Extreme Heat & Public Health

According to the Center for Disease Control and Prevention, Extreme heat kills on average more than 600 people in the U.S. each year. Over the course of just a few weeks this summer (2021), three different heat waves baked the western U.S., breaking numerous heat records and killing hundreds. In this episode, as part of our educational outreach to local communities, we interview three experts, Drs. Jennifer Vanos and Rachel Braun, from Arizona State University, and Dr. Adelle Monteblanco from Middle Tennessee State University, about the impacts of extreme heat on public health, especially in vulnerable populations. Episode art from Pixabay.

Resources mentioned in the interview:
How to protect yourself and others from high temperatures
Hot Spots for Heat Resilience in Border Cities project information

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Affiliate links:
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Transcript

[00:00:00] Sarah LeRoy: Welcome to Come Rain or Shine, podcast of the USDA Southwest Climate Hub and the USGS Southwest Climate Adaptation Science Center or Southwest CASC. I'm Sarah LeRoy, Science Applications and Communications Coordinator for the Southwest CASC. 

Emile Elias: And I'm Emile Elias, Director of the Southwest Climate Hub. Here we highlight stories to share the most recent advances in climate science, weather and climate adaptation and innovative practices to support resilient landscapes and communities. 

Sarah LeRoy: We believe that sharing some of the most innovative forward thinking and creative climate science and adaptation will strengthen our collective ability to respond to even the most challenging impacts of climate change in one of the hottest and driest regions of the world.

Emile Elias: [00:00:43] The content in this podcast is for informational and educational purposes and should not be substituted for, or interpreted as medical advice. Always follow the advice of your licensed healthcare provider. 

Extreme heat can be one of the deadliest natural hazards, according to the Centers for Disease Control and Prevention, extreme heat kills an average of more than 600 people in the United States each year.

Over the course of just a few weeks this summer, three different heat waves baked the Western U.S, breaking numerous heat records and killing hundreds. During the heat wave in the Pacific Northwest and Western Canada, Canada set a new all-time record of 121 degrees. And there were sharp increases in heat related hospital and emergency visits.

Unfortunately, these temperatures and events are in line with climate projections and are expected to get worse in the future. Today, we're talking with three experts about the impacts of extreme heat on public health, especially in vulnerable populations. Jennifer Vanos is an assistant professor in the School of Sustainability at Arizona State University, where she focuses on extreme heat, thermal comfort and air pollution in her research and examines health impacts on vulnerable populations.

The Adelle Monteblanco is an assistant professor in the Department of Sociology and Anthropology at Middle Tennessee State University, where she studies inequality at the critical nexus of health, gender, and environment. Rachel Braun is an expert in air pollution, heat and public health at Arizona State University, where she's a post-doctoral research fellow. Extreme heat is dangerous for everyone.

But there are some populations that are especially vulnerable. Jenni, can you start off by telling us a little bit more about these populations, who they are and why extreme heat is of particular concern for them? 

Jennifer Vanos: [00:02:50] Yes, definitely. Thanks, Emile. I think some of the first populations we think about when we think about heat impacts on health are older populations, the elderly.

So those who essentially might not have the ability to thermoregulate the way a normal, healthy adult would, especially those who already have preexisting illnesses or are on medications. And so I think those are the ones that come to top of mind first for many people and especially the ones we see on the news with some of these heat waves in terms of where are the numbers coming from.

We do see this in more of the over 65 year of age group. And then, another, I think a couple other vulnerable populations I'll throw out there that we need to make sure we keep at the top of our mind during these events, are those just generally of lower income who don't have the means to cope with extreme heat, especially extreme heat that they've never seen before in their city.

Like what Oregon was dealing with or what British Columbia was dealing with, and may not be able to afford the air conditioning or their air conditioner broke or might be isolated and not know where to go. Maybe don't have the means to transport themselves to a cooling center or are not nearby family members or friends.

And then lastly, thinking about outdoor workers I think is really important in these situations and making sure that if there is outdoor work going on, which for a lot of times when the temperatures get so high it really shouldn't be, but it still goes on in a lot of places, making sure that they're being watched, that we know which of those might be more vulnerable.

And that they're able to lessen the amount of work they have to do during heat events. For sure. Otherwise, we do see a lot of illness and sometimes death in the outdoor worker population. 

Emile Elias: [00:04:37] Yeah. So Jenni, you've done some research with these vulnerable populations and in this area, can you tell us a little bit about your work and what you found?

Jennifer Vanos: [00:04:46] Sure. I haven't done direct research with the elderly population. I've done more epidemiological research. So taking large data sets from many years across many cities and then starting to relate different temperatures or even some air pollution levels with how the elderly population might respond to the heat or the humidity or the interactions between heat and air pollution.

But we do see within those studies, a sharper increase in illness or deaths in the elderly population at lower temperatures. However the temperature at which that occurs depends on the city. And depends on the types of coping capacities you see that these populations might have. So we do know that up in Oregon and Washington and in British Columbia, there's a much lower rate of air conditioning usage.

Compared to maybe down here in Phoenix, where in general, you would hope that most elderly populations have access to air conditioning are able to stay inside in the cool environments when it's hot out. And so most of my work in that space is epidemiological that you would see in public health data sets.

And then we've been doing more interviews with outdoor workers in the Central Valley, trying to understand what were the combined impacts of heat and COVID were on their ability to perform their job and how COVID exacerbated a lot of these other heat risks that already occur in the Central Valley and are already really high risks for these workers.

We're working outdoors in the fields a lot of the time and trying to also understand what kind of individual or group level adaptive capacities or changes they might make to their schedule. If they're working at night, are they getting enough water? Are they able to take breaks when needed? Are they making decisions on work to rest ratios?

Based on the conditions that they're experiencing. And you know, do they have the resources and the knowledge they need and do they have that group think or group support they need? Because sometimes it's hard for one person who's feeling ill in the heat to speak up without having the permission to really speak up.

So just really understanding that culture, especially of workers who are from the U.S versus migrant workers who are not from the U.S and then where language plays a role in that too. It's really important. So that work is with colleagues from the University of California, Berkeley, and then from UC Santa Barbara as well.

So it's really enlightening work. The last population I work with is kids actually, and I didn't mention them earlier, but kids can be a lot more vulnerable to the heat for different reasons. Both physiologically and psychologically. But with kids, we don't see the numbers of deaths you would in the elderly population, but you do see illnesses.

You do see kids missing school. You do see kids going to the emergency department for heat illness and trying to understand ways that we can prevent that. Whether it's through education, through other adaptive capacities, through how we design things like outdoor play spaces or schools, that's where some of our work is, and we're really focused in the Phoenix area on understanding what makes a heat ready school in this really holistic way.

Not just saying you need to have air conditioning or you need to cancel recess, but saying here's how you can make sure that you are supporting the kids with shade and water and education and educating the teachers on how can they identify the impacts of heat on students or working with the nurses in their surveillance system and what they're looking for.

And I think doing this with some of these schools has been really enlightening and seeing how they can start to more holistically understand these impacts on kids and their learning and their behavior has been really, really nice. And so that's the last population that we've been working with and I work with the most closely hands-on I would say. 

Sarah LeRoy: [00:08:32] Thanks, Jenni. And speaking of education, Adelle you've done some work with midwives and doulas to educate that population and to bring awareness to the potential health effects of extreme heat on pregnant people and their infant children. So could you tell us how that population is particularly vulnerable and a little bit more about the work you've done with them.

Adelle Monteblanco: [00:08:55] Absolutely, Sarah. So when we think about populations that are vulnerable, we often consider three elements and those may intersect or compound with one another. So those elements are sensitivity, exposure and adaptive capacity. And there is mounting evidence now that pregnant people are sensitive to extreme heat exposure.

More specifically, the data suggests that exposure to extreme heat during pregnancy is significantly associated with serious adverse pregnancy outcomes. And those can include, but are not limited to preterm birth and low birth weight. I think most of your listeners know that these are health outcomes to avoid as much as possible because there are potentially long-term health effects for the baby and the mother.

Your listeners might also be curious about how heat exposure contributes to these poor birth outcomes. I will say I'm a sociologist and there still needs to be more data collected from the natural science and physiological science pieces. But the early evidence suggests that dehydration and inefficient thermoregulation play an important role.

So I say all that because the science is telling us that pregnant people are sensitive to extreme heat. So that means we need to think about outreach efforts that communicate risk and safety precautions, and who better than their care providers. So maternal health providers in particular are trusted sources of information and they have access to pregnant people.

So it creates this incredible opportunity to start a conversation about climate change and health. So I, with many of my esteemed colleagues on this call created curriculum and outreach materials to share with El Paso based midwives, doulas and lactation specialists. And to add just a few more details, Jenni and I hosted a workshop at an El Paso birth center, and we talked about a lot of different topics.

We talked about where to find information on local weather forecasts and the ways environmental exposures can increase poor birth outcomes. And it was at this workshop that we had a small group of maternal health providers. And they were really eager to learn. And I don't think this eagerness should surprise any of us.

These providers have a long-term commitment to continuing education and working every single day to promote healthy families. So we just helped add a few more resources to their conversation and care. 

Sarah LeRoy: [00:11:19] Thanks Adelle. And speaking to that energy, just to let listeners know this project was a couple of years now.

And Adelle emailed me a couple of weeks ago saying that one of the midwives that we worked with wants more outreach materials that we developed for her patients and her clients for the summer. So it's still, they're still engaged, which is very exciting.

Adelle Monteblanco: [00:11:43] Absolutely. And perhaps you can add to your show notes, the link to all the outreach materials that we created because they are absolutely still being downloaded.

We pilot tested them in El Paso and then Jenni and I created a few more based on feedback from the maternal health providers we are working with. And if any of your listeners have translation skills beyond Spanish, please get in contact with me. 

Sarah LeRoy: [00:12:06] Yes. Yeah, we will definitely include those links. And actually the funny piece of this is that the most popular outreach material was the urine chart that we adapted.

And it has the different colors of urine to tell you, whether or not you're dehydrated. And that was the one that people really wanted the most. Emile, I think you wanted to say... 

Emile Elias: [00:12:28] I was wondering if you have any plans to do similar workshops in other cities, or if anyone's approached you about that? Because I can imagine people will be really interested. 

Adelle Monteblanco: [00:12:38] I would love the funding to be able to do that and bring it to more places across the country. Right now I live in Tennessee and I would love the opportunity to do that. I don't know that I have the right resources or right social network to do that yet.

Those outreach materials and curriculum are publicly accessible. And so others have asked for those materials and at least communicated to me that they want to use them in other communities. I haven't followed through to find out if they are but hopefully they're adapting them and adopting them to their own communities and what their mamas and families need from them.

Sarah LeRoy: [00:13:15] Great. So shifting gears just slightly, I'd like to talk to Rachel a little bit. So Rachel, you study the relationship between air pollution and public health. So could you tell us a little bit more about your research and explain how these two areas are also linked with extreme heat and what people need to be aware of?

Rachel Braun: Yes. Thank you. So I'm a post-doc at Arizona State University with the healthy urban environments initiative and what our group really is working on is solutions to extreme heat and poor air quality in Maricopa County, which is home to the Phoenix Metro area. And my background's more in atmospheric sciences and the air pollution side.

But I got really interested in looking at intersection of these two issues because I think they're really related. So for example, one of the projects I worked on when I first started by post-doc was looking at the number of heat associated mortalities in Maricopa county. So this is a really bad ongoing issue.

Over the last five years, over a thousand people in Maricopa county have lost their lives to heat. And what we were interested in looking at was, is there any impact of air pollution as well on these numbers we're seeing. Obviously temperature's going to play a role, but we were curious if we could see an influence from other air pollutants too.

So what we found is there does seem to be a slight correspondence between the amount of particulate matter, so PM, air pollution and the number of heat associated mortalities. It's not as strong as the relationship with temperature, but it's interesting to see that there is some sort of relationship there and that we need to be working on air pollution issues alongside combating extreme heat as well.

So you also asked about the link between extreme heat and air pollution. I think there's lots of different ways that these two topics are linked. For example, ozone is usually worse in the summertime in a lot of studies around the world. And here in Maricopa county, actually over the last four years on over a quarter of the days when we had an ozone warning, so either a high pollution advisory or a health watch, we also had an excessive heat warning. So we were having these two types of issues that are occurring at the exact same time. Also, when we talk about vulnerable populations, they tend to overlap between the populations that are most vulnerable to extreme heat, and those that are vulnerable to air pollution.

So for example, if you look the CDC, the groups they say that're high risk for air pollution effects from ozone or negative health impacts, they have people who have lung diseases, but then also older adults, children, and then people who are exercising or working outside. So that's the exact same groups, right, that we were mentioning as vulnerable to heat. So I think they're very related in different ways. And so any solutions that we need to work on, combating extreme heat or combating air pollution to take the other into account as well. 

Emile Elias: [00:16:05] Thanks, Rachel. It seems like there could be an opportunity for a combined education programs since you're looking at the same populations and same populations of vulnerable people.

This is a question for all of you and we'll go ahead and ask Jenny first. What are the warning signs people need to be aware of and how do they know when they're in trouble and what should they do? 

Jennifer Vanos: [00:16:27] Yeah, I think that's a great question and it can vary between people. And I think it's important to understand that sometimes you have to watch for the warning signs in certain people.

So watching for the warning signs in children, or watching for the warning signs in maybe a more elderly person or someone who may not be able to understand what they're experiencing themselves is really important. And then also understanding what it means for you. But in general, some of those first warning signs that you're going to start to experience are headache and dizziness and just this lethargy too, which I think we've all experienced a little bit.

And that's the first signs of heat illness. And this is just, general across the population and you can start to see it. If people are getting dizzy, they might be more likely to trip. And we can see that with outdoor workers that on heat days, even other types of injuries are more common, not just a heat illness, but other types of injuries, trips, slips falls are more common on heat days because of some of the issues that can arise with heat and dehydration.

So recognizing some of those first signs is really important. And then also understanding the type of population you're dealing with or what you're doing yourself. So doing exercise versus being sedentary can result in different experiences for you and what you're expecting to experience. And hopefully you're not doing exercise under extreme heat.

But people still will do exercise on warm days, which is fine to do it safely. And it's good for acclimatizing to the weather. But knowing that some of those signs and symptoms look different in terms of how much you're going to be sweating, or if you're going to start getting clammy skin. But if someone starts going, like getting clammy skin and turning white that's a really bad sign because in general, if you're thermo-regulating really well, you're going to have more red skin because your blood is getting to your skin to try and release that heat.

If you stop sweating, that's a very bad sign because sweating is our number one mechanism to lose heat. So understanding some of those signs and symptoms, and especially in those populations that you might be taking care of and what they're dealing with then, and making sure you have plans in place to get them to a cool place as soon as possible.

With athletes, to get them into an ice tub as soon as possible. 

Emile Elias: [00:18:44] I wonder if there are any additional warning signs or different warning signs that would be for pregnant people. 

Adelle Monteblanco: [00:18:52] So I think the warning signs are very similar. But one thing I really appreciated about what Jenny said was both looking at symptoms in yourself and in others, in all my maternal health training, especially when we look at the postpartum phase, there's a comment that often gets posed. That is everyone wants to hold the baby who wants to hold the mother. And so I would ask us to make sure that we're looking out for moms especially in the postpartum phase, cause they're particularly vulnerable to numerous health concerns.

 And so I envision a world in which pregnant people have a village, a community to care for them and look out for them and provide resources. And so I think the symptoms are similar. I would tell them to ask their healthcare provider what symptoms to look out for. But yeah I, like I said, I appreciated Jenny's comment on looking for particular symptoms and where we all benefit from healthy families.

And so when we have friends in our lives and family members in our lives who are pregnant, we should be one of many looking up for them and doing what we can to protect them.

Emile Elias: I like your vision, Adelle. That sounds like what we need. That sounds great.

Sarah LeRoy: [00:19:57] So following up on this topic, and this is another question for all of you, but I'm wondering what tips you can share for coping during a heat wave.

So say for example, you're a farm worker and heat or not, you have to get the job done. And Jenny, you touched on this a little bit earlier already, but what can a person do to minimize their risk in extreme heat? And again, you mentioned maybe being a part of a social network is one of those right.

Checking on others, but what are some other specific things that someone could do? 

Jennifer Vanos: [00:20:28] Yeah. It's so situation dependent and the farmworker example is a really tough one. And I think making sure that, you know your rights and you know, what does Cal/OSHA require of the owners to make sure that their workers are safe and are those being followed?

I think though, that sometimes there is some concern of, if you speak up about the heat, you could lose your job. And there's also issues in this specific population in terms of outdoor farm workers around how they're paid. And so if they're paid by the piece, they're not going to want to stop and take a break.

Even if they probably should. And so when we see in studies, someone paid by the piece, then they have a higher risk of experiencing heat related illness or heat exhaustion, or heat stroke. It's hard though, because there is not going to be like a direct answer for how you sell something like that. Alot of the issues around outdoor workers and heat come down to unfortunately, economic value.

And, who's being paid, who's losing out due to the heat, crops need to be picked. Is the owner going to lose? Is the worker going to lose? I know with my quite a few people in my family, including my daughter are outdoor workers up in Canada, and recently they've been getting sent home all the time.

Because of the heat because they can't work and they have instruments right onsite and their union protects them and make sure that they don't get exposed to heat that could be quite dangerous to them. However, then they don't get paid. And so when you think of young workers and with young families needing that money to put food on the table, that's really tough as well, and they want to work.

And so I think that the issues surrounding extreme weight work or extreme heat and outdoor workers are quite complex. And depending on what country you're in, it's going to look different. What state you're in, where your workers are from? Are they local workers? Are they migrant workers? Are they able to speak up?

Are they part of a union or not? Are they doing day work? A lot of workers get a job in the morning and they're done that job at night and get paid, and then they go and do that again the next day. And that's a very different type of job than someone who has a long-term employment under a union situation and has more protections.

And I think those without protections are the most vulnerable in that situation as well. So that's more with outdoor workers in terms of just other situations too. Yeah. I might need you to repeat the question cause I think I'm getting off track. 

Sarah LeRoy: [00:23:15] No, that's perfect. Yeah. So let's maybe, let's think about elderly populations, right?

So if you've talked about what are some signs to look out for, but what could they do to minimize their risk, but then also what do they do if you start seeing those signs? 

Jennifer Vanos: [00:23:31] Yeah. So I think, if you're dealing with elderly population, let's say living in a city or town in their own home that's very different than the elderly population let's say, living in a nursing home or something, which hopefully has the cooling and people taking care of them and watching out for them. But it's more of those people who might be living alone on their own, in an apartment or house and could be socially isolated. Or are just, aren't aware of what's going on.

A lot of times you think, where are you getting your information? We hear people are getting their information about heat warnings from something like Twitter or Facebook, but like your grandma is probably not on Twitter or Facebook getting that information. So making sure they're getting the information they need in different places, making sure they're staying socially connected and somehow having knowledge of if they lose their air conditioning, if there's a brownout or blackout or if their air conditioning breaks, how can we know that? And it's really hard, especially in large cities to know who's the most vulnerable, who's even got air conditioning can be tough. What are those indoor temperatures? Because so far.

This year, I think the majority of deaths in Phoenix have been indoors and that is different than last summer. Last summer was also a unique summer due to COVID. But in general, we see 40 to 50% of deaths indoors in Phoenix. And so just understanding how can we have more knowledge about how high temperatures are getting indoors and why?

And I don't think enough can be said about the need to have social connections and know your neighbors. And know what your plan is in your neighborhood if there is a blackout. And having some kind of resilience effort or resilience hub around heat within your community. And I was on a call yesterday with Health Canada, talking about all the heat events and Health Canada, and then, how do you know when to evacuate people? And I said, evacuation is a really scary word for people, I think. And oftentimes people don't want to be evacuated from their home and be brought to a cooling center. Especially elderly or someone with a pet or something. And so finding ways that we know who's going to take care of that person under a situation like this is trusted.

And I said, if you told me right now, my grandparents lost their air conditioning up there, we would find a way to make sure they're brought somewhere else to someone else's home in our family. But not all elderly people have those connections or have loved ones nearby. So it's thinking about these plans and I think that this does happen a lot naturally, and we're not always aware of it.

But it's when it doesn't happen and that person, or those individuals are alone at home, not aware of the heat and can't perceive it as well, because they're older, they're not able to sweat as well. They don't drink enough. And then their bodies are going to be affected by the heat a lot quicker than an average adult.

That's when it gets scary. And that's when they don't know what to do. And I heard one story from a public health person in British Columbia, they did a wellness check call the morning to check in on someone who they knew is vulnerable and they sounded fine on the phone and everything seemed good.

And then they died that afternoon of heat in their home. And so these wellness check calls don't always help because you can't always hear or know how they're doing and you don't know the situation in their home. And so I think as we move forward, especially with technology and trying to understand how we can better assess exposure and response, I think there's going to be more on understanding and monitoring indoor heat and having the ability to know when someone's in their home.

And the temperatures are above a hundred, 105, 110. How do we go help that person? I think it, it will go that way, especially if that person is not able to get help themselves. 

Sarah LeRoy: [00:27:15] Thanks, Jenni. Adelle thinking about pregnant people and their infants, are there any precautions that they could take in extreme heat that might be specific to their situation?

Adelle Monteblanco: [00:27:26] So the suggestions that my colleagues offered are all relevant to pregnant people and infants when those options are available and possible for them. Pregnant people, just like everyone else facing these heat issues need to stay hydrated, they need to wear loose fitting clothing and avoid high humidity.

And for individuals who feel like they're overheating, they should apply wet cloths to their skin, or even soak in a cool bathtub. And especially because the focus here is on health, that if those symptoms worsen or just won't go away, please seek medical attention. And I appreciate this conversation around precautions.

I would like to put on my feminist sociologist, reproductive justice hat, and offer a caveat. And that is that I'm a little tired of holding pregnant people solely responsible for healthy pregnancies and healthy outcomes. And the conversation on extreme heat, the broader one not today's, is just one of many examples.

And so that responsibility to ask pregnant people to take all these precautions, for example, leaves a really big and unfair burden, largely on women with a failure to consider all the ways that pregnant people's environment and their institutions that they interact with have increased the risk of poor birth outcomes, especially for poor women and especially for black, indigenous, and women of color.

And so while these individual level precautions are super important and I will continue to promote them through myself and through maternal health providers, they're an important part of the story. They also are not enough. We have to think about creating neighborhoods and communities and work environments where health, including reproductive health can thrive.

And I know y'all have plans for an episode in which you talked to urban planners, and I bet they have a lot of brilliant ideas about how to develop urban environments where we can still prioritize people's health. And I hope that conversation in part helps us shift the responsibility of public health from individuals to policymakers and institutions. 

Emile Elias: [00:29:32] Thanks, Adelle. Yeah that's, it'll be an interesting episode. And we often ask on this podcast, what gives you hope around the work you do, where what's your climate hope? And so I'm going to start with Rachel, and I'm just curious about what you give, what gives you hope and what keeps you going and what are some of the positive things you've seen in the work that you do?

Rachel Braun: [00:29:54] Yeah, I think an interesting point about that question is it's sometimes the worst things lead to the hope, right? So like when you have these situations where you have these extreme heat waves or you have the wildfires or you have smoke filling all these cities really terrible air quality, that leads to more awareness for people.

And I think that's what gives me hope. People are more aware of these problems. They want solutions to these problems. They are thinking about, we can't keep going on as business as usual. What changes can we make? And so I think that's really interesting as researchers, being able to study these different things and being able to say, these are, these are things that we should do differently in the future tokind of avoid some of these issues. 

Emile Elias: [00:30:37] Yeah, absolutely. Adelle, that same question to you. What gives you hope? 

Adelle Monteblanco: [00:30:42] It's a big question. I guess what gives me hope is that so much of the mobilizing and social organizing around social justice issues right now are at an intersection. And so just to offer an example, a commitment to reproductive justice means that we have the right to gestate and parent children in safe and sustainable communities.

We can't do that without climate justice and housing justice and economic justice. And so I think to see more activism and even more scholarship, understand those interconnections gives me so much fire under my feet. 

Emile Elias: [00:31:19] Excellent. Thanks, Adele. And Jenny, the same question to you. What gives you hope?

Jennifer Vanos: [00:31:24] This is definitely a hard question. And I, I loved Rachael's response and Adelle's response and I agree. Those things are definitely important to give hope that the awareness is so important. I think it's hard for me to just pinpoint like one large thing that can give me hope because there's so many like different little things that can occur on a day-to-day basis or in our research with our different communities where we work with that can give us hope.

I think about some of the populations I work with and just, that ability to share our knowledge and our work in a way that can educate and then people themselves are learning about it and spreading the word and they're learning about it and spreading the word. And so there's more of this education going on and just talking more about the issues and ways to respond to  them.

And I think what Rachel said was true. Like, we're talking more about heat and its impacts on health because we're seeing more heat and it impact people so negatively in their health, unfortunately, and I wish it didn't have to come to a place where we had heat disasters and health disasters to have to start doing something or talking about it.

And it does give me hope that we're talking more about it and a lot of these issues, but I hope that it just, it doesn't just die off when the winter comes and that we're still able to continue our efforts to prepare for the heat season. We're able to put in heat mitigation techniques to understand how we need to adapt to understand that this is a problem we've been dealing with for decades or more in terms of heat causing death and causing a lot of illness and impacting our lives and understanding that there's a lot of changes we can make now that we should make now.

And that we shouldn't just leave it off until 2050, because it's, it's a climate problem. It's not necessarily a climate problem, heat is now a problem and it's just being exacerbated by climate change. So I think that thinking about that and making people understand that and the need  to act now is good.

And then seeing people, the light bulb go off and what they can do and what power they have to make changes is really, it makes me hopeful. 

Sarah LeRoy: [00:33:32] Thanks, Jenni, and that's actually a perfect segue into our episode for next month, where as Adelle mentioned, we'll be talking to some urban planners and how different cities are adapting and thinking ahead to plan for extreme heat.

So that wraps this up. And so I just like to throw it to you all and see if there's anything else that you'd like to share. Or any last thoughts?

Adelle Monteblanco: [00:33:56] If I just might add one little thing, you all ask the important question about was our project in El Paso, the maternal health workshop that we did, kind of a one and done and we moved on? Like, how have we been able to use our resources and our knowledge other places? And the truth is we had a lot of resources, financial to be able to do that. And so it, it doesn't have to look the same everywhere. And so just as another example, I was invited by CAPPA which is an acronym for the Childbirth and Postpartum Professional Association, they host a virtual conference. And so I could have a little virtual booth and talk about heat with maternal health providers. And it provided an opportunity to do outreach from people across the globe. And they could dip in and dip out based on their interests and steal the outreach materials.

There are opportunities like that, that I keep trying to seek out that look different than the workshop, but that still offer those resources. 

Sarah LeRoy: [00:34:48] And Adelle mentioned, you just mentioned that funding that, that project was funded. So I will mention the funder that we will also put. The funding for that project was through the Agnese Nelms Haury Program in Environment and Social Justice, which is through the University of Arizona.

And they offer a lot of grants for this type of work. So any last thoughts? 

Emile Elias: [00:35:09] I was going to say that's great, and it really gives me hope. I think a lot about outdoor workers and farm labor, especially because we work with farmers and ranchers. And foresters. I, it gives me hope the work that you're doing and how that can translate to those vulnerable populations.

So thank you. Thanks for doing the work you're doing.

Sarah LeRoy: [00:35:29] Okay. Thank you all very much for talking with us today on this topic of extreme heat and public health. And as I mentioned before, next month we'll be talking about extreme heat and urban planning. 

Rachel Braun: [00:35:43] Yeah. Thank you. 

Adelle Monteblanco: [00:35:44] Thank you. 

Jennifer Vanos: [00:35:45] Thank you, everyone.

Emile Elias: [00:35:46] Now highlight from one of our previous guest speakers. Last November, we spoke with James McAdam from Tucson Water, on the Santa Cruz River Lives Again episode. Tucson Water and artist, Alex! Jimenez are asking you to join their community-wide participatory audio project. This summer, capture the sounds of a Tucson monsoon or chubasco and contribute to an audio archive of the unique tropical storms that visit us each year. A chubasco is a particularly violent storm with thunder and lightning that drops water in a deluge. Pause from your busy life and record a three minute sample of the chubasco speaking. Check out our episode description box for the link.

 Emile Elias: Thanks for listening to Come Rain or Shine, podcast of the USDA Southwest Climate Hub

Sarah LeRoy: and the USGS Southwest CASC. If you liked this podcast, don't forget to rate or review it and subscribe for more great episodes. A special thanks to our production crew, Skye Aney and Reanna Burnett. If you want more information, have any questions for the speakers or would like to offer feedback, please reach out to us via our websites.