Some of the health impacts of climate change are obvious and already apparent in Florida, such as more cases of heat stress and mosquito-borne tropical diseases. But it may be surprising that as climate conditions intensify, health experts say it also will increase the risk of sickness and death for people with diabetes.
That’s significant for Florida, where a staggering 1 in 10 residents are part of the nationwide diabetes epidemic according to data from the Centers for Disease Control and Prevention. Many at the highest risk, experts say, are the poor and communities of color.
At first glance, it may be hard to recognize the links between climate change and diabetes but they’ve been traced in a number of studies.
Some are indirect. For type 1 diabetics who rely on taking insulin, disruptions to accessing medication and healthy food — such as flooding or power outages affecting the supply chain or blocking access to pharmacies and stores — can be life-threatening. One study from Dr. Mihail Zilbermint of Johns Hopkins Medicine-Suburban Hospital, published in the National Library of Medicine, documented how Hurricane Katrina and Hurricane Harvey caused shortages of medical supplies and food. Florida gets lots of hurricanes, underlined by last season’s double whammy of Ian and Nicole.
Then there is more direct threat from rising temperatures, which can worsen the myriad health challenges for diabetics.
“Because of the heat, you increase the risk of dehydration, you increase your glucose and increase the risk of kidney damage as there’s decreased circulation to the kidneys,” said Dr. Cheryl Holder, interim executive director of Florida Clinicians for Climate Action. “In many diabetics that high glucose already causes impact on much of the metabolic functions.”
And Florida is only going to continue to get hotter. Miami-Dade has about 133 days of the year that are over 90 degrees, according to a county report on extreme heat. By 2050, it could leap to 187 days. Miami is also one of the hottest cities in the United States, making diabetics more susceptible to heat-related complications. Heat is also a problem for other reasons. It can place an excessive load on electrical systems, triggering power outages and refrigeration failures that can damage stored insulin.
Holder said one of her group’s largest initiatives is educating community clinicians on heat and health impacts as Miami’s heat season approaches in May. FCCA has identified 50 health centers in vulnerable communities to provide physicians with materials to protect their patients from extreme heat conditions.
Holder — a recently retired professor at Florida International University’s Herbert Wertheim College of Medicine and associate dean for diversity, equity, inclusivity and community Initiatives — also warned of other impacts to diabetics from increasing air pollution and psychological stress from dealing with both the disease and new climate challenges.
The d iabetes belt is a region of the United States — mostly counties in southern states such as Mississippi, Alabama and Georgia — where people are more likely to have type 2 diabetes than people in other parts of the nation. The belt consists of 644 counties, according to the CDC, including Calhoun, Gadsden, Holmes, Jackson and Madison counties in North Florida.
Even outside of this belt, other counties like Hardee and Baker have double the rates of diabetes than the overall state rate of just over 12 percent.
People with multi-marginalized identities, such as being Black, poor and older, are at a higher risk of developing type 2 diabetes and experiencing the impacts of climate change. The two working in tandem can be overwhelming for patients, leaving them in “food swamps” — areas with few grocery stores and options that consist mostly of fast food or stores without fresh, healthy food that can help control the disease. Holder encourages diabetics to prepare in advance as best as they can for climate emergencies by keeping canned and frozen vegetables that still have high nutritional value.
“You take a population that already has a chronic disease that has a lot more considerations for day-to-day living, where they have to make sure their diets are proper, they have to have access to life-saving medications, they have to continue treatment, they can’t just skip their treatment for their eye disease. They can’t just skip treatment for their kidney problems,” Holder said.
“Then you add all these additional stressors that we without all these chronic conditions have to deal with. You’re looking at extraordinarily more stress,” she said. “And as resilient as you are, it still is an additional burden.”
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This climate report is funded in part by a collaboration of private donors, Florida International University and the Knight Foundation. The Miami Herald retains editorial control of all content.
