For the first time, Los Angeles County residents can see how many people are ending up in emergency rooms, their bodies pushed past the limit, during heat waves.
The county Department of Public Health says its new Heat-Related Illness and Mortality Dashboard will provide heat illness counts in “near real time,” which means weekly. That might seem like a lag, but until now the data were only provided upon request and in ad hoc reports.
Heat is the leading cause of weather-related death in the United States and heat waves are only getting more frequent and intense as the climate changes.
Public health experts called the tracker a meaningful step toward assessing how well county programs are addressing heat risks.
“It’s showing the county’s commitment to reducing the burden of heat on people’s health,” said David Eisenman, director of UCLA’s Center for Public Health and Disasters. “As the county puts more resources into that, this is a metric that allows the public to judge the effectiveness of the work.”
“There’s a handful of other places that also do this, but they’re all relatively new,” said Bharat Venkat, director of the UCLA Heat Lab, noting as examples Imperial and Riverside counties in California, Harris County in Texas and Maricopa County in Arizona. “It is very much welcome.”
The tracker takes heat illness data from patient complaints and doctor diagnoses provided by a countywide monitoring project that was previously available only to public health officials. The website says that what it provides is an undercount. The records often fail to count people when heat exacerbates more obvious health problems.
“Heat piggybacks off of preexisting health conditions,” Venkat said. “Say you go to the ER and you’re experiencing an intense psychotic episode, or a heart attack or a stroke. It’s very likely that the doctor is going to diagnose that as a psychotic episode, heart attack or stroke, and less likely that they’ll note that heat is contributing to that.”
Heat-related deaths are counted from death certificates, which present similar issues for undercounting. Those numbers will be reported monthly on the dashboard.
L.A. County has a recently approved heat action plan that aims to educate the public and reduce indoor and outdoor temperatures with strategies such as opting for shade and air conditioning.
The new tracker breaks down daily heat-related emergency room visits and deaths by age group, geography, and race and ethnicity.
It shows that people over 65 are more vulnerable to heat illness. For Black residents, heat is disproportionately fatal. And people in the San Fernando, San Gabriel, and Antelope valleys see the most heat-related emergency room visits.
Kelly Turner, a professor of urban planning at UCLA, stressed that heat sickness tracks closely with social inequality and is preventable.
“A heat death or heat illness is dependent on who you are and what assets you have,” Turner said. “If you have air conditioning or not, if you work outside or you don’t, all of those factors factor in.”
She noted that there is more risk in the San Fernando and San Gabriel valleys because of the combination of hotter days and more people who are unprotected. “When you map those two things on top of each other, you get a hot spot of vulnerability,” she said.
California already has a tool called CalHeatScore that uses historical hospital records and temperatures to forecast risk for different ZIP Codes in the state during heat events.
Public health officials hope to use the new dashboard to target messaging and public outreach when extreme heat strikes.
“If we’re having an extended heat event we can show that, ‘Hey, we’re having heat impacts’ as they’re happening,” said Dr. Nicole Quick, chief science officer at the L.A. County Department of Public Health.
Venkat said he would like to see the tool become more robust, in line with Maricopa County’s dashboard, widely viewed as the current gold standard for heat illness and mortality tracking. He said the Arizona county, which includes Phoenix, dives deeper into health records and conditions surrounding hospitalizations and deaths to better reflect the role of heat.
“They do scene investigations and send someone out to take notes about where the body was found,” Venkat said. “What was going on? Did they have air conditioning? Were they outside? Did they have access to water? What medications were they taking? All those things provide important context.”
Eisenman said he would like to see the county train physicians on recording heat-related illness, as it has been “clear for a long time” that doctors don’t make the diagnosis enough.
“It would have to be more than just a handout or a few slides. You’d really have to have each institution make some effort to change physicians’ behaviors,” Eisenman said. He added that it probably hasn’t been done because of the costs involved.
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