HOUSTON, Texas -- Climate-change events can create a significant challenge for community health centers serving clients in states such as Texas. Three of those centers are now participating in a pilot project to enhance their response.
The Harvard T.H. Chan School of Public Health has identified clinics in Houston, Beaumont and Matagorda County that need support to address climate-related impacts on health and health care.
Dr. Aaron Bernstein, interim director of the Center for Climate, Health, and the Global Environment at the school, said often people think of fortifying buildings to address climate change, but when hurricanes, heat waves or other disasters strike, care providers and clinics need to have resources that reduce harm to their patients.
"Patients with cancer, lung cancer in particular, in the state of Texas have worse outcomes when they're in counties that have been more heavily impacted by hurricanes," Bernstein explained.
When Hurricane Harvey hit in 2017, the Episcopal Health facility in Matagorda, a rural, underserved area, had to be evacuated. More recently, many patients and staff were impacted by February's unexpected winter storm.
Bernstein noted the pilot program will allow participating clinics to fill knowledge gaps about how to intervene for their specific patient populations.
Neena Arora, chief operations officer for the San José Clinic south of San Antonio, said with more extreme weather events that compromise access to power, medications and medical records clinics need to buffer risks to the patients that will improve health outcomes.
"Our patients live in these pockets of town which are lower in income, and they don't have the means to take care of what's needed when these storms hit," Arora stressed.
The project also will benefit clinics in California, Massachusetts and North Carolina.
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Extreme heat kills about 700 people in the United States each year, but a new toolkit and weather alerts can protect folks in Texas and beyond.
According to an analysis by Climate Central, the annual number of risky heat days has increased in 232 U.S. locations since 1970.
Saqui Maleque Cho, president of the health and development nonprofit Americares, said the new Heat.gov pilot project will help frontline clinics and the patients they serve better prepare for and respond to climate shocks.
"For example, our hurricane resources remind patients to refill their medications before a major storm," she said. "For diabetic patients who depend on insulin, we remind them to keep icepacks and a cooler in the event of a power outage."
From 1970 to 2022, Reno, Nevada, reported the highest number of what Climate Central called "minimum-mortality temperature" days. However, three Texas cities - Austin, Houston and McAllen - were in the top ten for hottest temps.
The toolkit is available in Spanish and English at Heat.gov.
Kimberlyn Clarkson, chief advancement officer at Texas' San Jose Clinic, said doctors already are seeing health impacts to patients from high heat, including life-threatening dehydration. Those are often people, she said, who work in the agribusiness industry or construction.
"They don't have the option of not going in when it's a 99-degree day, or not reporting for work if there's some sort of inclement weather," she said. "They need the work. They don't have PTO; if they don't go to work, they don't earn income."
To create the Climate Resilience for Frontline Clinics Toolkit, said Caleb Dresser, a physician and director of Harvard University's climate program, a needs assessment was conducted of 450 physicians and clinicians to learn what would help them better respond to their patients affected by heatwaves, hurricanes, floods or wildfires.
"As we look both short-term, medium-term and long-term at what climate change is," he said, "it means greater exposure to climate-responsive hazards for a whole lot of people, all over the country."
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A new report cites a pressing need for better health-care support and better internet access for older adults in Alabama.
The United Health Foundation's 2023 Senior Report found that older Alabamans' health challenges range from inadequate internet access and health-care worker shortages to early death rates.
Despite an increase of 5% in the number of personal care and home-health-care workers between 2020 and 2021, Dr. Michael Stockman, market chief medical officer for UnitedHealthcare, said the report demonstrates that many older adults aren't receiving the assistance they need.
"As we try to support people in their homes, either people who have long-term disabilities or people who are recovering from surgery and need to be at home," he said, "having that low home-healthcare worker rate presents a challenge."
Stockman said the early death rate is a major concern. The report said factors such as smoking rates, lack of exercise, inadequate sleep and multiple chronic health conditions all are high among Alabama seniors, but it also showed a rise in early death rates in other states as well, reversing longer-term improvement.
Experts have said the impact of the COVID-19 pandemic on older adults also has heightened the need for community support. Stockman said Alabama ranks fairly well in that regard, promoting stronger connections and active community involvement.
"Alabama seniors have a lower prevalence of excessive drinking," he said. "There is a high level of community support expenditures within the state, and then there is a low prevalence of severe housing problems among seniors."
The report also noted significant progress nationwide in combating food insecurity among older adults, with a noticeable 6% reduction in the nationwide rate from 2019 to 2020.
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Two-thirds of adults are dealing with gut issues.
A new survey from healthcare provider MDVIP found a majority of Americans aren't keeping their gut health in check and are experiencing recurrent digestive issues such as gas, bloating and abdominal pain - but very few actually seek medical care.
Chief Medical Officer with MDVIP Dr. Andrea Klemes said many in Nevada and across the country know very little about how important good gut health is.
She said gastrointestinal issues are linked to other serious health conditions such as diabetes, heart disease and even Alzheimer's disease.
"Now, the gut has good and bad bacteria in it, and that bacteria is a balance," said Klemes. "That's what makes you have a healthy gut or an unhealthy gut. That unhealthy gut can make you have bigger disease issues like the heart attack, but also can cause symptoms like brain fog or fatigue, moodiness or even eczema or psoriasis."
Klemes said their survey found more than half of participants have used over-the-counter digestive products such as fiber supplements and laxatives.
She added that "people are looking for a magic pill," but says the best way to a have a healthier gut is through the food you eat.
She said probiotic foods such as yogurt and pickles can really go a long way. Prebiotic foods like garlic, onions, asparagus and oats feed the good bacteria.
Klemes added that most adults believe the myth that healthy people should have a bowel movement every day. She said that simply isn't true.
She said the number of times you visit the restroom in a day or week varies from person to person. She said one should understand what is "normal for you" - and when something is abnormal, she said you should visit your doctor.
Klemes said women are also more affected by digestive woes than men, with three in four experiencing symptoms a few times a month or more.
"It is interesting because women said they felt more dismissed by their doctor," said Klemes. "So it is hard, if you have a GI issue, you shouldn't suffer in silence. If your doctor doesn't take it seriously, then you need to find another doctor."
Klemes said stress, daily activity and other lifestyle habits can also have an impact on gut health. She encouraged everyone to take her group's "Gut IQ" quiz to learn more about proper gut health.
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