Recent years have highlighted how extreme weather events are becoming more prevalent, which means patients are experiencing increased health risks like heat-related illnesses, mental health struggles, respiratory issues, and more.
A Sept. 25 study from the Commonwealth Fund ranked states to determine how prepared they were for extreme weather events and their role in contributing to greenhouse gas emissions. The healthcare research foundation analyzed publicly available federal and state data between 2020 and 2024 to show how states stacked up in categories including extreme heat, flood risk, and air quality.
Research from 2021 found 11,755 people worldwide had died as a result of natural disaster in 2019, with 95 million additional people impacted, at a cost of almost $130 billion. And a 2023 study projected that if there were an electrical grid failure in Phoenix, Arizona, during a two-day heat wave, nearly 800,000 people would require emergency department care for heat-related illness and nearly 13,000 people would die in the city.
In May, a group of health organizations including the American Public Health Association, Physicians for Social Responsibility, and Health Care Without Harm signed an open letter urging “leaders at every level take swift action to address the health impacts of climate change and reduce the pollution driving it.”
“What I hope the scorecard helps health systems understand is that they need to be leveraging their voice in these policy decisions on clean energy because it both affects their operations and it affects the health of their populations,” Lisa Patel, executive director of environmental and health group the Medical Society Consortium on Climate and Health, told us.
The findings. To get to the good news first, Vermont, New York, Washington, New Jersey, and Maine all had top scores in the study, meaning these states are at a lower risk of environmental hazard, have cleaner and greener energy policies, and emit lower emissions across healthcare.
West Virginia, Kentucky, Louisiana, Florida, and Mississippi all scored among the lowest.
Arizona, Nevada, and New Mexico see higher temperatures and worse air quality, with Arizona topping the latter list, something that surprised Northeastern University Associate Professor of Environmental Engineering Matt Eckelman, who was also an author on the study.
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“For a long time, we’ve known California has had the most serious air pollution issues in the nation,” he told Healthcare Brew. But when it came down to population density and air quality index numbers, he said, “Arizona came out even worse.”
As far as states that are at a higher risk for environmental hazards like floods, hurricanes, and severe winter weather, Florida and South Dakota scored the worst while West Virginia, Wyoming, and North Dakota had the highest greenhouse gas emissions per capita.
Prepping hospitals. Already, hospitals in some states are taking measures to better prepare for extreme weather.
Last year’s Hurricanes Helene and Milton showed the preparedness of Florida health systems, like Tampa Bay General Hospital and its new AquaFence, which helped provide a barrier against flooding. On the other side of the country, California-based Kaiser Permanente is taking on wildfires with community awareness and support. And nonprofit Americares recently announced it would award grants to clinics and community health centers across the country to combat extreme heat.
“For new facilities, this is the best opportunity there is to plan for the future, to make sure that not just the hospital, the physical building, but all the systems that support the hospital, including all the access and connected infrastructure, are also protected,” Eckelman said.
Without preparations in place, hospitals have to take measures like evacuating patients or closing entirely—in addition to “disruptions in the supply chain,” like what happened last year with IV maker B. Braun—all of which “really does impact their bottom line,” Lovisa Gustafsson, VP of the Making Health Care Affordable program at the Commonwealth Fund, who also contributed to the study, said.
This year, the Trump administration has cut funding to research across healthcare and federal agencies focusing on climate change, which can complicate tracking efforts and remove support systems for states most impacted by climate change.
“We as healthcare providers are seeing the impacts of climate change today, right now,” Patel said. “We need to take climate change out of the realm of politics, understand that this is about the health and well-being of our communities, and empower our health leaders to act.”