Oregon Health Authority Reports That Wildfires, Heat Waves etc. Most Affect Marginalized Communities

Climate events most affect marginalized communities, OHA finds

New report shows wildfires, drought, heat waves touch every Oregonian, but economically, socially disadvantaged people suffer more health issues

PORTLAND, Ore. – Climate-related extreme events, such as heat waves, drought and wildfires, continue to unfairly affect economically and socially marginalized people and communities, according to a new Oregon Health Authority (OHA) report.

OHA’s Climate and Health in Oregon 2021-2022 report, released today, affirms findings of its 2020 report: that events linked to climate change affect communities of color, Tribal communities, those living with lower incomes, older adults, people with disabilities, people who live or work outdoors, and under- or uninsured people more than other populations.

“Heat waves occur from time to time as a result of natural variability. But human-caused climate change, mainly from the burning of fossil fuels, is contributing to the intensity of extreme weather events here and around the globe,” Oregon Public Health Director Rachael Banks explained in the report. “Due to climate change, nearly the entire state will need to prepare for steady increases in extreme heat over the next several decades.”

Banks said the 2021 heat wave is part of a “web of climate risks” that include worsening drought conditions, more wildfires and more flooding events. “These hazards increase the likelihood of deaths and hospitalizations in our state, but we can, and must, act now to prevent the worst outcomes,” she said.

Since 2014, when OHA published its first significant report linking climate change and health, the agency has worked to document evidence of the need to protect people in Oregon from increasing climate-related threats. OHA issued its first annual Climate and Health in Oregon report in 2020, and today is releasing a combined report for both 2021 and 2022. Last year’s report was not completed due to staffing issues related to the state’s response to the COVID-19 pandemic.

The Climate and Health in Oregon 2021-2022 report highlights several high-profile extreme climate events that triggered spikes in hospitalizations and deaths in Oregon over the last two years:

  • Two heat waves during summer 2021 caused more than 100 deaths, including an agricultural worker in St. Paul and a construction worker in Hillsboro. Most of those who died were older adults, isolated or living with low incomes.
  • Heat-related illness visits to Oregon emergency departments and urgent care centers between May and August 2021 jumped 242% from 2020. Nearly 60% of patients seen for heat-related illnesses in 2021 lived in ZIP codes with a median household income below $50,000.
  • For 2021 and 2022 combined, Black/African American, American Indian/Alaska Native, Hispanic and other non-white populations had a disproportionately high percentage of heat-related deaths compared with non-heat related deaths.
  • Wildfire smoke in central and southern Oregon in 2021 caused people in Bend, Klamath Falls and Medford to experience a combined 83 days with air that was at or above levels considered unhealthy for sensitive groups, compared with 41 days in 2020 and 11 days in 2022. Several counties also saw 20% higher asthma-like illness visits to emergency departments and urgent care centers compared with 2020.
  • Severe drought, which can have long-term effects on agriculture as well as drinking and recreational water quality, affected almost every county during 2021 and 2022. All Oregon counties had some area in the abnormally dry to extreme drought range as of September 2022; more than a quarter of the state experienced exceptional drought conditions at some point in the last year.
  • In November 2022 in Klamath County, many homes had no running water, as 461 domestic wells went dry or were slow to refill. Thirteen public water systems in 2021 experienced low water supply, compared with eight between 2016 and 2020. In 2022, there were 14 public water systems experiencing low water supply.
  • The report noted that reduced access to water and poor water quality can lead to food and nutrition insufficiency, acute and chronic respiratory complications and reduced sanitation and hygiene. In addition, aquatic life and waterway health become stressed as the hot, dry conditions benefit harmful algal blooms that release toxic cyanobacteria to recreational and drinking water sources.

But the report points to signs of hope. They include governor-supported investments by the Oregon Legislature over the last three years to build climate and health resilience, such as:

  • Public health modernization, which directed more than $43 million to community-based organizations and local public health authorities to address community-identified priorities, including environmental health risks and climate adaptation strategies.
  • The Healthy Homes grant program within OHA that provides $10 million in funding to help Oregonians make their home environments more resilient to climate and weather impacts.
  • About $4.8 million in funding to modernize public health systems that serve Tribes and American Indian/Alaskan Native people in Oregon, including those that promote environmental health, emergency preparedness and traditional ecological knowledge.
  • The 2022 renewal of Oregon’s Medicaid waiver application allowing coverage of climate change-related expenses, such as air conditioners and air filters, for certain low-income patients under the Oregon Health Plan.

“The state is making foundational investments in environmental justice and health equity, with a priority on building climate resilience in communities across the state,” Banks said in the report. “By resourcing Tribal and local health authorities and community-based organizations to carry out this work, OHA is able to work in partnership toward the goal of eliminating health inequities in Oregon by 2030. It is a bold goal, but the facts are before us and lives are on the line – we simply cannot aim for anything less.”

For more information visit www.healthoregon.org/climate.

Local climate and health projects in action

Many local public health authorities and community-based organizations (CBOs) around Oregon are working on projects to address health inequities related to climate change. The aim is to help communities build resilience and prepare for climate-related extreme weather events and disasters. The following is a sampling of a few projects now under way:

United Way of the Columbia-Willamette

The devastation caused by the massive wildfires that started on Labor Day 2020 was unprecedented. But it also became a rallying point for a group of culturally specific CBOs that wanted to better support underserved, frontline, rural and low-income communities of color that are disproportionately impacted by disasters and climate change. Enter United Way of the Columbia-Willamette (UWCW), a leader at advancing equitable disaster resilience through funding, advocacy, partnerships and communications.

“When the 2020 fires happened in Southern Oregon in September, it activated folks to donate resources to United Ways, and this created a rapid response fund that allowed us to be really intentional about its allocation to community-based organizations, whose populations were communities of color functioning in these marginalized gaps,” said Jamila Wilson, UWCW’s Climate Resilience Program manager.

Since 2020, in partnership with OHA and Trauma Informed Oregon, UWCW has brought together more than 20 CBOs into a Disaster Resilience Learning Network that works to improve and support the health and wellness of culturally rooted CBO leaders impacted by disaster and working toward climate resilience. The network places culture and interdependence at the core of disaster resilience, and increases representation at decision-making tables while building relationships for these leaders across the state.

“This network positions itself really well in providing sort of a sphere of support for, particularly, leaders of color,” Wilson said. Last year, UWCW published a report on Preparing Oregon’s Communities of Color for Disaster that highlighted statewide gaps in linguistically accessible, culturally competent communications and messaging during disasters.

“Statewide emergency response and disaster preparedness directly impacts our public health and community resilience,” said Cristy Muñoz, Climate Resilience senior manager at UWCW. “What we’ve been working on now, after the research report came out last year, is advocating for Oregon’s communities of color who deserve equitable access to lifesaving and culturally relevant disaster preparedness resources, while also building statewide, cross-sectoral relationships and trust between government, CBOs and funders toward increasing collective resilience.”

Climate and Health Central Oregon

The people living in the high-desert region of Central Oregon know extreme weather events all too well: wildfires and related smoke; drought and dry domestic wells; blistering winter storms and excessive heat. It’s one of the state’s most unique climate zones.

That’s why Climate and Health Central Oregon – an effort focused on Deschutes, Crook and Jefferson counties, and coordinated out of Deschutes County Health Services (DCHS) – is raising awareness of climate effects in the region by distributing health-promotion and safety information in health care settings and through CBOs and other regional partners. Major projects include tracking data on climate hazards and health impacts related to wildfire smoke, drought (dry wells), winter storms (accidents and power outages), and extreme heat (illnesses and deaths attributed to heat). DCHS is also partnering with regional CBOs serving high-priority populations (LatinX, older adults, homeless) to identify needed resources – such as clean-air shelters and N95 masks – and provide education around climate health concerns.

“A lot of our work is focused on serving populations that are disproportionately affected by health impacts related to climate,” said the project’s lead, Sarah Worthington, regional climate and health coordinator. “There’s a lot of discussion going on around what we can do to provide for unhoused persons, for example.”

Multnomah County Health Department: Healthy Homes & Communities

The team in the Multnomah County Health Department’s Healthy Homes & Communities Program is fighting climate change by applying core public health functions such as monitoring diseases and causes of premature death and determining their relationship to climate change, as well as responding to emergencies caused by climate hazards. County officials are also forming community partnerships to work for policy, system and environmental changes that protect people from future hazards.

That, says Brendon Haggerty, supervisor of the Healthy Homes & Communities Program, will help the county accomplish “a just transition to a resilient community” that is more involved in decision-making and better able to manage climate change effects.

One recent example of this is the county’s Climate Justice Plan, a vision for climate action developed in partnership with community organizations. The county also recently launched a Heat Vulnerability Index (HVI) to guide planning and investments to reduce effects of extreme heat. The HVI is an interactive map that displays differences in people’s sensitivity to heat based on age and prevalence of underlying health conditions, as well as heat exposure levels based on population and housing densities, tree canopy and vegetation, impervious surfaces and urban heat islands.

The HVI also displays data on factors that predispose a person to heat exposure, such as whether they live in rental housing or have cognitive difficulty.


At Nurturely, pursuing climate resilience solutions is a natural function of its work. The Eugene-based nonprofit promotes physical and psychological wellness during the perinatal period – the time immediately before and after birth that is critical to the long-term health of both parent and baby.

It’s the time when prolonged, low-level wildfire smoke exposure can increase risk of pregnancy complications such as hypertension, low birth weight, preterm birth, later immune system problems and compromised lung function in babies, and severe parental stress associated with pregnancy complications and mental health challenges. It’s also the time when people of color are particularly vulnerable to poor health outcomes.

“We are focused on health equity and homing in on racial injustice and racial inequity as the underlying threats to the health and well-being of all of us, not just pregnant and postpartum people,” said Emily Little, Ph.D., Nurturely’s founder and executive director. “It’s really that intersection of anti-blackness and racism in perinatal health and during the perinatal period that is the root cause of broader inequities we see in society.”

Nurturely is combatting these inequities by equipping perinatal professionals – nurses and nursing home visitors, doulas, physicians and midwives – with tools to provide more equity-centered care. This includes sharing evidence-based information with patients in a culturally competent way to help reduce their smoke exposure, or providing them with N95 masks or air filtration devices.

Trauma Informed Oregon

Recognizing and responding to the impacts of lifetime trauma on a person’s health and wellbeing is the hallmark of being trauma informed. It’s why Trauma Informed Oregon – a nonprofit based out of Portland State University– is concerned about how life-threatening, climate-related weather events, such as wildfires, poor air quality, droughts, floods, and extreme cold and heat, effect lifelong health.

Trauma Informed Oregon was initially recruited by United Way of the Columbia-Willamette to evaluate how trauma-informed care could be imbedded in a new Disaster Resilience Learning Collaborative that was created in response to the devastating wildfires that swept across Oregon in September 2020. The collaborative is made up of more than 20 culturally specific, community-based organizations serving communities of color disproportionately affected by disasters, and its members quickly realized they needed more than just a “one-and-done” evaluation by Trauma Informed Oregon, and invited it to become a permanent part of a new, expanded Disaster Resilience Learning Network to advance equitable disaster resilience.

“Organizations that interact within the disaster sector have slowly become organized around trauma and trauma response,” said Trauma Informed Oregon research assistant Christy da Rosa. “We help organizations move back into that flexibility, that fluidity and that long-term planning that are really needed to move away from that crisis.”

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