Washington, Multnomah and Clackamas counties are working together on a series of climate reports that document the health impacts of extreme weather in the Portland metro area. Findings from the most recent report show that more than 200 people have died from extreme weather events. In 2021 alone, more than 90 people died from the heat.
The report also discusses mental health and found that extreme weather events have compounded trauma from the COVID-19 pandemic and there’s a lack of mental health providers and services. Brendon Haggerty is a Healthy Homes and Communities manager at the Multnomah County Health Department. He joins us with details of the report.
Note: This transcript was computer generated and edited by a volunteer.
Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. We start today with the health effects of climate change. Beginning in 2019, Clackamas, Multnomah, and Washington counties have worked together on a series of reports to document the ways that climate change is affecting people’s health and wellbeing. The latest was just released. It’s the first biennial report that includes data on the heat dome of 2021, and the first one to take a deeper look into the connections between acute climate events and mental health. Brendon Haggerty is the Healthy Homes and Communities manager at the Multnomah County Health Department, and he joins me now. Welcome.
Brendon Haggerty: Hi, Dave. Nice to be with you.
Miller: It’s great to have you on. So this is the third report of its kind, but as I noted, it seems to be the first one to offer a broad view of climate change’s impacts on mental health. Why did you want to include this in the report?
Haggerty: Well, I think anyone who lived through the 2020 wildfires or the 2021 heat dome remembers the feelings of anxiety that were common during that time. It was something that we recognized anecdotally in ourselves and among our community, and it’s being recognized broadly in public health as a research discipline. We knew we wanted to try to capture that trend in the region. In the most recent version of the report from two years ago, we issued a call for help basically in how to measure this. Because we looked high and low for good ways to measure this and didn’t come up with an answer that we liked.
Miller: What were the challenges in getting data about this?
Haggerty: It’s a great question. All of us have a primary care doctor for our physical health needs. That’s not true of our mental health needs. So, if we compare it to other kinds of diseases, we have lots of good data from what doctors aggregate and report. We don’t really have the same thing for mental health conditions.
Miller: You don’t have the same for mental health conditions, meaning that it wasn’t as easy to find long term data that you could correlate to serious climate affected events?
Haggerty: Yeah. For a lot of different kinds of diseases, most of the ones that we include in this report, we have systems set up so we can track trends over time. Those same systems just don’t exist for mental health impacts.
Miller: So where did you end up turning?
Haggerty: Well, I’m really proud of the colleagues who worked on this with me from Washington and Clackamas and Multnomah counties because we came up with some pretty creative ways to do this. One of those is tracking internet search terms. We found that, in the weeks following the heat dome for example, search terms associated with trauma showed an increase in frequency in our region. People searching terms like “mental health services,” we could see an increase in those terms.
Another thing that we did was interview mental health care providers and responders to hear what they were seeing in their practice. And that yielded some really rich insights. But again, I think we’re still going to struggle to find ways to track this over time. So this is an ongoing challenge for us.
Miller: What were some of the insights that you got from those first responders or mental health professionals?
Haggerty: People were really clear that access to mental health services is a really big barrier. They’re seeing overwhelming demand and not enough services, especially during emergency events.
I think another insight that we had was that, for a lot of folks, the climate events, the climate hazards are a compounding factor. They’re adding on another layer of stress to folks, what folks are already experiencing. And if you think about that during the pandemic, during a housing crisis, we had a lot of folks dealing with a lot of stressors, and the climate hazard was a compounding thing on top of that.
Miller: What about demographics? What groups did you find were at higher risk for negative mental health outcomes from climate change?
Haggerty: The folks we talked to identified people experiencing houselessness, older people, and Black, Indigenous, and People of Color as being more vulnerable to experiencing mental health effects.
Miller: So what can you do about this at the county level? If part of your mission is to actually improve community health in the region, what can you do with the data that you have collected?
Haggerty: Well, I think one thing we can do is plan ahead and learn from the past climate events that we’ve already been through. During the 2020 wildfires and then again in the 2021 heat dome, we were kind of learning as we went. We had some plans in place, but they weren’t quite calibrated to the magnitude and the severity of those events. We can be better about planning so that we have resources available. And that might look like making sure that our own providers have adequate coverage during the season when we might experience these hazards.
And I think we can also provide training to the providers that we work with directly so that they’re better equipped to help people through this stressor.
Miller: Do you plan to dig deeper into this issue of climate change and mental health for future reports?
Haggerty: We will absolutely continue to make attempts to measure this. Our hope in publishing this report with this attempt to track mental health impacts is that it might attract the notice of some folks who could help us with this. In particular, academic partnerships, I think could be really helpful here. This is an emerging area of public health that we need all the help we can get with.
Miller: One of the newer pieces of this report is sort of a more granular look at data from emergency department visits. What stood out to you in the data that you crunched?
Haggerty: We did notice that, compared to the other symptoms we looked at in emergency department data, we found that more people were visiting emergency rooms for air quality related illness than for any of the other conditions. That includes people going to the emergency room with concerns about pollen allergies, which is one pathway by which climate change can impact health.
I think what we also noticed is that we saw some pretty unusual things in 2020 during the first year of the pandemic, where people’s people’s patterns of exposure changed or maybe they were nervous about accessing health care for fear of exposure to COVID-19. So, we noticed some really unusual things in the data from that year. But as we’re looking at it this year, it does look like rates are going back somewhere closer to pre-pandemic levels.
Miller: We talked about disparities in mental health impacts from climate change. Do those disparities hold true when you look at, say, emergency department visits?
Haggerty: They do. I would say broadly, the health impacts of climate change are visiting our region’s most vulnerable residents first and worst. They’re more severe among older adults, children, people experiencing houselessness, Communities of Color, communities that are geographically isolated, people who work outdoors, and people who lack access to emergency communication systems.
Miller: This is the first regional climate and health monitoring report that includes the deadly heat dome of 2021. A lot has been written about that event at this point, more than two years later. What more does this report add?
Haggerty: Something that really stands out to me is the rate of hospitalizations for heat illness during 2021. The chart in the report looks like a hockey stick, kind of low numbers going back for more than a decade, and then a huge spike in 2021. That’s not something that we had published before, but the increase was, you know, 5.5 times more than expected, think about that as 550%. It’s a really big increase. 74 people were hospitalized in the region, more than we would have expected in a typical summer. It’s a really big number, it’s costly, and it has real impacts on people’s lives.
Miller: Did the heat dome permanently change the tri-county approaches to public health?
Haggerty: Unquestionably, in my view. I think we saw that even as soon as a month or two later. The heat dome really overshadows that summer, but we had a second pretty severe heat wave in August of 2021. And by the time that came around, I would say all three counties were much more prepared, and had already incorporated changes into our responses. And those would include closer collaboration with cities, more use of emergency notification systems, and faster ramping up of overnight shelters.
Miller: The report notes that since 2014, 236 people in the region have died because of extreme weather events. Most of them were because of extreme heat. But 84 people died from cold, from hypothermia, which the report calls a growing concern. What does that mean for public health officials?
Haggerty: I think a lot of people think of climate change as in terms of global warming. But we’re seeing all kinds of more severe weather, including in the past few years we’ve had major ice storms that caused the largest power outage in Oregon history. It means for public health that we need to be prepared for all kinds of extreme weather events. And that’s not just public health, that’s our partners in all the responding agencies.
Miller: What do you hope to explore in future reports?
Haggerty: Questions left unanswered by this report are why do some of the rates differ between counties or over some years? For example, it appears that the death rate from heat was higher in Multnomah County. And then last year it appears that the emergency department visits for air quality related illness were higher in Washington County, or at least increased faster. We want to understand why, what’s going on with that. And that’s another place where we could potentially partner with a researcher or a state agency to dig deeper.
And then as we’ve already discussed, we hope to dig deeper into the mental health impacts of climate change and continue to refine our ability to track that over time.
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