Editor's Note: Dr. Claire Castellano (she/her/hers) is a resident physician in pediatrics at the Children’s Hospital of Philadelphia. In addition to her MD, Claire has a Master’s in Public Health, focusing on global epidemiology. Claire hopes to combine her interests in medical education and global health in her career as a pediatrician.
Climate change and climate-related disasters pose a real and increasingly severe threat to human health. In an article and accompanying video abstract being early released in Pediatrics this week, Dr. Caroline Stephens and colleagues from the University of California San Francisco, University of Louisville, and University of Utah note that children are especially vulnerable to climate-related injuries for multiple reasons (10.1542/peds.2024-067567):
- Physiologically, they have more relative surface area that is exposed to the environment (e.g., heat)
- Socially, they “depend on caregivers to flee” their built environment
- Structurally, most community hospitals are “less prepared to accept pediatric patients.”
Climate change research in pediatrics has to date focused more on the impact from climate events, such as infection or respiratory disease, and less on the direct injuries from the climate or weather event.
In their ecologic study entitled, “Weather-Related Pediatric Fatalities in the United States: 2001-2021,” Dr. Stephens and colleagues seek to analyze pediatric deaths directly due to climate events.
The authors used multiple existing databases for their analysis. First, they used the Storm Events Database (SED), maintained by the National Oceanic and Atmospheric Administration National Center for Environmental Information, to understand what climate events led to weather-related fatalities. Secondly, they compared these fatalities to all pediatric fatalities, both all-cause deaths and unintentional injury-related deaths, as documented in a CDC online database. Lastly, they analyzed the locations of fatalities and sorted them by whether or not the region had an associated Pediatric Disaster Care Centers of Excellence (COE). COEs are programs associated with 19 states and territories that focus on infrastructure to prepare regions for climate disasters.
They found the following:
- On average, there were 68 pediatric weather-related fatalities each year
- Of these fatalities,
- 37% were due to floods or currents
- 13% were due to cold, ice, or winter weather
- 12% were due to tornados
- 11% were due to hurricanes or storms
- The remainder were due to a mixture of wind, fire, and other disasters
- From 2001 to 2021, weather-related fatalities:
- Were stable by absolute number
- Increased annually compared to all-cause fatalities
- Increased annually compared to unintentional injury fatalities
- 42% of weather-related fatalities were in rural communities, although only 22% of all children live in rural areas
- 54% of weather-related fatalities were in non-COE areas
These results suggest that a growing proportion of child fatalities are related to weather and climate injuries. In addition, a disproportionate number of these fatalities are in rural communities, and a majority of them are in communities without COE support. Taken together, this highlights the need to put time, money, and resources in disaster preparedness for climate-related injuries.
The recent devastating fires in Los Angeles are yet another frightening example of the devastating effects of climate on health. It is essential we work proactively to avoid future weather-related child injuries and deaths.
