November 4, 2021

Multnomah, Washington and Clackamas counties this week released their second Regional Climate and Health Monitoring Report, updating an initial report with three additional years of data, from 2018 to 2020. The report documents the health impacts of extreme weather, disease and poor air quality — indicators affected by the climate crisis.

One of the new report’s key takeaways: Asthma-related emergency room visits increased by nearly a third in the four weeks during and after wildfires in fall 2020 that choked the skies with smoke.

The report, funded through a one-time grant from the National Association of County and City Health Officials with support from the Centers for Disease Control and Prevention, details how climate change — which propels extreme and dangerous weather, promotes the spread of diseases, and contributes to poor air quality — threatens the health and mental well-being of the region’s 1.8 million residents.

This report documents events through December 2020. Since then we have seen other climate-related disasters that put lives and health at risk.

“Aside from COVID-19, the region’s three biggest emergencies in the past 10 months — the 2020 wildfires, the 2021 ice storm and power outage, and this summer’s heat dome — were all caused, to some degree, by climate change,” said Brendon Haggerty, Multnomah County’s Healthy Homes and Communities supervisor. “As public health workers, we are trained to get to the root cause of poor health. When we’re talking about climate change, there are two things we need to do to protect health: stop using fossil fuels and strengthen our infrastructure to withstand the hazards we’re already beginning to experience.”

As of July 2021, 81 heat-related deaths were reported in the tri-county region as a result of June’s heat dome — an event not documented in the current report. The heat dome, while far outside the norm, is an event consistent with climate models that show extreme heat becoming much more common as emissions rise.

“During the heat event, many of the people who died were older and lacked adequate air conditioning,” said Kathleen Johnson, Washington County senior program coordinator, who contributed to the report. “Extreme climate events worsen existing economic and health inequities and disproportionately affect low-income, Black, Indigenous, Latinx and other communities of color as well as older people, children, people with underlying health conditions and people with disabilities.”  

COVID-19 also had a profound impact on many of the report indicators, nearly all decreased in 2020, coinciding with changes in exposure and diagnosis patterns related to the pandemic. 

Even though the pandemic likely skewed the data, the trendline that began in 2010 will provide a benchmark for future measurement and may help guide mitigation. The region must brace for a creeping trendline to a warmer climate and more extreme events. 

Region follows global trend

The release comes as a global collaborative of academic institutions and United Nations agencies publishes its 2021 Lancet Countdown(link is external) on health and climate change. That report found:

  • Heat-related mortality among people 65 and older reached a record high of almost 345,000 deaths in 2019, 81 percent higher than the 2000–05 average.
  • 3.3 million deaths were attributable to ambient PM2.5 particulate matter pollution from human sources in 2019, a third of which were directly related to fossil fuel combustion.
  • Food systems, including agricultural production, cause between 21 and 37 percent of all greenhouse gas emissions. Agricultural production emissions have continued to grow, as cattle production contributed 52 percent of global agricultural production emissions.
  • As much as 19 percent of Earth's surface suffered from extreme drought in any given month last year, a value that never exceeded 13 percent between 1950 and 1999. And the five years with the most parts of the planet affected by extreme drought have all occurred since 2015.
  • Sea levels could rise by as much as 7 feet above current levels within 80 years, even as 147 million people live in coastal areas within three feet of current sea levels.

To meet the world’s Paris Agreement climate goals, global greenhouse gas emissions must drop by half within a decade, the report found. “However, at the current pace of reduction, it would take more than 150 years for the energy system to fully decarbonise.”

The National Climate Assessment found that the Pacific Northwest has warmed about 2 degrees Fahrenheit since 1900, resulting in warmer winters, declining snowpack, more widespread and extreme drought, more severe heat waves, and bigger wildfires.

And still, average summer temperatures are predicted to rise another 10 degrees by the turn of the century. But we’ll see the alarming effects much sooner, scientists say. By 2040, streams and rivers will see a dramatic decline in flow rates; the Willamette River could see a 40 percent drop in summer months. By 2080, the median annual forest area burned will be four times the median annual of 1916-2007 and sub-alpine forests may be completely lost; converted to vegetation less vulnerable to heat.

“Climate change is causing sweeping and irreversible harm to our planet and to our people. To all of us, in fact. It’s affecting everything from the air we breathe, to the safety of our food and water, to the safety of our very homes, as we saw in the devastating fire season of 2020 right here in Clackamas County,” said Clackamas County Health Officer Dr. Sarah Present. “And I know many in our younger generations are fearful of what the future holds. Climate change is  affecting both physical and mental health in our community.”

Impact on mental health

The regional report called for some way to measure the impact of climate change on people’s well-being. Health  officials from the Metro region and the Oregon Health Authority scoured research literature, but found little data to document mental health impacts over time.

The Yale Climate Opinion Survey estimates the number of people worried about climate change; between 2014 and 2020, the estimated percentage of people worried about global warming and who believe global warming will harm future generations increased every year, in each county.

No data tracks how the crisis climate harms youth mental health, but Oregon's Student Health Survey documents students' general emotional and mental health. Between 2011 and 2019, in every county, for both 8th and 11th graders, the percentage of students who report “excellent” or “very good” mental health decreased while the percentage of students reporting “fair” or “poor” mental health increased.

“I’m starting to get more people coming to me with climate concerns, especially young people,” said psychologist Thomas Doherty. “Every therapist in Portland is seeing this. With the fires, smoke and heat last year, it’s right here in our lives. It’s in front of us.”

Doherty said he and all therapists struggle with how to help people cope with the reality of a warming climate — and individuals’ feelings of helplessness — but also find ways to feel they have agency, and find reasons to hope. 

“You don’t want to sound like Pollyanna. But there is potential for camaraderie, collaboration, hope, reclaiming the future,” he said. “There’s a potential for happiness with the future, a potential for change. I tell people I work with that, ‘your actions do matter. There’s a sense of meaning in your personal actions.’” 

“Every age faces challenges,” he said. “This is ours.”