In September, the streets of downtown Fort Myers were flooded by Hurricane Ian. Such disruptions can disrupt medical and food supply chains, increasing health risks for people with diabetes and other chronic diseases. This is one of the startling effects of climate change facing Florida and other coastal states.
pportal@miamiherald.com
Some of the health effects of climate change are evident and already evident in Florida, such as more cases of heat stress and mosquito-borne tropical diseases. But surprisingly, as weather conditions intensify, health experts say it can also increase the risk of disease and death for people with diabetes.
That means a lot for Florida, where a staggering one in 10 residents is part of the national diabetes epidemic, according to the Centers for Disease Control and Prevention. Many of the people most at risk are the poor and communities of color, experts say.
Read more: Climate change could bring more mosquitoes and disease to South Florida
At first glance, it may be difficult to recognize the link between climate change and diabetes, but many studies have tracked them down.
Some are indirect. For people with type 1 diabetes who are dependent on taking insulin, disruptions in access to medicines and healthy foods — such as floods or power outages that affect supply chains or block access to pharmacies and stores — can be life-threatening. A study published in the National Library of Medicine by Dr. Mihail Zilbermint of Johns Hopkins Medicine Suburban Hospital documents how Hurricanes Katrina and Harvey led to shortages of medical supplies and food. Florida is often hit by hurricanes, as highlighted by Ian and Nicole’s double whammy last season.
Then there’s the more immediate threat from rising temperatures, which could exacerbate the myriad health challenges people with diabetes face.
“Because of the heat, you increase your risk of dehydration, increase your glucose and increase your risk of kidney damage because circulation to the kidneys is reduced,” said Dr. Cheryl Holder, interim executive director of Climate Action, a Florida clinician. “In many people with diabetes, high blood sugar already has an impact on most metabolic functions.”
Florida will only continue to get hotter. According to a county report on extreme heat, about 133 days of the year in Miami-Dade exceed 90 degrees. By 2050, that could jump to 187 days. Miami is also one of the hottest cities in the United States, which makes people with diabetes more susceptible to heat-related complications. Heat is also a problem for other reasons. It puts an excessive load on electrical systems, causing power outages and refrigeration failures that can damage stored insulin.
As Miami’s heat season approaches in May, Holder said, one of her team’s biggest initiatives is educating community clinicians about heat and its health effects. 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 Florida International University Herbert Wertheim School of Medicine professor and associate dean for diversity, equity, inclusion and community initiatives — also warned that increased air pollution and the psychological stress of dealing with illness and new diseases will Other impacts on diabetes climate challenges.
The Diabetes Belt is an area of the United States — primarily counties in southern states such as Mississippi, Alabama and Georgia — where people are more likely to develop type 2 diabetes than people in other parts of the country. The belt is made up of 644 counties, including Calhoun, Gadsden, Holmes, Jackson and Madison counties in North Florida, according to the CDC.
Even outside the belt, other counties like Hardie and Baker have diabetes rates that are more than double the state’s overall rate of more than 12 percent.
People with multiple marginalized identities, such as black, poor and older, are at higher risk of developing type 2 diabetes and experience the effects of climate change. The two working in tandem can overwhelm patients, leaving them in a “food swamp”—grocery stores are few and far between, options consist mostly of fast food restaurants, or stores are devoid of fresh, healthy foods that help keep the disease under control. Holder encourages diabetics to prepare for the climate emergency as far in advance as possible by preserving canned and frozen vegetables that still have high nutritional value.
Read more: UM Group has spent 25 years trying to prevent diabetes
“If you take a population that is already chronically ill, they have more consideration for their day-to-day life, they have to make sure their diet is appropriate, they have to have access to life-saving medicines, they have to continue treatment, they can’t just Skip treatment for eye disease. They can’t just skip treatment for kidney problems,” Holder said.
“Then you add in all these additional stressors that we have to deal with without all these chronic diseases. You’re dealing with a very high level of stress,” she said. “As resilient as you are, it’s still an added burden.”
Part of this climate report was funded through a collaboration between private donors, Florida International University and the Knight Foundation. The Miami Herald retains editorial control over all content.
