During the July heat wave, Baltimore’s health department declared a Code Red alert and flagged those most at risk, such as the elderly. Absent from the list

— other than infants and small children locked in cars — were kids. That might suggest that they’re not vulnerable. But they are.


As more research is done on the impact of extreme heat on health, there’s more news about the effects on young people. While they generally are less vulnerable than the elderly, they can experience some of the same problems. Those include heat exhaustion and heat stroke — which can kill even trained young athletes playing in very hot weather.

Nor are the young immune to chronic diseases like asthma and diabetes that afflict adults and are made worse in high heat and humidity, according to stories

published this month by the University of Maryland’s Howard Center for Investigative Journalism and Capital News Service in collaboration with NPR.

Extreme heat is dangerous in the way it can affect key organs and systems in our bodies, which is why those with existing cardiovascular and lung diseases are particularly at risk. Some medicines may compromise the body’s ability to cool itself. The American Psychiatric Association warns about the impact on those with mental illness, which often begins before adulthood: Exposure to extreme heat “has been associated with increased use of alcohol to cope with stress,” along with increased hospital visits and suicides.

Pregnant women and fetuses also can be affected. The Journal of the American Heart Association reported a study this year that suggested higher temperatures from climate warming may increase the number of infants born with heart defects between 2025 and 2035.

Asthma is especially worrisome because it is widespread, more so in low-income communities with poor housing. Sufferers find it harder to breathe. Young asthmatics are more likely to miss school.

For the tens of thousands of city residents with low incomes, central air, the No. 1 way to protect yourself, is a stretch. They may have to make do with one or two room-size units – or none at all. In Baltimore rowhouses located in heat islands where tree cover is scant and temperatures are highest, people may experience the heat index (a measure of how the combination of temperature and humidity feel) soaring over 100 degrees well into the night, the Howard Center found.

But there are affordable ways to help asthmatics and others affected by exposure to extreme heat. One way to increase the use of air conditioners is to make them and the electricity they use less expensive for users. A coalition of nonprofits, civic-minded business leaders and government officials could pool funds to buy and then sell energy-efficient room units at below-market cost in economically distressed areas.

Here are other ideas that can make the city a national model for dealing with climate warming:

  • Require new development to include heat-reducing measures — including trees, reflective roofs and breezeways, which that circulate air among buildings.
  • In economically distressed areas, turn black-tar rowhouse roofs into sunlight reflectors that cool homes and the streets they’re on. Link demolition of dilapidated vacant rowhomes to creation of pocket parks to provide shade and cool heat islands.
  • Engage community leaders and keep money for this work where it belongs by training and paying residents in target neighborhoods.
  • Nurture creation of small businesses.
  • Create a website to make spending, hiring and work transparent.

Baltimore’s health care system urgently needs to embrace the challenge. Step one: Come together and acknowledge the threat of climate warming. Step two: Develop a plan in concert with the city’s respected but underfunded health department. The mega academic medical centers, Johns Hopkins Medicine and the University of Maryland Medical System, must be at the forefront, but Baltimore’s other hospitals must be on board, too. There aren’t better places to educate the public about extreme heat’s dangers than hospitals and doctors’ offices.

There’s money to help. Non-profit hospitals are required to commit resources to the community in lieu of paying federal taxes. Some of those resources can be directed to programs to mitigate climate warming’s effects. And Hopkins’ and Maryland’s schools of public health can do more research on the issue.

The only big obstacle is political apathy, but there’s an election for mayor coming up. Who among the candidates will make kids’ health the heart of their campaign?

John Fairhall (john.fairhall@verizon.net) was a contributing editor on the Howard Center’s project on climate warming and public health.