Climate Change is Coming to Hospitals

In August 2023, time was running out for health workers along Florida’s Gulf Coast. Hospital administrators and staff had to decide how to prepare themselves, their patients, and their facilities as Hurricane Idalia – a category 4 – made landfall. Flooding in hospital basements, four hospitals and eight emergency rooms in the Tampa Bay metro area were closed. Hospitals transported patients to safety by ambulance.

In about a month, health care leaders in two other major US cities will face similar tests. On the West Coast, historic rain knocked out power at a hospital in Los Angeles, while in New York, severe storms caused power outages and electrical damage at a hospital in Brooklyn – both of which prompted emergency evacuations.

Recent hospital closures in the United States reflect a larger trend that is already in motion. Human-driven climate change has increased the risk of hospital injuries by 41 percent between 1990 and 2020, according to a December 2023 report published by XDI, or the Cross Dependency Initiative, an Australian climate risk data company.

Thousands of healthcare facilities around the world are straining under the effects of climate change, a trend that experts predict will worsen in the coming decades as extreme weather increases the pressure on hospital infrastructure and at the same time creates more demand for care.

Professional warnings

In a May 2024 report, the United Nations Population Fund estimated that about 1,500 hospitals are in low-lying coastal areas of Latin America and the Caribbean that are already enduring life-threatening hurricanes and floods. More than 80% of hospitals in Aruba, Bahamas, Cayman Islands, Guyana, and Suriname are located in these dangerous areas.

Hundreds of US hospitals are at risk of flooding, according to a 2022 study by Harvard researchers. Along the Atlantic and Gulf Coasts, hospitals in Delaware, Florida, Louisiana, New Hampshire, Massachusetts, Maryland, New Jersey, New York, and Pennsylvania were at high risk of flooding from the Category 2 storm.

On the other side of the world, severe floods and landslides closed 12 health care facilities in five southern provinces of Thailand in 2023. The year before that, floods in Pakistan reduced the operation of at least 1,460 health facilities, about 10 percent of the health care facilities. the essence of the world.

By looking at the weather vulnerability of nearly 200,000 hospitals due to floods, fires, and hurricanes, XDI researchers estimate that by the end of this century, one in 12 hospitals worldwide may be at risk of being partially or completely closed due to severe weather.

Some regions are more vulnerable than others. The report estimates more than 5,800 hospitals in South Asia alone – an area that includes India, the world’s most populous country – could be at high risk of closing under a global warming scenario of 4.3 degrees Celsius.

Some regions are not protected, however. More than half of hospitals in the Central African Republic and more than a quarter of hospitals in the Philippines and Nepal will face the same fate.

Pressure Compounding with Extreme Heat

The summer of 2023 was the hottest on record. The sweltering temperatures have brought deadly heat waves and wildfires that have ripped through forests and towns near cities – all of which can affect people’s health and the hospitals and clinics where people seek care.

“The Northern Hemisphere has just experienced one of its worst summers – with repeated heat waves causing devastating wildfires, damaging health, disrupting daily life, and causing lasting damage to the environment,” said World Meteorological Organization Secretary-General Petteri Taalas in a statement.

That summer, in Arizona, for example, extreme heat put stress on power grids and caused an influx of people needing medical attention for heat stress.

A 2021 study found that heat-related emergency room visits in Taiwan increased by 50% on days that reached a wet-bulb temperature — which accounts for both heat and humidity — of at least 89.6 degrees Fahrenheit. At that level, it is very difficult for sweat to evaporate and therefore it is difficult for people to cool themselves.

Looking Ahead to Future Risk

In the coming decades, healthcare infrastructure will face increasing pressures from the effects of extreme weather and rising temperatures – power outages, hospital closures and building damage.

At the same time, the need for care can increase. Climate change is expected to exacerbate more than half of known human diseases in the next 25 years, expand the range of fungal diseases and increase the risk of viruses and mosquito-borne diseases. Meanwhile, extreme heat will likely send people to the hospital.

Making significant changes to the way hospitals operate may seem difficult, but facilities can start small by adapting and creating solutions unique to their needs.

An example of this approach can be found in Vietnam. Almost half of all hospitals in that country do not have a reliable source of water, whether that is due to drought, floods, or creeping salt water intrusion. The result: patients often bring their own. Faced with this major barrier to care, three rural hospitals in Vietnam started projects to achieve climate resilience by addressing water availability. Each facility found new ways to get more water using solutions like rainwater catchment and storage systems, desalination, and better infrastructure to capture nearby runoff.

“Unfortunately, we can expect that climate change threatens water in health care facilities throughout Vietnam, so it is important to act quickly with adaptation measures,” said Angela Pratt, WHO representative in Vietnam.

As the impact of climate change puts healthcare systems at higher levels of risk, it is imperative that hospital leadership teams around the world begin to develop climate resilience plans related to infrastructure and workforce to protect healthcare in a changing world.


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