Rx for Heatwaves: Sacramento Needs a Comprehensive Plan for Extreme Heat

Nneoma Nwachuku Ojiaku

Originally published September 1, 2022 on Medium

Chart note:

Sacramento County, California, age 172 years old.

Experiences higher-than-average ambient temperatures leading to significant illness and death.

Condition worsened by continuing climate change.

Extreme heat events run in the family; neighboring counties and states, also at risk.

County is minimally aware of current condition. Unprepared. Requires urgent intervention.

End dictation.

Sacramento is sick. Heat sick.

Last summer our city endured some of the hottest temperatures on record, with July 2021 posting the second-highest temperature ever—113 degrees—for downtown Sacramento. By century’s end, Sacramento could be grappling with the limits of human survivability if comprehensive action is not taken now on extreme heat.

Heatwaves are more than a mere inconvenience: they are deadly. Extreme heat claims more lives than any other weather-related event. Heatwaves can cause heat stroke, in which the body overheats, damaging multiple organ systems. Exposure to extreme heat exacerbates pre-existing cardiovascular disease. Also, some medications, especially vital psychiatric drugs, affect temperature regulation, putting people at increased risk of heat-related illness and death.

As an obstetrician, I see the effects of heatwaves on pregnant people. Exposure to extreme heat is linked to preterm birth, blood pressure disorders, and birth defects. As a clinician serving marginalized communities, I am disturbed by this avoidable scourge that disproportionately affects my patients and their families. Racism, codified by biased housing policies and political disenfranchisement, sequesters non-white populations into the hottest city blocks—known as urban heat islands.

The best approach to addressing chronic illness is a holistic one that identifies and addresses root causes, while prescribing interim solutions. Climate change is a root cause of heatwaves. According to the United Nations’ report released earlier this year, we must curtail the release of greenhouse gas emissions to prevent further global warming that underlies extreme weather events. We can do that by electrifying transportation, greening urban spaces, and investing in low-carbon fuel sources and technologies.

We have interim solutions, too. Governor Newsom released an Extreme Heat Action Plan that pledges $300 million towards adapting to the state’s warmer reality. Assembly Bill 2076, the Extreme Heat and Community Resilience program, takes the governor’s plan further, ensuring accountability in our state’s efforts to protect the most vulnerable from our hotter reality—youth, outdoor workers, the elderly, homeless residents, pregnant people, and historically disadvantaged communities.

Sacramento needs improved and strengthened public health messaging. California undercounts the number of extreme heat related deaths—a grievous public health error that needs to be rectified. We also must warn our communities about impending heatwaves, just as we do with hurricanes and tornadoes.

Cooling centers serve as a low-cost, effective intervention to protect residents from extreme heat. Sacramento hosts a few of these centers, but to protect the most vulnerable, free transportation should be made available to these sites. Beyond this, Sacramento County needs to invest in local community resilience hubs to prevent death and illness from the disastrous effects of climate change in our community.

Section V: Climate and Health Equity Fellowship (CHEF)

As a region, we must ensure access to financial assistance to help low-income families cool their homes. And we must invest in improved building construction that promotes cooler indoor temperatures and efficient energy use. Weatherization of buildings and communities must include renters, as well as homeowners.

AB 2076 also calls for a statewide Chief Heat Officer to address the public health, environmental, and economic effects of extreme heat events. Sacramento would do well to follow in the footsteps of other cities, like Los Angeles, Phoenix and Miami, and create a similar position for our county.

Yes, Sacramento is heat sick, but we have an effective treatment plan. This treatment plan requires an all-hands-on-deck, holistic approach to addressing the issues of climate change and human health.

Our prognosis may be dire, but the condition is treatable, if we act now.