19-minute listen/watch | 11-minute read | 1-minute teaser
Heat significantly affects pregnant women and infants, increasing risks like dehydration, heat exhaustion, and developmental issues in children. Expectant mothers are more vulnerable due to physiological changes, while infants face heightened danger because of immature temperature regulation. These challenges are further intensified for families with limited resources. Researchers are investigating these impacts to provide lawmakers with the knowledge needed to create protective measures for these at-risk groups.
Transcript
Ruohao Zhang
Extreme heat results in more than 5,000 hospitalizations, 600 emergency department visits, and more than 130,000 outpatient visits, and nearly 344 adverse birth outcomes.
Host
Welcome to Growing Impact, a podcast by the Institute of Energy and the Environment at Penn State. Each month, Growing Impact explores the projects of Penn State researchers who are solving some of the world's most challenging energy and environmental issues. Each project has been funded by the Institute's seed grant program that grows new research ideas into impactful energy and environmental solutions. I'm your host, Kevin Sliman.
Heat can have significant and often overlooked effects on vulnerable populations, especially pregnant women and infants. Pregnancy increases susceptibility to heat exhaustion and dehydration due to physiological changes, making it essential for expectant mothers to stay cool and hydrated during hot weather. Studies also suggest that extreme heat during pregnancy could have lasting effects on a child's development, including cognitive abilities.
For newborns and infants, the risk is even greater because their bodies are not yet equipped to regulate temperature effectively. These risks are further amplified for families facing socioeconomic challenges. To address these critical issues, a team of researchers is investigating the intricate link between heat exposure and its impact on maternal and infant health. Their goal is to bridge the knowledge gap and empower lawmakers with actionable insights to protect these at-risk groups.
Thank you for spending time with me and coming on Growing Impact and talking about this project. I really appreciate it. So I want to welcome you to the program.
Ruohao Zhang
Thank you. Thank you, Kevin.
Host
Can you introduce yourselves, provide your name, title, and a little bit about your research?
Ruohao Zhang
My name is Ruohao [Zhang] and I am an assistant professor of agriculture economics at the Department of Agricultural Economics, Sociology, and Education. My research is mostly focused on environmental economics and related topics. When I say related topics, it's related to public policies, environmental regulation policies, and the environmental impact on public health.
Kristin Sznajder
My name is Kristen Sznajder. I'm an assistant professor of public health sciences in the Department of Public Health Sciences in the Penn State College of Medicine. I'm an epidemiologist, and I'm interested in maternal and child health outcomes and very interested in environmental exposures that could impact health outcomes for this population.
Host
Well, thank you both. This is going to be an interesting topic. Everyone is dealing with warmer temperatures. So places that were cooler feel a little more warmth. But places that were warm are experiencing higher temperatures and it's causing challenges. So your project is focused on human health impacted by intense heat from climate change, specifically in California. Can you tell us about the heat in California and what is the weather like for people, and what health issues are arising from it?
Ruohao Zhang
California is, as we all know, is located in the southwest of the country. So it usually be considered as a warm area with a lot of sunshine. So compared to the other areas in the states, California is one of the places that we see quite frequent heat waves as extreme temperature events are happening. A report from the [California Department of Insurance] has shown that from 2013 to 2022, there are seven major extreme heat events, all lasted for at least seven days with really high temperature and caused nearly 460 deaths and almost $7.7 billion economic loss in the states in many different forms of economic loss, including the loss to wages and productivity, agriculture and the manufacturing disruptions, power outage, infrastructure damage and more.
And the same report also shown that the extreme heat resulted in more than 5,000 hospitalizations, 600 emergency department visits, and more than 130,000 outpatient visits and nearly 344 adverse birth outcomes. So the impacts are pretty huge from the public health aspects. And in addition, the heat waves do not just directly affect the people's health it also has some we may call them a collateral damage through other related disasters -- for example, heat waves will also increase the risk of wildfires in California.
Host
Let's talk about the overall goal of your project. Could you help us understand that?
Ruohao Zhang
Climate change makes extreme weather events more frequent, including these extreme temperature events and the vulnerability of individuals such as low-income minorities, seniors, children and the pregnant women are usually more affected by the extreme weather events. So in this project, we aim to conduct a pilot research to investigate the health impact of extreme temperature events. We will also explore the socio-economic disparities in relation to these extreme temperatures.
Households can certainly use air conditioning systems to overcome extreme temperatures, but it comes with less affordable energy bills, especially for these low-income communities. This makes the impact of the extreme temperature disproportionately greater on low-income households. We hope our study will inform government policies related to the affordable energy that may help address social inequity concerns regarding to the resilience against these climate change and extreme weather events.
Host
One of the groups is pregnant women and newborn children, and that's a focus of this project. Can you talk about why it's so important to focus on these groups when it comes to heat?
Kristin Sznajder
It's important to focus on these groups when it comes to heat because maternal outcomes are important for the country, and outcomes in the US are disproportionately high. So pregnant women are susceptible to extreme temperature. This is because pregnant women's ability to thermal regulate is compromised, and pregnancies are susceptible to complications at all stages of gestation. Consequently, extreme temperature could affect pregnancy progression and fetal development.
This may not only affect a mother's health but could potentially cause long lasting impact on newborns' health and well-being. Because of the socio-economic disparities, pregnant women from low-income communities may suffer from extreme temperatures. Think about the potential long-term impact on newborns, despite the immediate social inequity concern we have here, this may also worsen the future social justice by amplifying the intergenerational transmission of health inequity.
I think we should also say something maybe here about just that maternal health in the US is a real national importance. Our outcomes here in this country are worse than other developed countries. And it's a high priority for almost all organizations and high priority for the country.
Host
Interesting.
Kristin Sznajder
And so this is one possible exposure that could be impacting this population.
Host
Yeah.
Kristin Sznajder
And why do we have such poor outcomes?
Host
In your project description, Ruohao, you already talked a bit about how heat disproportionately affects individuals with lower income. Is there anything to discuss to go in a little deeper? Maybe take it one step further to talk about how lower income individuals are disproportionately affected by heat.
Ruohao Zhang
In addition to the less affordable energy bills and the air conditioning systems, we do have several other factors that might make these climate impacts disproportionately greater to low-income communities. For example, the house conditions, the living in a house with a maybe relatively poorer conditions compared to the other communities, for example, they don't have enough like, functional insulation to block the heat or even the cold weather out of their house.
And, also, neighborhood environment is a very important factor. For example, if their neighborhood is covered by a lot of trees, then the whole area might be cooled down by this green infrastructure. But we are living near a huge parking lot, then it can heat up pretty quickly under the sunshine. Yeah, and there are several other things, for example, that are work in the environment.
If poorer neighborhoods are more likely to be exposed to extreme temperatures in the workplace, then there is another potential reason that they are disproportionately affected. Several other things: they are more likely to have some preconditions... pre health condition, chronic health conditions that makes them more susceptible to the extreme temperature.
Host
One of the components of your project is informing policymakers and making changes that are going to be positive for these individuals. Can you dive into that a little bit and talk about how informing policymakers can actually make these changes for individuals?
Kristin Sznajder
We hope our study will inform government policies to help disadvantaged communities and vulnerable households develop resilience to extreme temperature. For example, different types of affordable energy programs, home improvement programs, investing in neighborhood green infrastructure, and enhancing OSHA regulations to avoid extensive workplace exposure, and more. We think that our project has huge potential to impact policy, and that's what makes it so exciting.
Host
It's hard to tell those stories and for people to understand how challenging some of these things are, because that knowledge gap exists. And so I agree, I think it is exciting that this is something you're taking on because it's so important. And I feel like that's, such an important aspect of research is to fill in these knowledge gaps for not just, you know, other researchers, but those who are then going to maybe take that data and use it in, you know, some positive way to affect others.
Kristin Sznajder
Something I love about this project is that it helps us build a story through the data, as you're saying. And I think it's really exciting because the data that we're going to have, and analyze through this work will be something we can use for advocacy to really help people. And since this issue of climate change and heat really affects everyone and is getting worse, we think our data are going to be really important.
Ruohao Zhang
The climate, like at the extreme temperature exposure, impacting our health is kind of people usually expect. But, the reason that our project is important is that we actually provide a solid evidence of that it’s actually happening. And we will give you a number of at what extent it affects the health, especially for the pregnant woman and infant.
Host
Yeah. So it's concrete data that people can point to and say, this is what's happening. Let's talk about collaborations and why it's crucial to have people beyond your own discipline to work together to assist in making a project like this a success.
Ruohao Zhang
Okay. Yeah, yeah. So, this definitely is an interdisciplinary project because it focuses on the nexus of climate change, energy, and public health. The reason that we need a different expertise to involve is because first, it is interdisciplinary. For example, we needed the scientific and epidemiological expertise to study how extreme temperatures actually affect the human bodies in general.
And we also need a social scientist because they can help link a household's socioeconomic status with their resilience to extreme temperature, especially through their different behaviors or decisions of adapting air conditioning systems or how to how to allocate their incomes on the energy bills or other related stuff. And, we will need the economics and the statistical expertise to analyze the causal impact of extreme temperature on health outcomes.
That is really the kind of data that I produce, this project will actually provide us, solid evidence of your health is actually affected by the extreme temperature, not just as some correlations are there. And the economist can also help us capitalize the negative impacts so that we can have a very nice piece of policy information to provide them to the policymakers to know that, oh, if you did this, if you have the communities to build up their climate resilience, what is the benefits in dollar value? Yeah. And in addition, we will also need the public policy expertise to properly communicate our policy implications to the policymakers.
Host
Can we talk a little bit about next steps? What are some next steps for this research? And maybe things that you're excited about or maybe... and/or challenges maybe that you're seeing for this project?
Ruohao Zhang
Yeah. So in the past several months, we were mainly working on two major tasks. [Editor's Note: This episode was recorded in August 2024.] The first task is we were working on the data application and the IRB application with the California Department of Public Health. So we are applying for the California birth record data, which includes a very detailed health and socioeconomic information on both the babies and the parents.
So that data is kind of, sensitive. So this IRB application takes a long time, and we need to provide a very detailed information about what we plan to do in this project using this data. The second task we've been working on is that, during the time that we are waiting for this birth record data to arrive, we conduct our preliminary studies to investigate the impact of extreme temperature on county average birth weight.
The reason that we do this study is because the county average birth weight is kind of a public information that you can directly find on the CDC website. So the good news is our data application just got approved by the California Committee for the Protection of Human Subjects two weeks ago. And our immediate next step is to prepare for this data transmission and to start a more comprehensive analysis using this individual level data.
Host
Is there something that is surprising to you that you either have learned or are learning during this project?
Ruohao Zhang
We don't have too much results so far because it is still early stage of the project. But from our studies using this county-aggregated level birthweight data, we do find something surprising because initially we phrase this project as the heat waves impact on the infant health. But by analyzing these county-aggregated birth weight data, we not only find that that heat wave have the impact on the new birth weight, but also the extreme cold weather.
So both actually have quite significant impact on the birth weight. And another interesting thing still found is that for the counties that have a relatively higher temperatures... for the counties in the warm area, the pregnant mother and the newborns weight are more affected by the extreme cold weather. But for the counties in the cold areas, they are more affected by the heat waves.
We also looked at all the counties and compared results with the counties with relatively higher poverty rate. And we do find that for the counties with higher poverty rates, the negative effect is greater compared to the others. So that also makes sense and is consistent with our expectations that there is such socioeconomic disparities on the extreme temperatures, impact on the infant health.
Host
All right. So this is the big opportunity. You just got in an elevator and a US senator or some industry leader or other world leader, whatever... some very important person steps onto the elevator with you, and you have 20 seconds to explain why your project is so important. What would you say if you had 20 seconds with a US senator?
Kristin Sznajder
Our project's important because in California, there's over 400,000 live births every year, and populations of pregnant women are more vulnerable to temperature changes and to heat. And due to this fact, we think our project, our project is important because it's going to give us more information on the health risks to this population, including especially infant health outcomes like preterm birth and low birth weight, our research will aim to provide the data to inform policies that can potentially mitigate these impacts of climate change, which is something that's happening across the globe and is happening in California.
Our research is going to help mitigate the impact of climate change and help ensure that pregnant people can be healthier during their pregnancy and give birth to healthier infants, which will ensure a healthier population in California.
Host
Thank you for coming on Growing Impact. I appreciate you talking about this important topic. It was a fascinating conversation, and I learned a lot about the way that heat is impacting these different vulnerable populations. So, thank you both. Thank you, Kristin and Ruohao. Thank you for being on the episode.
Ruohao Zhang
Thank you so much.
Host
This has been season five, episode ten of Growing Impact. Thanks again to Ruohao Zhang and Kristin Sznajder for speaking with me about their project. To watch a video version of this episode and to learn more about the research team, visit iee.psu.edu/podcast. Once you're there, you'll find previous episodes, transcripts, related graphics, and so much more.
Our creative director is Chris Komlenic, with graphic design and video production by Brenna Buck, marketing and social media by Tori Indivero, and web support by John Stabinger.
Join us again next month as we continue our exploration of Penn State research and its growing impact. Thanks for listening.
