volunteers to track urban heat since 2017.

Citizen science projects like the one-day temperature mapping effort help people learn more about heat and get them involved, Stone said. But the data’s single-day focus is limited.

Still, the project helped show where “urban heat islands” are and which areas lack tree canopy, said state Rep. Marvin Lim, who helped lead the effort.

Lim said his greatest insight from the data was that “unless there were significant trees between heavy-use roads/industrial areas and residential areas … adjacent residential areas were still going to be very hot.”

“It made me think of how difficult it is for trees to exist in these kind of urban landscapes - the impervious surfaces are going to reduce their cooling effect, which means, in my mind, you really need a significant number of trees in these areas,” Lim said.

In concrete terms, the data helped influence a decision to apply for a grant from the American Academy of Dermatology to build a shaded bus shelter along Jimmy Carter Boulevard in Gwinnett. That was driven by the heat mapping project and determining where people walked a lot.

The location at Nett Church was chosen “because it gets hot there (little tree cover, industrial area), but people are frequently walking in that area.”

DeKalb County is working on a tree canopy study that will establish a baseline map and track changes over time in unincorporated areas, according to its website.

In Cobb County, a class of Georgia Tech students working with Professor Jairo Garcia mapped heat islands in 2022. They also provided recommendations, suggesting the county develop a climate resiliency plan.

The county is working on it, Chief Sustainability Officer Kimberly White told Healthbeat, though it’s in early stages.

Rebecca Grapevine is a reporter covering public health in Atlanta for Healthbeat. Contact Rebecca at rgrapevine@healthbeat.org.

Public health risks of urban wildfire smoke prompt push for more monitoring

2025-04-08T16:07:32+00:00

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When the catastrophic Los Angeles fires broke out, John Volckens suspected firefighters and residents were breathing toxic air from the burning homes, buildings, and cars, but it was unclear how much risk the public faced. So, the professor of environmental health at Colorado State University devised a plan to get answers.

Volckens shipped 10 air pollution detectors to Los Angeles to measure the amounts of heavy metals, benzene, and other chemicals released by the flames, which burned more than 16,000 homes, businesses, and other structures, making it one of the country’s costliest natural disasters.

“These disaster events keep happening. They release pollution into the environment and to the surrounding community,” said Volckens, who shared his results with local air regulators. “We have this kind of traumatic experience, and then we’re left with: Well, what did we just breathe in?”

Scientists and public health officials have long tracked the pollutants that cause smog, acid rain, and other environmental health hazards and shared them with the public through the local Air Quality Index. But the monitoring system misses hundreds of harmful chemicals released in urban fires, and the Los Angeles fires have led to a renewed push for state and federal regulators to do more as climate change drives up the frequency of these natural disasters.

It’s questionable whether the Trump administration will act, however. Last month, Environmental Protection Agency Administrator Lee Zeldin announced what he described as the “biggest deregulatory” action in history, which critics warn will lead to a rollback of environmental health regulations.

A small air quality monitoring sensor can help people understand what's in the air after disasters like wildfires. This AirPen device was dispatched to Los Angeles during the January fires.

While Air Quality Index values are a good starting place for knowing what’s in the air, they don’t provide a full picture of pollutants, especially during disasters, said Yifang Zhu, a professor of environmental health sciences at UCLA. In fact, the AQI could be in a healthy range, “but you could still be exposed to higher air toxins from the fires,” she added.

In February, nearly a dozen lawmakers from California called on the EPA to create a task force of local and federal authorities to better monitor what’s in the air and inform the public. Locals are “unsure of the actual risks they face and confused by conflicting reports about how safe it is to breathe the air outside, which may lead to families not taking adequate protective measures,” the lawmakers wrote in a letter to James Payne, who was then the acting EPA administrator. The EPA press office declined to comment in an email to KFF Health News.

Bills would fund more air monitors, study smoke impact

Lawmakers have also introduced bills in Congress and in the California legislature to address the gap. A measure by U.S. Rep. Mike Thompson, a California Democrat, and U.S. Sen. Jeff Merkley, an Oregon Democrat, would direct the EPA to allocate grant money to local air pollution agencies to communicate the risks of wildfire smoke, including deploying air monitors. Meanwhile, a bill by Democratic state Assembly member Lisa Calderon would create a “Wildfire Smoke Research and Education Fund” to study the health impacts of wildfire smoke, especially on firefighters and residents affected by fires.

The South Coast Air Quality Management District, a regional air pollution control agency, operates about 35 air monitoring stations across nearly 11,000 square miles of the Los Angeles region to measure pollutants like ozone and carbon monoxide.

During the fires, the agency, which is responsible for the air quality of 16.8 million residents, relied on its network of stations to monitor five common pollutants, including PM2.5, the fine particles that make up smoke and can travel deep inside the body. After the fires, the South Coast AQMD deployed two mobile monitoring vans to assess air quality in cleanup areas and expanded neighborhood-level monitoring during debris removal, said Jason Low, head of the agency’s monitoring and analysis division.

Local officials also received the data collected by Volcken’s devices, which arrived on-site four days after the fires broke out. The monitors — about the size of a television remote control and housed in a plastic cover the size of a bread loaf — were placed at air monitoring stations around the fires’ perimeters, as well as at other sites, including in West Los Angeles and Santa Clarita. The devices, called AirPens, monitored dozens of air contaminants in real time and collected precise chemical measurements of smoke composition.

Researchers replaced the sensors every week, sending the filters to a lab that analyzed them for measurements of volatile organic compounds like benzene, lead, and black carbon, along with other carcinogens. Volcken’s devices provided public health officials with data for a month as cleanup started. The hope is that the information provided can help guide future health policies in fire-prone areas.

“There’s not one device that can measure everything in real time,” Low said. “So, we have to rely on different tools for each different type of purpose of monitoring.”

Urban wildfire smoke more dangerous that tree and bush fires

ASCENT, a national monitoring network funded by the National Science Foundation, registered big changes after the fires. One monitor, about 11 miles south of the Eaton fire in the foothills of the San Gabriel Mountains, detected 40 times the normal amount of chlorine in the air and 110 times the typical amount of lead in the days following the fires. It was clear the chemical spikes came from urban wildfire smoke, which is more dangerous than what would be emitted when trees and bushes burn in rural areas, said Richard Flagan, the co-principal investigator at the network’s site in Los Angeles.

“Ultimately, the purpose is to get the data out there in real time, both for the public to see but also for people who are doing other aspects of research,” said Flagan, adding that chemical measurements are critical for epidemiologists who are developing health statistics or doing long-term studies of the impact of air pollution on peoples’ health.

Small, low-cost sensors could fill in gaps as government networks age or fail to adequately capture the full picture of what’s in the air. Such sensors can identify pollution hot spots and improve wildfire smoke warnings, according to a March 2024 U.S. Government Accountability Office report.

Although the devices have become smaller and more accurate in the past decade, some pollutants require analysis with X-ray scans and other costly high-level equipment, said J. Alfredo Gómez, director of the Natural Resources and Environment team at the GAO. And Gómez cautioned that the quality of the data can vary depending on what the devices monitor.

“Low-cost sensors do a good job of measuring PM2.5 but not such a good job for some of these other air toxins, where they still need to do more work,” Gómez said.

UCLA’s Zhu said the emerging technology of portable pollution monitors means residents — not just government and scientists — might be able to install equipment in their back yards and broaden the picture of what’s happening in the air at the most local level.

“If the fires are predicted to be worse in the future, it might be a worthwhile investment to have some ability to capture specific types of pollutants that are not routinely measured by government stations,” Zhu said.

This article was produced by KFF Health News, Healthbeat’s national reporting partner, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Global study finds rodent boom linked to climate change in New York City and beyond

2025-02-05T15:11:36+00:00

This story was originally published by THE CITY. Sign up to get the latest New York City news delivered to you each morning. Sign up to receive Healthbeat’s free New York City newsletter here.

New York City is getting rattier, thanks to climate change.

That’s a takeaway from a new study, which found cities that warmed the most saw the largest hikes in rat populations.

Using data from public rat sightings and inspections between 2007 and 2024, the researchers examined 16 cities around the world and found two-thirds saw increases in rat populations. New York City saw the fourth-highest spike in rats.

The rats don’t just run this town — they also run Washington, San Francisco and Toronto, which, according to the study, had the biggest rat increases, respectively. On the other end of the spectrum, three of the 16 cities covered saw significant drops in their rat population with the biggest decrease in New Orleans, followed by Louisville and Tokyo.

The study, published in the journal Science Advances, is the first of its kind to use data to demonstrate the connection between climate change and rats. Its 19 authors hailed from all over the world and represented a variety of fields, including biology, environmental health, and pest control.

“The number one priority for cities should be waste management, and in particular, food resource management,” said the study’s lead author, Jonathan Richardson, an urban ecologist at the University of Richmond. “New York has kind of been in the dark ages in terms of trash management for a long time, but things are changing in a way that I think is really positive.”

City “Rat Czar” Kathleen Corradi, whose official title is citywide director of rodent mitigation, says the results are a reminder that humans need to step up to counter forces that push rat populations to grow.

“What this study underscores is some kind of factors that are outside the control of an immediate governance,” Corradi said, “but the management of this animal is absolutely essential.”

A rat is “the perfect urban exploiter,” added Corradi. “Rat behavior is almost entirely fueled by human behavior.”

Mayor Eric Adams has made the war on rats a central part of his administration’s strategy, with his Department of Sanitation moving ahead with containerization of trash in the city. Meanwhile, he continues to swat at Department of Health and Mental Hygiene summonses alleging a rat infestation at his Brooklyn home. The Daily News reported Tuesday that the mayor missed a December hearing date on the latest rodent citation and owes $330.

Just as human behavior fuels rat behavior, so too does human behavior fuel climate change — chiefly a result of burning fossil fuels, which release gases and heat up the planet.

In New York City, temperatures have increased about 0.3 degrees each decade since the 1950s. They are projected to rise between 2 and nearly 5 degrees on average by the next decade, according to the New York City Panel on Climate Change. Across the board, cities tend to be hotter than rural or suburban areas because of concrete, tall buildings that limit air circulation and heat-generating activities — like driving and running air conditioners — that emit heat.

Since rats are (relatively) small mammals, they must regulate their body temperatures. Cold weather places limits on rats, requiring them to stay sheltered for longer and find more food to maintain internal temperatures. On the other hand, warming weather gives rats more time to be out and about, foraging and breeding.

“It seems like those warming trends impact the physiology of these rats in a way that benefits them,” Richardson said. “We certainly would predict that as warming continues, the rats will continue to benefit, probably because they’re able to be active during the cold weather months more than they are, or more than they were previously.”

While the researchers found that rat population booms were most closely linked to increases in each city’s temperature over the past century, other factors that played into growing rat populations included a lack of greenery and high human population density. The more people, the more food waste, which feeds rats.

Previous research had found New York City rat sightings peak in late summer and dip to lowest rates in the middle of winter — which can be attributable to a change in both rat and human activity. More rats are outside in the summer, as are New Yorkers, who see and report them.

To fight rats, the Adams administration is asking businesses and residents to put trash and organic waste into containers for disposal, rather than in bags piled up on sidewalks that provide a feast for rats. (Though determined rats can still chew through those bins.)

The city also set up four Rat Mitigation Zones to focus on ousting rats in high-needs areas. Early data suggest the programs have been promising.

New Yorkers can learn about rodents and pest management through the Rat Academy, hosted by the the city Department of Health, and become part of a so-called Rat Pack.

In the fall, the City Council greenlit a pilot program to deploy rat birth control, rather than poison, in certain areas in order to save birds and other urban wildlife that have become sick or die after eating poisoned rats.

The bottom line, according to the authors of the study: Cities that want to get rid of rats should focus on changing the environment that allows rats to thrive, rather than on removing rats themselves.

Samantha Maldonado is a senior reporter for THE CITY, where she covers climate, resiliency, housing and development. Email her at smaldonado@thecity.nyc.

Warming centers fill up as metro Atlanta experiences its coldest week of winter yet

2025-01-23T20:44:18+00:00

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As metro Atlantans have braced their way through teeth-chattering weather this week, some of the area’s efforts to keep unhoused residents out of the freezing cold have exceeded their expected capacity.

Warming centers are an essential way to keep Atlantans without homes out of dangerously cold weather, said Will Smith, director of the Exchange Recreation Center near Decatur. Earlier this week, Georgia Gov. Brian Kemp ordered a winter storm state of emergency, and the Georgia Emergency Management and Homeland Security Agency, GEMA, reported a hypothermia-related death caused by the state’s freezing temperature.

DeKalb County has used Smith’s center as an overnight warming center throughout the winter and added a 24-hour option last week. Like other centers throughout the state, it offers hot meals throughout the day.

“I think we’ve done everything humanly possible to provide for our unhoused residents here in DeKalb County,” Smith said.

At times, that’s been a challenge. Earlier in the winter, he estimated that the Exchange could shelter up to 60 people. But on Wednesday afternoon, a day Atlanta saw a low of 12 degrees Fahrenheit, he said the center was hosting 97 residents.

“People were just coming in late at night,” he said. “At 1 or 2 o’clock in the morning, if it’s 20 degrees outside, of course we’re going to let you in and try to service you.”

That increased capacity has made it difficult for Exchange staff to make everyone comfortable, Smith said. While the Red Cross and DeKalb Emergency Management Agency gave Exchange additional cots for people to sleep on, it’s been hard for employees working around the clock to address everyone’s needs.

He said Exchange could accommodate more people, but getting more beds, blankets, and food could be difficult.

“It’s not that we don’t want to take them,” Smith said. “But we want to service them to the best of our ability.”

The city of Atlanta opened a fourth warming center after three others reached capacity earlier this week.

“No one was turned away,” said Michael Smith, press secretary for the mayor’s office. “The very reason the fourth location was activated was to make sure everybody can be accommodated.”

Atlanta is planning to keep the warming centers open overnight through at least Sunday morning, when temperatures are expected to rise.

Even with the additional space, the centers have been crowded this week. On Wednesday, Christopher Pough, who’s been living on the Atlanta streets, said he had stayed at the Central Park Recreation Center gymnasium for three days. While the warming shelter was set to accommodate 75 people, he estimated there were twice as many people staying there by mid-week.

“We’re really right next to each other like sardines,” he said. “It’s hard to move around.”

Other social service providers have also faced capacity challenges keeping people warm through a frigid week.

Keisha Zimmerman, executive director of Calvary Refuge Center in Forest Park, said her homeless shelter has 59 beds where people can stay up to 21 nights. Throughout these cold weeks, the shelter has been at full capacity and having to refer people to other nearby warming centers.

“We can’t have people sleeping on the floor or in the hallways or in a chair in the dining hall,” she said.

While there are some warming centers in Clayton County, Zimmerman said they fill up quickly. Often, she has to refer people seeking shelter to options in Atlanta.

She wishes there were more ways to stay warm off the streets south of Interstate 20.

“There is a need for more warming stations in our area,” she said.

An updated list of open warming centers can be found at GEMA’s website.

Allen Siegler is a reporter covering public health in Atlanta for Healthbeat. Contact Allen at asiegler@healthbeat.org.

Climate change threatens mental well-being of youths. Here’s how to help them cope.

2025-01-09T14:46:55+00:00

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We’ve all read the stories and seen the images: The life-threatening heat waves. The wildfires of unprecedented ferocity. The record-breaking storms washing away entire neighborhoods. The melting glaciers, the rising sea levels, the coastal flooding.

As California wildfires stretch into the colder months, and hurricane survivors sort through the ruins left by floodwaters, let’s talk about an underreported victim of climate change: the emotional well-being of young people.

A nascent but growing body of research shows that a large proportion of adolescents and young adults, in the United States and abroad, feel anxious and worried about the impact of an unstable climate in their lives today and in the future.

Abby Rafeek, 14, is disquieted by the ravages of climate change, both near her home and far away. “It’s definitely affecting my life, because it’s causing stress thinking about the future and how, if we’re not addressing the problem now as a society, our planet is going to get worse,” says Abby, a high school student who lives in Gardena, California, a city of 58,000 about 15 miles south of downtown Los Angeles.

She says wildfires are a particular worry for her. “That’s closer to where I live, so it’s a bigger problem for me personally, and it also causes a lot of damage to the surrounding areas,” she says. “And also, the air gets messed up.”

Climate change is a serious concern for young people

In April, Abby took a survey on climate change for kids ages 12-17 during a visit to the emergency room at Children’s Hospital of Orange County.

Rammy Assaf, a pediatric emergency physician at the hospital, adapted the survey from one developed five years ago for adults. He administered his version last year to over 800 kids ages 12-17 and their caregivers. He says initial results show climate change is a serious cause of concern for the emotional security and well-being of young people.

Assaf has followed up with the kids to ask more open-ended questions, including whether they believe climate change will be solved in their lifetimes; how they feel when they read about extreme climate events; what they think about the future of the planet; and with whom they are able to discuss their concerns.

“When asked about their outlook for the future, the first words they will use are helpless, powerless, hopeless,” Assaf says. “These are very strong emotions.”

Assaf says he would like to see questions about climate change included in mental health screenings at pediatricians’ offices and in other settings where children get medical care. The American Academy of Pediatrics recommends that counseling on climate change be incorporated into the clinical practice of pediatricians and into medical school curriculums, but not with specific regard to mental health screening.

Assaf says anxiety about climate change intersects with the broader mental health crisis among youth, which has been marked by a rise in depression, loneliness, and suicide over the past decade, though there are recent signs it may be improving slightly.

A 2022 Harris Poll of 1,500 U.S. teenagers found that 89% of them regularly think about the environment, “with the majority feeling more worried than hopeful.” In addition, 69% said they feared they and their families would be affected by climate change in the near future. And 82% said they expected to have to make key life decisions — including where to live and whether to have children — based on the state of the environment.

And the impact is clearly not limited to the United States. A 2021 survey of 10,000 16- to 25-year-olds across 10 countries found “59% were very or extremely worried and 84% were at least moderately worried” about climate change.

Susan Clayton, chair of the psychology department at the College of Wooster in Ohio, says climate change anxiety may be more pronounced among younger people than adults. “Older adults didn’t grow up being as aware of climate change or thinking about it very much, so there’s still a barrier to get over to accept it’s a real thing,” says Clayton, who co-created the adult climate change survey that Assaf adapted for younger people.

By contrast, “adolescents grew up with it as a real thing,” Clayton says. “Knowing you have the bulk of your life ahead of you gives you a very different view of what your life will be like.” She adds that younger people in particular feel betrayed by their government, which they don’t think is taking the problem seriously enough, and “this feeling of betrayal is associated with greater anxiety about the climate.”

Abby believes climate change is not being addressed with sufficient resolve. “I think if we figure out how to live on Mars and explore the deep sea, we could definitely figure out how to live here in a healthy environment,” she says.

How to ease kids’ anxiety about environment

If you are a parent whose children show signs of climate anxiety, you can help.

Louise Chawla, professor emerita in the environmental design program at the University of Colorado-Boulder, says the most important thing is to listen in an open-ended way. “Let there be space for kids to express their emotions. Just listen to them and let them know it’s safe to express these emotions,” says Chawla, who co-founded the nonprofit Growing Up Boulder, which works with the city’s schools to encourage kids to engage civically, including to help shape their local environment.

Chawla and others recommend family activities that reinforce a commitment to the environment. They can be as simple as walking or biking and participating in cleanup or recycling efforts. Also, encourage your children to join activities and advocacy efforts sponsored by environmental, civic, or religious organizations.

Working with others can help alleviate stress and feelings of powerlessness by reassuring kids they are not alone and that they can be proactive.

Worries about climate change should be seen as a learning opportunity that might even lead some kids to their life’s path, says Vickie Mays, professor of psychology and health policy at UCLA, who teaches a class on climate change and mental health — one of eight similar courses offered recently at UC campuses.

“We should get out of this habit of ‘everything’s a mental health problem,’” Mays says, “and understand that often a challenge, a stress, a worry can be turned into advocacy, activism, or a reach for new knowledge to change the situation.”

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. KFF Health News is Healthbeat’s national reporting partner.

New York City officials downgrade drought warning to watch, citing recent rainfall

2024-12-16T22:35:16+00:00

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New York City officials downgraded the city’s drought warning to a watch on Monday, citing significant rainfall that has replenished upstate watersheds.

“Thanks to recent precipitation and melting snowfall upstate, in addition to our decision to pause the Delaware Aqueduct repair project, we’re in a much better place than we were a few weeks ago,” Mayor Eric Adams said in a statement.

Adams added that if favorable conditions continue, the city might be able to lift the drought watch, which is the lowest level of the city’s three water conservation declarations.

State officials also downgraded the drought warning in 10 upstate counties on Monday. Still, every county in the state remains under a drought watch, according to the state Department of Environmental Conservation.

New York City’s water supply — a network of upstate reservoirs — was at 68.2% of its overall capacity on Monday, compared to the typical 82.8%, according to city data. But following an exceedingly dry October, precipitation picked up in November and December, slightly surpassing historical averages. In Central Park, more than 2 inches of rain has fallen since Dec. 1, close to the normal amount of precipitation, according to the National Weather Service.

City and state officials had issued a drought warning for New York City and some upstate counties on Nov. 18, on the heels of an unusually dry autumn and as local wildfires raged. City agencies were directed to reduce water consumption, including by washing city garbage trucks, buses, and subway cars less frequently.

At the time, Adams also announced the pause of the final phase of the $2 billion project to repair the Delaware Aqueduct, a pipeline that delivers about half the city’s water supply. The repair project aimed to stop 35 million gallons of drinking water from leaking out of the pipeline every day — but the project forced the city to rely more on the Croton Watershed, which had received little rainfall.

In recent months, city officials have urged New Yorkers to take voluntary measures to reduce water consumption, including by taking shorter showers, flushing toilets less frequently, and reporting leaky fire hydrants. On Monday, city officials asked residents to continue to conserve water, despite the downgraded drought status.

“As we confront a changing climate, we need to use our natural resources more wisely,” Environmental Protection Commissioner Rohit T. Aggarwala said in a statement. “Continuing to practice water conservation is a sustainable habit valuable even outside times of drought.”

Earlier this month, Adams lifted the city’s previous ban on open flames and fireworks.

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org .

New York’s fire season: Drought conditions and dry winds increase wildfire risk

2024-11-20T11:48:34+00:00

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I didn’t expect to write this post for our New York community when I moved here from California, where wildfires are common and worsening. Yet wildfires are burning across New York, New Jersey, and Connecticut, making it important to understand their impact on our health and how to stay safe.

Over the past couple of weeks, multiple fires have ignited across New York, New Jersey, and Connecticut.

The Jennings Creek fire along the New York-New Jersey border has burned more than 5,000 acres, making it the largest wildfire in New York since 2008. (Healthbeat reported on this recently.)
Over the weekend, strong winds led to the voluntary evacuation of 165 houses in Warwick, New York.
Last week, an 18-year-old New York State Parks employee died while responding.
Between Oct. 29 and Nov. 12, the Fire Department of New York City responded to 229 brush fires — the most in a two-week period in city history.
- Brush fires have occurred in Brooklyn’s Prospect Park, Manhattan’s Inwood Park, and Queen’s Alley Pond Park.

With dry and windy conditions expected to continue for the next few weeks, fires may take longer to put out, and additional fires may start.

Tips to prevent wildfires

This fall has been abnormally dry in New York state, making it easier for wildfires to ignite and spread quickly. Because it has been so dry, much of New York state is under a drought warning.

To reduce the risk of new wildfires, Gov. Kathy Hochul recently issued a statewide fire ban until Nov. 30. The FDNY also issued a public service announcement sharing these tips for how to reduce brush fires:

Do not use fire pits, bonfires, campfires, or open cooking fires at least until Nov. 30.
Do not grill outside in New York City. Outdoor grilling is banned in city parks until the end of the drought watch.
- If you are elsewhere in the state and you must grill, be very careful and stay away from dry grassy areas. Keep a bucket of water and fire extinguisher within easy reach.
Dispose of cigarette butts and ashes properly.
If you see a fire, call 911.

Breathing in any kind of smoke isn’t healthy

Poor air quality from wildfire smoke poses health risks to everyone, but some groups are especially sensitive:

Older adults
Pregnant people
Children
People with pre-existing respiratory and heart conditions

Why? Wildfire smoke contains various gasses and particles, but the most concerning are fine particles known as PM2.5. These particles measure less than 2.5 micrometers in diameter (smaller than a human hair), and can penetrate deep into the lungs and enter the bloodstream, causing both immediate and long-term health effects.

Symptoms can range from mild (e.g., eye irritation) to serious health impacts (e.g., asthma exacerbation or heart issues). Recent studies have shown increases in hospitalizations, heart attacks, and strokes during periods of elevated PM2.5 exposure from wildfire smoke. Health risks increase the longer you’re exposed to smoke and the more dense the smoke is.

Monitor the air quality in your neighborhood

Air quality is measured by sensors that detect the concentration of pollutants in the air. Results are reported as the Air Quality Index, which is a number between 0 and 500. The higher the AQI, the more polluted the air is, and the higher the health risk. There are six AQI levels to describe levels of health concern, and what activities should be avoided at each level. When the AQI reaches 50 (the yellow category), people who are more sensitive to poor air quality should reduce strenuous activity outdoors (like working out). Once the AQI hits 100 (the orange category), everyone should reduce strenuous activity outdoors.

Air Quality Index levels of health concern.

The New York Department of Health issued a health advisory last week when the AQI reached over 100. You can easily check the air quality of your local area on some weather apps, AirNow, or download the EPA’s AirNow mobile app.

At a recent glance, air quality is good or moderate in most of New York, but it’s good to check this frequently if there are wildfires around — air quality can change rapidly over the course of a day.

New York Air Quality Index data from Monday.

What can I do to avoid health effects of smoke?

The Centers for Disease Control and Prevention suggests multiple ways to reduce your risk. These include:

Stay indoors, if possible.
Keep your indoor air as clean as possible. Run an air conditioner if you have one, but keep the fresh-air intake closed.
Use an air filter/purifier. Use a freestanding indoor air filter with particle removal.
Do not add to indoor pollution. Do not use candles, fireplaces, or smoke tobacco. Do not vacuum because it stirs up particles inside your home.
Wear an N95 mask outside. Recent research found that N95s reduced hospitalizations from wildfire smoke by 30%. In other words, it offers some protection, at least in the short term, for example while running to the grocery store. Cloth or paper masks and tissues will not filter out the smoke.

It seems like we are getting more wildfires. Why?

We know that changing climate trends, like warmer temperatures and less rain, are associated with a longer fire season, more frequent fires, and more intense fires that spread farther. The New York City Department of Environmental Protection commissioner reported that this October was the driest in New York City in over 150 years. Higher temperatures and drought conditions have made our region more fire-prone, even into the fall.

Bottom line

With drought conditions and dry winds in New York, wildfire risk is very high. Report any fires and avoid wildfire smoke as much as possible. Stay safe!

Love,

Your Local Epidemiologist

Dr. Marisa Donnelly, a senior epidemiologist with wastewater monitoring company Biobot Analytics, has worked in applied public health for over a decade, specializing in infectious diseases and emerging public health threats. She holds a PhD in epidemiology and has led multiple outbreak investigations, including at the California Department of Public Health and as an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention. Marisa has conducted research in Peru, focusing on dengue and Zika viruses and the mosquitoes that spread them. She is Healthbeat’s contributing epidemiologist for New York in partnership with Your Local Epidemiologist, a Healthbeat supporter. She lives in New York City. Marisa can be reached at mdonnelly@healthbeat.org.

City buses, trains may look dirtier as NYC takes steps to conserve water

2024-11-18T22:31:09+00:00

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Buses and trains may look dirtier in New York City as local agencies take steps to conserve water amid worsening drought conditions.

City and state officials issued a drought warning on Monday for New York City and 10 upstate counties. The warning — the second of three stages of water conservation declarations — underscored the ongoing danger of the city’s historically dry autumn and low reservoir levels. Officials had announced a citywide drought watch earlier this month.

“Climate change is real and it’s impacting our city, and while we cannot make it rain, we can take action to reduce the risk of drought emergencies in our city,” Mayor Eric Adams said during a press conference.

Under a drought warning, city agencies must take steps to reduce water consumption, and residents are urged to voluntarily limit their use of water, including by taking shorter showers, not letting faucets run, and flushing the toilet less frequently. City officials also asked the public to immediately call 311 to report open fire hydrants.

Long Island Rail Road and Metro North trains, as well as city subways and buses, will be washed less frequently, said Janno Lieber, chief executive of the Metropolitan Transportation Authority. The MTA will also prioritize addressing leaks in tunnels and stations, and he noted that employees are on high alert for fires within the transit system.

Other city agencies will take water conservation steps as well. City garbage trucks will be washed less frequently, NYC Parks will limit the use of water for fountains and golf courses, and city building facades will no longer be washed, among other measures.

New York City has faced an unusually dry autumn, with the second-longest dry streak in more than 150 years in October. Over the last 10 weeks, the city has had about 8 inches less rain than is typical, said Department of Environmental Protection Commissioner Rohit T. Aggarwala.

At the same time, the upstate reservoirs that supply the city’s drinking water are at about 60% capacity, but they should be above 79% at this time of year, Aggarwala said.

“This drought has come on fast, it has come on furious,” he said.

Adams also announced Monday that the city will pause the final phase of the $2 billion project to repair the Delaware Aqueduct, a pipeline that delivers from the Catskills about half of the city’s water supply. The long-awaited repair project, announced earlier this fall, aimed to stop 35 million gallons of drinking water from leaking into the ground every day. But the repairs have forced the city to be more reliant on the Croton Watershed, which has received little rainfall.

Dry conditions in the city and throughout the state have led to several wildfires. The Jennings Creek wildfire continues to burn on the New York-New Jersey border, about an hour northwest of New York City. The fire encompasses about 3,100 acres in New York state, according to officials. A statewide burn ban remains in effect.

More locally, brush fires have emerged throughout New York City, including a recent fire that burned two acres of Prospect Park. City firefighters have extinguished more than 300 brush fires this month, said New York City Fire Commissioner Robert S. Tucker, who also stressed that water conservation is vital for the FDNY’s work to keep New Yorkers safe.

New York City Emergency Management Commissioner Zach Iscol asked New Yorkers to call 911 to report smoke and fires. He added that residents should take steps to protect themselves from poor air quality due to wildfires, including by avoiding strenuous exercise, staying indoors, closing windows, using air purifiers, and wearing a mask when outside.

If the city issues a drought emergency — the third level of water conservation declarations — mandatory public restrictions would go into effect.

Aggarwala said it was difficult to say how close the city could be to a drought emergency, but emphasized that the city’s current efforts were an attempt to stave off reaching that level.

“There is a little bit of rain on the forecast. It’s not enough to end the drought,” he said. “I think we’ll reassess in a week or two.”

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org .

City officials urge New Yorkers to turn off the tap, take shorter showers during drought watch

2024-11-04T22:14:14+00:00

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With New York City and parts of upstate New York under a drought watch, officials are urging residents to limit their use of water.

Following a historically dry October, Mayor Eric Adams and Department of Environmental Protection Commissioner Rohit T. Aggarwala issued a citywide drought watch on Saturday. A drought watch marks the first of three water conservation declarations by the city, which could escalate to a warning or an emergency, depending on conditions in the coming weeks and months.

The New York State Department of Environmental Conservation declared a drought watch for Westchester and the Catskills, in addition to New York City, over the weekend. New Jersey and Connecticut are also facing droughts, and firefighters in both states are battling wildfires.

October saw the the second-longest dry streak in New York City records dating back to 1869. Just 0.01 inches of rain fell in Central Park that month, compared to the 4.4 inches that are typical, according to data from the National Weather Service. Additionally, the upstate reservoirs that supply water to the city are at lower levels than they should be at this time of year, city officials said.

“We’re really urging all New Yorkers to be conscious of water consumption,” Aggarwala said during a press briefing at City Hall on Monday, noting that New Yorkers collectively consume an average of about 1 billion gallons of water per day.

The city transitioned from an unusually wet August to a severely dry autumn, and drier-than-average conditions are expected in the coming months, Aggarwala said. The city faces a nearly six-inch deficit of rainfall — comparing the last 10 weeks to the average rainfall — and its reservoirs are below two-thirds, when they should be at or above three-quarters, he added.

“We need a lot of rain, not just a little,” Aggarwala said.

The drinking water for New York City’s more than 8 million residents comes from a nearly 2,000-square-mile watershed in parts of the Hudson Valley and the Catskills. The city’s public water supply system dates back to the early 19th century, with the creation of a dam and aqueduct that carried water from the Croton River into the city.

Droughts are relatively rare in New York City. The city last experienced a severe drought about two decades ago, when reservoir levels dropped to 44 percent. During that period, the city issued a drought watch in December 2001, followed by a drought warning in January 2002 and the first stage of a drought emergency that April. The 14-month drought ended in January 2003.

The current drought warning is a preparatory measure, Aggarwala said. The city is likely weeks away from issuing a drought warning, he added, during which time city agencies would start to reduce their own water use and urge public water conservation, in order to delay the mandatory restrictions necessary under a drought emergency.

Every city agency has protocols for reducing water consumption, Emergency Management Commissioner Zach Iscol said during Monday’s briefing.

During a drought watch, the city surveys hydrants and conducts leak detection and repair programs. If the city issues a drought warning, city agencies will start limiting water use, including reducing the washing of city vehicles and restricting lawn watering.

If the city declares a drought emergency, public water shortage rules are enforced with sanctions and fines. Pools are closed, athletic fields and golf courses cannot be watered, fountains and aesthetic water displays are prohibited, restaurants cannot serve water unless requested, and other limitations are in place.

For the time being, Aggarwala urged New Yorkers to call 311 to report leaking fire hydrants. He also advised city residents to shorten their showers by a few minutes — one minute in the shower uses about 5 to 7 gallons of water — and to run a fully loaded dishwasher, rather than washing dishes by hand. Aggarwala also urged residents to turn off the tap when using the sink, fix running toilets, and flush toilets less frequently.

“It will save you money on your water bill,” he said. “It will also save the city the water that we need.”

Eliza Fawcett is a reporter covering public health in New York City for Healthbeat. Contact Eliza at efawcett@healthbeat.org .

Can a $10 billion climate bond address California’s water contamination problem?

2024-11-01T13:20:21+00:00

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When Cynthia Ruiz turns on her kitchen faucet, she hears a slight squeak before cloudy fluid bursts out of the spout. The water in her Central Valley town of East Orosi is clean enough most of the time to wash dishes, flush toilets, and take showers, but it’s not safe to swallow. Drinking water is trucked in twice a month.

“There are times where the water is so bad you can’t even wash dishes,” said Ruiz, who is advised not to drink the tap water, which is laden with nitrates — runoff from orange and nectarine fields surrounding the town of roughly 400. “We need help to fix our water problem.”

Tucked in a $10 billion climate bond on Tuesday’s ballot is an earmark to improve drinking water quality for communities such as East Orosi. Proposition 4 would allocate $610 million for clean, safe, and reliable drinking water and require at least 40% be spent on projects that benefit vulnerable populations or disadvantaged communities. But it’s a fraction of what the state says is needed.

While most Californians have access to safe water, roughly 750,000 people as of late October are served by 383 failing water systems, many clustered in remote and sparsely populated areas. A June assessment by the California State Water Resources Control Board pegged the cost of repairing failing and at-risk public water systems at about $11.5 billion.

“We have communities in California that are served drinking water that has been out of compliance with regulatory standards for potent toxins like arsenic for years,” said Lara Cushing, an associate professor in UCLA’s Department of Environmental Health Sciences.

And climate change is eroding people’s access to clean water, she said. “There is kind of a perfect storm, if you will, of compounding hazards.”

Supporters say Proposition 4, to enact the Safe Drinking Water, Wildfire Prevention, Drought Preparedness, and Clean Air Bond Act of 2024, would jump-start upgrades by authorizing grants and loans for local governments to repair water systems contaminated with lead, arsenic, nitrates, or other chemicals tied to cancer, liver and kidney problems, and other serious health issues.

Water priorities vary by region, and the bond would give communities flexibility to address their needs, said MJ Kushner, a policy advocate at the Community Water Center, a statewide nonprofit. “It isn’t a one-size-fits-all solution,” Kushner said.

A taxpayer group opposing the bond says the state will go further into debt on piecemeal projects. It says the state is increasingly addressing its climate-related programs with bonds, which it calls the most expensive way for government to pay for things, rather than within the state budget.

Lawmakers in July added Proposition 4 to the ballot after Democratic Gov. Gavin Newsom, facing a $47 billion deficit, cut $6.6 billion in climate spending from the state budget, according to Department of Finance spokesperson H.D. Palmer. The reductions followed $3.1 billion in climate cuts Newsom and lawmakers enacted in 2023.

Susan Shelley, a spokesperson for the Howard Jarvis Taxpayers Association, said the state has already borrowed billions and that now isn’t the time to add more debt given the deficit.

“If the legislature chose to cut these from the budget, they should not go on the credit card,” Shelley said. “It’s irresponsible.”

According to the nonpartisan Legislative Analyst’s Office, the state has routinely allocated state funds for climate-related programs, with about 15% coming from bonds. The office estimates it would cost taxpayers $400 million a year for the next 40 years to repay the bond — a total of $16 billion.

Since 2000, California voters have approved eight water bonds totaling $27 billion, for projects involving flood management, habitat restoration, drought preparation, and drinking water improvement, according to the Public Policy Institute of California.

Scientists say climate change has led to more severe weather, including devastating floods and droughts; the spread of infectious diseases such as West Nile virus; and earlier deaths from respiratory illnesses. Public health experts add that as climate change worsens, its impact on people’s health will grow more severe and could cost the state more in the long run.

“If we quantify the damages associated with the do-nothing policy, you’ll see that typically, at the end of the day, the bill plus the interest costs are going to be less than the cost if we do nothing,” said Kurt Schwabe, an environmental economics and policy professor at the University of California-Riverside.

If approved, Ruiz hopes Proposition 4 can help East Orosi, a predominantly Latino and low-income community. Though she receives 25 gallons of drinking water twice a month, she sometimes runs out. The last time the 47-year-old drank tap water at home was when she was in high school.

“I don’t think any community anywhere in California should have to wait this long to get clean water,” Ruiz said.

Vanessa G. Sanchez is a reporter for KFF Health News, Healthbeat’s natiional reporting partner.

Proposed federal heat rule might have saved these workers’ lives

2024-10-29T14:34:47+00:00

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On a sweltering afternoon in July 2020, Belinda Ramones got a call that her brother was in the hospital. The call was from a woman at the Florida landscaping business that he had joined that week, the Davey Tree Expert Co., Ramones said. By the time she arrived, she said, “My brother was swollen up from hands to toes.”

Two days later, her brother, Jose Leandro-Barrera, died at age 45 with acute kidney failure caused by heatstroke, according to a report from the Hillsborough County medical examiner. His temperature in the ambulance had been 108 degrees Fahrenheit, the report said.

It described the circumstances preceding his death, as recorded by a nurse. At the job site, Leandro-Barrera had advised his supervisor that he was not feeling well, and the supervisor told him to sit in a vehicle until he felt better. While there, he “urinated himself, had seizure like activity” and became unresponsive.

“Employee suffers from heat exhaustion while doing landscaping,” said an investigation into the incident from the Occupational Safety and Health Administration. The agency issued a $9,639 fine to the Davey Tree Expert Co. The company did not respond to requests for comment.

Without national regulations on preventing heat-related illness and death, OSHA has difficulty, in general, protecting workers before it’s too late, said Paloma Rentería, a Department of Labor spokesperson.

Laborers have suffered as summers have grown progressively hotter with climate change. But health policy and occupational health researchers say that worker deaths are not inevitable. Employers can save lives by providing ample water and breaks and building in time for new workers to adjust to extreme heat.

This is the logic behind proposed national rules that President Joe Biden set in motion in 2021, aiming to protect an estimated 36 million workers exposed to extreme heat. The Bureau of Labor Statistics counts about 480 worker deaths from heat exposure each year, on average. But these are “vast underestimates,” according to OSHA, because heat stress is an underlying factor often unaccounted for in medical records.

The advocacy organization Public Citizen estimates that as many as 2,000 U.S. workers die of heat annually, based on extrapolations from heat injury data.

Both estimates are upsetting, said Linda McCauley, dean of the nursing school at Emory University and an occupational health researcher. “No one should go to work expecting that they might die,” she said.

Proposed heat rules may depend on election

The proposed rules — a heat standard from OSHA — reaches a milestone Dec. 30, when the public comment period closes. But it’s unlikely to be finalized before Biden leaves office.

Vice President Kamala Harris would likely carry the heat rules forward if she wins the presidency next month, said Jordan Barab, who was OSHA’s deputy assistant secretary during the Obama administration. She advanced heat regulations in California in 2020.

Should Donald Trump win, the rules would stall, Barab predicts. In general, Republicans have opposed workplace safety regulations over the past 20 years, saying they are costly to businesses and consumers. And during the first Trump administration, the number of OSHA inspectors tasked with monitoring workplace safety hit an all-time low across the agency’s 48-year history. Workplace inspections regarding heat stress dropped by half on Trump’s watch, according to an analysis by the National Employment Law Project.

OSHA’s rules would require employers to provide ample, cool drinking water, and shade or air conditioning for breaks, when temperatures exceed 80 degrees. Above 90 degrees, employers would need to provide paid 15-minute breaks every two hours.

Two additional aspects of the standard confront overlooked problems that contribute to heat deaths at work. More than 70% of workers who die of heat do so within their first week on the job. And delayed medical care is a common theme.

“We need to stop telling people who complain of being about to pass out to go sit in the car or take a break,” McCauley said. “Rest breaks are needed to prevent the problem, but once someone has symptoms, they need help fast.”

The proposed rules require employers to allow new workers time to acclimate to high temperatures and to institute protocols, like a buddy system, so that workers get rapid medical care as soon as they show signs of heat illness, like dizziness, confusion, and cramps.

Agricultural workers, like this person harvesting ferns in Pierson, Florida, would be protected from heat illness and death by a set of proposed heat regulations.

By the time an emergency medical team arrived to help one laborer in July 2021, he had stopped breathing, according to one Department of Labor press release. A supervisor at the ecological restoration company EarthBalance had seen him earlier that day, it said, and he was “sweating heavily, his hands were trembling, and he seemed confused.” He rested. “Only 30 minutes later, the supervisor returned to the man finding him unresponsive.”

That evening, Gilberto Macario-Gimenez died at the hospital, said a medical examiner case report. It noted “the decedent had overheated” and attributed his death to heart disease and hypertension. Heat can exacerbate those conditions.

OSHA investigated the situation. It fined EarthBalance $9,216, finding that “the employer failed to ensure that a person adequately trained to provide first aid to employees [was] working in an area where there was no infirmary.”

EarthBalance did not respond to requests for comment.

OSHA has received at least 12,980 comments on its proposals posted to the federal register. One woman wrote about her cousin who died while clearing shrubs for a rancher in Texas when temperatures exceeded 100 degrees: “He was only 34. There was no water or rest breaks.”

Republicans, industry groups oppose the standards

After the comment period ends in December, OSHA will hold a public hearing, incorporate changes, and finalize the rule. If Harris is president, Barab said, the agency may finish the process by 2026. For the rule to work, Congress would need to fund OSHA adequately, so that it can hire staffers to teach employers how to implement the standards, and enough investigators to enforce them.

Several industry groups have opposed the standard or requested changes. A single temperature threshold isn’t fair when climates and jobs vary widely, in addition to workers’ abilities to tolerate heat, wrote the Associated General Contractors of America in an online statement this year.

Some Republican lawmakers have called the rule government overreach. Rick Roth, a Republican Florida state representative, told Al Jazeera that workers are pushing for paid breaks because they “don’t want to work so hard.” If they didn’t feel safe, they could change jobs. “Go work for somebody else,” he said.

Critics also say that the regulations will cost employers. But a UCLA analysis of workers’ compensation claims in California suggests that a national heat standard saves money overall. The study estimated the cost of heat-related injuries between $750 million and $1.25 billion a year in California alone, including medical bills, lost wages, and disability claims.

A controversial set of national heat regulations would require employers to provide laborers cold water and paid rest breaks when temperatures exceed 90 degrees Fahrenheit.

Because six states have varying sets of rules to reduce heat-related illness — California, Colorado, Maryland, Minnesota, Oregon, and Washington — researchers and union representatives have been able to see where policies need strengthening. One issue with enforcement is that OSHA largely relies on employees to report hazards. One study found that just 14% of nearly 600 farmworkers surveyed in California knew about acclimatization and how much water they needed when temperatures were high.

Although Florida doesn’t have specific heat regulations, Dominique O’Connor of the Farmworker Association of Florida said the biggest obstacle in ensuring occupational safety is that workers are afraid of getting fired for filing a complaint with OSHA.

This is especially true for farmworkers with H-2A visas, which permit noncitizens to fill temporary jobs. Because these workers depend on their employers not only to remain in the country but often for transportation and housing, retaliation from employers would be life-altering. “This summer we talked with H-2A workers who were only given dirty water on the job,” she said. “They were told to just pretend it was coffee.”

Leaders in several Republican-led states are likely to push back against the federal standard if it’s issued. Last April, Florida Gov. Ron DeSantis approved legislation that blocks local governments from requiring employers to offer workers water and shade when temperatures rise.

And the Supreme Court’s decision to overturn the “Chevron doctrine” this year may embolden employers to challenge OSHA’s ability to enforce the rules. For decades, the Chevron doctrine had required courts to defer to expertise at regulatory agencies when interpreting regulations, but the high court’s ruling ended that. “We are in uncharted territory,” Barab said.

Correction: This article was updated at 10:30 a.m. ET on Oct. 29, 2024, to correctly reflect the Associated General Contractors of America’s current position on OSHA’s proposed heat standard. The article originally quoted a 2019 statement from the organization that called national heat regulations “unnecessary, unworkable, and impractical.” The group is no longer opposed to the idea but would like to see changes to the proposed rules.

Amy Maxmen is Healthbeat’s national reporter through a partnership with KFF Health News. Jeremy Young, senior producer at Fault Lines on Al Jazeera English, contributed to this report.

North Carolina mountain town confronts unexpected public health catastrophe from Hurricane Helene

2024-10-18T15:52:50+00:00

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Before Hurricane Helene, had you stopped by one of the many breweries, art galleries, or award-winning restaurants in Asheville, North Carolina, and spoken with anyone who lives in these parts — including me — most would have told you they felt pretty safe from climate disasters.

The mountains of western North Carolina have been known to flood: The area is bursting with creeks and rivers and enjoys an abundance of rain. There are occasionally wildfires. But the ravages of the climate crisis’ worst impacts — including increasingly powerful hurricanes — felt like a problem for another place. Asheville sits almost 250 miles from the nearest coastline.

After Hurricane Helene roared across the state, causing historic flooding, downing trees, snapping power lines, decimating water infrastructure, and leading to the deaths of at least 72 people in Buncombe County alone, communities are still shaking off the shock of a storm they never thought could touch these mountains.

“People relocate to Asheville not just because it’s beautiful, but because it isn’t prone to natural disasters,” said Katie Gebely, an artist in Asheville. “But that sense of safety is gone.”

I live in Beech, a historic community in Weaverville, North Carolina, at the eastern end of a two-lane road called Reems Creek, which is named after the waterway running parallel to it. The town of Weaverville, just north of Asheville, is five miles down the road.

Helene’s destruction created a major problem for people dependent on insulin, power wheelchairs, oxygen CPAP machines for sleep apnea, or home dialysis equipment. Without electricity, their health is at risk.

Diane Anna of Weaverville, North Carolina, holds food rations delivered by the Federal Emergency Management Agency on Oct. 8. FEMA promised 120 truckloads a day of food and water to western North Carolina, according to Rep. Chuck Edwards, who represents the area in Congress.

To get to Weaverville from Beech in the days immediately after the storm, cars had to thump over dozens of downed power lines. Other lines were propped up with large, downed tree limbs or tied up with rope so cars could get under them. Utility poles were snapped in two. A transformer lay on the side of the road, as did a rather large boat, washed up from who knows where. Just last week, power crews arrived on Reems Creek Road, but there’s still no word on when everyone will regain electricity.

Jackie Martin of Canton, North Carolina, relies on supplemental oxygen for chronic obstructive pulmonary disease and emphysema. When the storm hit, she had four hours’ worth left. Because of her condition, Martin and her husband, David, have an electrical generator, which David checks every month to make sure it works.

“We keep enough gas to run about eight hours,” Jackie Martin said. But the Martins were without power for nearly a week. When they ran out of gasoline, their neighbors gave them the gas from their lawn mower. Then another neighbor evacuated and offered his propane generator. The Martins’ daughter came through with four tanks of propane.

“We went through tons of gas and propane,” Jackie Martin said. “Never did I think I would need every drop and then some. Thank goodness we got power back after a week.”

Potable water may take weeks to restore

In Buncombe County, population 275,000, there were still more than 50,000 customers without electricity almost two weeks after the storm. Duke Energy reported that outages were down to about 1,600 customers in the Asheville area as of Wednesday.

In most places, the debris that littered the road has been cleared. Cars, trucks, and military vehicles can make their way through. But huge piles of trash still line the roadways. Buncombe County is asking residents not to burn it out of concern for air quality.

In a scene out of biblical end-times, yellow jackets swarmed in the days after the storm — displaced after falling trees and floodwaters destroyed their nests. Three or four days after the storm hit, an EMT drove through my neighborhood looking for Benadryl. My husband handed over what we had: a half-full bottle.

Overhead, helicopters fly day and night. The Federal Emergency Management Agency arrived in my neighborhood two Sundays ago to deliver bottled water and food rations. Potable water in some areas of western North Carolina, including Asheville, may take weeks or months to restore.

Weaverville’s residents were under a boil-water advisory until Oct. 11.

“We had sewer and water line breaks,” said Patrick Fitzsimmons, Weaverville’s mayor. “We had a lot of infrastructure destruction.”

Households with wells have fared no better. Well pumps don’t work without electricity. And storm-damaged or flooded wells may be compromised. Officials are urging residents to disinfect their wells before consuming water. The federal Environmental Protection Agency has given residents kits to test their well water.

A dry-erase board outside a distribution center in Barnardsville, North Carolina, lists needed items. With cold weather on the horizon, donation collection sites are asking donors for warm clothes and blankets.

A physical therapist at Asheville Specialty Hospital, who asked not to be identified out of concern for losing their job, told me that in the first days after the storm, crews hauled trash cans full of water into the facility so that staff could flush toilets with buckets.

“The water got shut off and we managed. We took care of people the best we could,” the therapist said. “But the amount of water that it takes to run a hospital is unsustainable for the length of time they think we’ll be out of water.”

The hospital is a 34-bed long-term acute care facility down the street from Asheville’s Mission Hospital. Nancy Lindell, a spokesperson for Mission Health, which operates both hospitals, said in a statement that fewer than 100 “low acuity patients in stable condition” at the organization’s facilities were transferred “to hospitals outside of the areas hardest hit by this disaster.”

“This decision, which was made in collaboration with more than 50 physicians and nursing leaders, helps ensure we have the capacity to meet the most critical needs of our region,” she said. “It also provides relief for our caregivers, who have been working around the clock in the wake of the storm.”

U.S. Rep. Chuck Edwards, who represents North Carolina’s 11th District, said FEMA has shipped 6 million liters of water and 4 million individual meals to western North Carolina. FEMA has promised 120 truckloads a day of food and water with no specified end date, the Republican congressman said.

Officials say recovery will be long

The Biden administration has also opened an emergency program for uninsured North Carolinians to replace lost prescriptions and medical equipment.

Fitzsimmons, Weaverville’s mayor, said he’s concerned about the impact of the storm on mental health. “People are going for an extended period of time without power or water,” he said. “Their nerves are frayed.”

Richard Zenn, chief medical officer at North Carolina-based Vaya Health, said the recovery will be long.

“We’re now in the phase where we have to deal with the effects of this ongoing trauma we’ve all suffered,” Zenn said. “Connect with others. Don’t get too isolated. Eat. Sleep. Try to get back into a normal routine. Do whatever reduces stress for you.”

For me, that has always been hiking or running through these ancient mountains. But there are too many uprooted trees to safely do that now. Instead I take solace on my porch and give thanks that I still have a porch to sit on. It’s a near-perfect day in Appalachia. The sky is painfully blue. I listen for the songs of birds, but all I can hear are generators.

This story was produced by KFF Health News, Healthbeat’s national reporting partner.

Health Secretary Becerra touts extreme heat protections. Farmworkers want more.

2024-09-05T19:59:33+00:00

On a sunny August morning in this agricultural town, before temperatures soared to 103 degrees, U.S. Health and Human Services Secretary Xavier Becerra stood outside the small public library.

He came to talk about the Biden administration’s efforts to protect farmworkers from extreme heat and wildfire smoke, two emerging public health issues at the forefront of the climate crisis.

“There are still not enough protections for workers that are picking the food that we eat,” Becerra told a group of local reporters and government officials, who outnumbered the farmworkers in the audience.

Becerra, whose father worked in the fields, had just come from visiting women picking grapes who protect themselves from the sun by dressing in sweaters, long pants, and kerchiefs that cover their noses and mouths. The summers are long and intense in Clarksburg, a town of about 300 people along the Sacramento River that supplies California’s wine industry with petite sirah, sauvignon blanc, and other grapes harvested by hundreds of farmhands.

“It’s going to be a hot day,” he added. “But they are still dressed as if it were winter.”

The nation’s top health officer, who is mulling a run for governor, has emerged as one of the Biden administration’s leading voices on climate change, focusing attention on low-income and other marginalized workers, who feel the impacts of extreme weather the most. In March, HHS released voluntary safety guidelines and educational materials that farms can use to protect their workers from smoke and heat.

NYC looks to trees, reflective roofs to curb health threat

Becerra’s appearance before reporters in front of the library was brief and scheduled to mark Farmworker Appreciation Day, not far from his home in Sacramento, where his wife, a doctor specializing in high-risk pregnancies, remains at work. He advertised the educational materials on the risks of heat illness and when temperatures might be too high to work. But he acknowledged that there is only so much he can do because workplace protections are overseen by the Department of Labor.

“Much of our jurisdiction doesn’t reach those workers directly,” Becerra acknowledged after meeting with grape pickers. “We owe everyone who is working to put food on our table the best effort to make sure that they are working under the safest conditions.”

His aides distributed a press release that listed a number of resources, including free workplace health investigations by the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health; a training on the dangers of heat and smoke from the National Institute of Environmental Health Sciences Worker Training Program; and planned awards to 77 health care providers in high-need areas, totaling $50 million, from the Health Resources and Services Administration.

Deaths due to extreme heat have jumped

Climate change is increasing the frequency and intensity of extreme heat, which is already the No. 1 weather-related killer in the United States, as well as fueling wildfires across the nation. There’s no official count of farmworker deaths from weather, but heat-related deaths have increased in recent years, jumping from 1,722 in 2022 to about 2,300 last year.

The U.S. Department of Labor in July released a proposed workplace heat standard that would require employers to give rest breaks, water, and shade or air conditioning to workers exposed to excessive heat, but a final rule is likely years away. It’s unclear if it would supersede state regulations.

Outreach worker Virginia Moscoso said some farms haven’t allowed her to come onto their property to educate workers about how to prevent heat illness. (Vanessa G. Sánchez/KFF Health News)

Five states have heat safety protections for workers in outdoor or indoor settings. In California, for instance, employers must provide water, cool-down areas, and breaks to workers when temperatures hit 82 degrees indoors and 80 degrees outdoors. The other states are Colorado, Minnesota, Oregon, and Washington, and Maryland is expected to finalize a heat standard this year.

While Becerra said states can create their own workplace safety regulations, a federal heat safety standard would offer protections nationwide, forcing states like Florida and Texas — whose Republican governors have signed laws banning heat safety protections — to comply with minimum standards.

Becerra is hoping states will tap into the programs his health department is offering even though they are optional. Even in California, which has one of the country’s toughest heat protection standards, workers could benefit.

Lizbeth Mastache, who met privately with Becerra beforehand, said the days she spends in the fields picking grapes shrouded in wildfire smoke and extreme heat are not only becoming more frequent, but they are also making her sick.

She has had headaches, fatigue, and nausea from the heat, and has gone to the emergency room after smoky skies triggered her asthma. She and other farmworkers told Becerra they need guaranteed sick leave — to care for themselves when the smoke and heat sickens them — and affordable health insurance.

“I had to work picking grapes during the wildfires and they didn’t give us masks,” said Mastache, a farmworker for the past 14 years.

She said some farms haven’t allowed outreach workers onto their property to educate workers about how to prevent heat illness.

That’s a problem when many seasonal workers, who move for work among different states, don’t know that California requires employers to provide water, breaks, and training.

Many farmworkers don’t get rest breaks

About three years ago, researchers at the University of California-Merced’s Community and Labor Center found that 15% of California farmworkers did not receive minimum rest breaks, and over 40% said their employer never provided a heat illness prevention plan. More than a third of farmworkers said they would not file a report against their employer, most of them for fear of retaliation.

The California Farm Bureau, which represents about 29,000 farmers, disputes the center’s findings, saying there have been few cases of heat illness among its members’ workers. Bryan Little, director of employment policy at the bureau, said his organization has trained hundreds of farmers and ranchers on how to protect workers from heat illness, such as by providing water and portable shaded spaces in the field for employees to cool off.

“They’re doing things every day to try to make sure that we can avoid exposing human beings to these risks, to the greatest extent that we can,” Little said.

While farmworker advocates praise Becerra for drawing attention to the harmful and sometimes fatal impacts of heat and wildfire smoke, they worry federal dollars won’t reach the most vulnerable. For example, there’s no guarantee much of that $50 million earmarked for health care providers will go to health care centers that serve farmworkers, said Amy Liebman, a chief program officer at the Migrant Clinicians Network, who has worked in migrant safety and health for over two decades.

“We need to make sure that our health centers are prepared and our clinicians are prepared,” Liebman said. “So that means that there needs to be a shift in terms of not just this emphasis, but some of the funding for it.”

As Becerra left his podium, covered with the sign “Protecting Communities From Extreme Heat,” he disappeared into the library and minutes later departed for Stockton to champion the next issue — lower prescription drug prices — with Democratic Rep. Josh Harder, who represents a competitive Central Valley congressional district.

Vanessa G. Sánchez is a reporter for KFF Health News, Healthbeat’s national reporting partner.

NYC looks to trees, reflective roofs to curb health threat — and unequal burden — of extreme heat

2024-07-29T20:24:14+00:00

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Arif Ullah walked down Bruckner Boulevard under a scorching July sun. There was little shade on the street, a congested stretch of the South Bronx that leads into a major interchange of highways.

Further beyond were the expressways, waste transfer stations, train yards and warehouses that choke the Bronx’s southern shore, degrading the area’s air quality and contributing to its high rates of asthma.

“We have limited access, among the lowest in the city, to both green spaces and trees,” said Ullah, executive director of South Bronx Unite, an environmental justice organization. “That makes a bad situation worse. That exacerbates respiratory illnesses on hot days like this.”

As New York City faces continued heat waves this summer, extreme heat is an especially pressing public health issue. Extreme heat kills more New Yorkers per year than any other type of extreme weather event, and as summers intensify with climate change, its harms are poised to mount.

“This heat is not normal, we’ve said it over and over again,” Mayor Eric Adams said during a recent briefing. “Climate change is here and is real, and it is a clear and present danger.”

The damaging effects of extreme heat aren’t equally distributed. Each summer, an estimated 350 New Yorkers die due to hot weather; Black residents die from heat stress at twice the rate of white residents. Areas like the South Bronx, with reduced tree canopy cover and more limited access to air conditioning, are especially “heat vulnerable,” and at the highest risk of heat-related mortality.

Confronting weeks of high heat, the city’s Emergency Management Department and its Department of Health and Mental Hygiene have issued repeated extreme heat warnings, emphasizing the city’s cooling centers, detailing its network of sprinklers and reminding residents to hydrate, seek out shade and watch for symptoms of heat illness.

But as heat waves become more intense and frequent with climate change, researchers, physicians, city leaders and community advocates are turning to longer-lasting solutions, aiming to turn down the temperature of the city itself — and target solutions to the most vulnerable neighborhoods.

“The heat that we see today won’t be the heat we see in the future,” said Dr. Arnab Ghosh, an assistant professor of medicine at Weill Cornell Medical College whose research focuses on climate change and health. “We need to adapt not just to today’s circumstances, but the circumstances moving ahead.”

The South Bronx waterfront is crisscrossed by expressways, bridges, train lines, waste transfer stations, and warehouses, which degrade the area's air quality and contribute to its high rates of asthma.

Some neighborhoods are hotter

New York is much hotter than many other parts of the country. The city’s heat-absorbing buildings, roads and infrastructure drive up its overall temperature — the urban heat island effect. A new study from Climate Central, a climate science nonprofit group, found that on average, New Yorkers experience 9.7 more degrees of heat due to the city’s built environment than residents of rural areas.

With climate change, scorching summers will increasingly become the norm. Based on city data, New York City could see many more days per year of temperatures higher than 90 degrees, from a baseline of 17 days annually in recent decades to a projected 27 to 54 days by the 2030s — and 46 to 108 days by the 2080s.

Extreme heat can be particularly harmful to children, elderly adults, unhoused people, outdoor workers, and those with chronic health conditions. And its most damaging effects are often clustered in more disadvantaged areas of New York.

The city’s heat vulnerability index shows that neighborhoods throughout the city — including Mott Haven in the Bronx, East Harlem in Manhattan, East Flatbush in Brooklyn and Jamaica in Queens — have the highest citywide risk of residents dying during and immediately after extreme heat events. Those neighborhoods tend to have higher daytime summer surface temperatures, less green space, reduced access to air conditioning and lower median incomes than other parts of the city.

Many of these communities bear the scars of historic disinvestment and redlining — a discriminatory practice in which mortgage lenders denied loans on the basis of race — which has been linked to higher land surface temperatures. Today, these neighborhoods function as heat islands within heat islands, said Dr. Perry Sheffield, an associate professor of environmental medicine, climate science and pediatrics at the Icahn School of Medicine at Mount Sinai.

“We know cities are hot, but there are these micro heat islands now, in communities that have higher proportions of Black and brown residents,” she said.

Trees can cool street by 2 degrees

Efforts are underway to cool New York in the long term — and rectify historic inequities in the process.

The mayor’s citywide climate and sustainability plan, released last year, proposed goals including instituting mandatory cooling requirements for new construction by next year, setting a maximum summer indoor temperature policy by 2030, and installing a million square feet of cool roofs each year, the continuation of a longstanding program to paint rooftops with a reflective coating that prevents heat absorption.

The city also aims to achieve a 30% tree canopy cover, up from the 22% of public and private land that is currently shaded by trees citywide.

“Trees do so much,” Elijah Hutchinson, the executive director of the Mayor’s Office of Climate and Environmental Justice, which oversees the city’s climate initiatives, said. “They add biodiversity, they can help with interior drainage and street flooding, they help with shade, obviously. For trees that get added to city streets, they can cool a street by up to 2 degrees Fahrenheit, so a really significant cooling effect.”

The city Department of Parks and Recreation announced in May that it had planted more than 15,000 trees in the past fiscal year, the highest total since 2016. The department also aims to plant a tree “in every viable spot” in the city’s most heat-vulnerable neighborhoods by 2027.

With the combination of an expanded tree canopy, reflective roofs and other cooling street designs, “you really start to mitigate against that urban heat island effect,” Hutchinson said.

Ghosh, at Weill Cornell, is researching how to maximize the cooling effects of urban trees, based on species type and planting location. He said that the city’s goal of reaching a 30% tree canopy is “doable and necessary,” but that maintenance will be key to ensuring trees’ survival and growth.

“You can’t just plant the trees and walk away and hope everything will be hunky dory. You’ve really got to spend the time to see that to fruition,” he said. “That’s what I think the big challenge is going to be.”

Other key initiatives aim to lower indoor temperatures.

The federally funded Home Energy Assistance Program offers a cooling benefit to cover the purchase and installation of a fan or air conditioner for low-income families. The program is first-come, first served and its annual application period closed in mid-July. Its $22 million in available funds will be expended to provide cooling assistance to more than 27,000 households, said Darren O’Sullivan, a spokesperson for the state Office of Temporary and Disability Assistance.

Hutchinson said his team is advocating to expand resources for the program, which has received criticism for quickly exhausting its available funds due to high demand.

City Councilmember Lincoln Restler of Brooklyn recently introduced a bill that would require landlords to provide air conditioning and keep units below 78 degrees indoors when it’s above 82 degrees outdoors.

“The indoor max temperature law would be a really big deal because while citywide air conditioner access is around 90 percent, in the most vulnerable communities, it can be much lower,” said Caleb Smith, the resiliency coordinator for WE ACT for Environmental Justice, a nonprofit.

Arif Ullah, the executive director of South Bronx Unite, an environmental justice nonprofit, walks down a stretch of the South Bronx with little shade on July 11, 2024.

Greener future envisioned

Linda Morgan, 74, sat in the shade on a recent morning in Mott Haven, a neighborhood of the South Bronx. She was perched with her friends outside their apartment building, an affordable housing development for seniors. The sun beat down on the busy intersection surrounding them.

A native New Yorker, Morgan said she’d seen many hot summers in her lifetime — but the heat wave that baked the city in mid-July was the longest one she could remember. She’d survived the hot weather by staying inside for days, grateful for her air conditioning. Eventually, it had cooled down and the air quality had improved enough to permit a quick trip out for groceries, she said.

“We’re all seniors,” Morgan said. “We’re coping as best we can, not to venture out when the sun is high in the sky.”

Ullah envisions a transformed South Bronx where residents like Morgan can enjoy ample green space and shade and benefit from a re-envisioned waterfront, with interconnected green spaces. Deeper investments in the area are sorely needed, he said.

“On top of cooling centers, we need green corridors,” he said. “We need streets that are lined with trees. We need neighborhoods that have greater tree canopy. We need neighborhoods that have more real green spaces.”