Extreme Heat Health Risks: Community Solutions

Driving home from work in 110-degree Arizona summer heat, Dr. Kyle Meehan was 2 or 3 miles from her South Tucson clinic when she saw two women walking on the side of the busy road. With a shock, she realized that one woman was a patient who was quite far along in her pregnancy.

“I pulled over and asked if they needed a ride, which they accepted,” says Meehan, who is the prenatal provider for the University of Arizona Department of Family and Community Medicine Mobile Health Program. She was concerned about the women’s health. “I’ve had three children myself,” Meehan says. “Thinking about any person – but pregnant women in particular — walking in 110-degree weather, it was hard to think that that is something that people have to experience.”

Meehan made sure her pregnant patient had transportation assistance for her prenatal visits going forward. But the incident was a reminder of how heat affects every aspect of health — from transportation to appointments to health outcomes — especially for those with the fewest resources, people living with low incomes and without insurance. Those are the patients at the nation’s free and charitable clinics, including the mobile clinic where Meehan works.

“It’s not uncommon for us to get back to our cars after our clinic session and our inside car temperature reads 125, 126 degrees,” says Meehan. “So inside trailers or small apartments that don’t have access to air conditioning can be at those temperatures — people die. We have patients we hear about not making it through the summer, even if they are housed, let alone our unhoused patients that we serve in this [mobile clinic] program.”

In July 2024, the world recorded its hottest days ever, increasing health risks for everyone, but especially those most in danger of heat-related illness, including pregnant and older people, those working outside or in hot conditions and people with chronic disease including mental illness. Millions of people across the nation rely on free and charitable clinics and community health centers for free or low-cost health care.

“It’s critical that frontline clinics have the resources they need to address heat-related health risks in their patients,” says Americares Director of Climate and Disaster Resilience Elena Ateva. “By preparing clinics now, we can save lives immediately and be ready for heat waves in the years to come.”

This summer, more than 40 safety net clinics across the U.S. began working on heat-health action plans that connect patients with community resources that will keep them safe when temperatures rise. Americares and the Center for Climate, Health and the Global Environment at Harvard T.H. Chan School of Public Health (Harvard Chan C-CHANGE), helped clinics create locally tailored plans that reduce patients’ exposure to extreme heat. The Climate Health Equity for Community Clinics Program, supported by Johnson & Johnson, aims to reach 100 U.S. clinics by 2025. Americares provides free online resources for free and charitable clinics and community health centers that provide care to millions of people living with low-incomes, including the uninsured. These resources include a Climate Resilience for Frontline Clinics Toolkit tailored for safety-net clinics. Americares heat toolkit tip sheets include specialized advice for patients with dementia, diabetes, heart disease, kidney disease, limited mobility, lung diseases (such as COPD), mental health conditions and multiple sclerosis (MS) as well as guidance for people who are pregnant or breastfeeding, of older age, on chronic disease medications, who work outdoors or use substances. The toolkit was created with support from Biogen. Find all of Americares climate-related resources on the website.

Heat can be especially dangerous for pregnant people and newborn babies. “Within the mobile health program, I was seeing women go into pre-term labor or start to have contractions due to dehydration,” says Dr. Meehan.  “We’ve had a couple women who have ended up in the hospital, either admitted for observation, while we rehydrate them with IV fluids or even women who have delivered early due to preterm labor related to heat.” Pre-term delivery carries life-time risks for the mother and baby.