Climate Change Vulnerability and Opportunities for Adaptive Capacity in Patients with Heart Failure in an Ambulatory Setting.

Abstract

Introduction: Climate change, a global crisis, affects health through changes such as more intense and longer lasting heatwaves. Some populations are more vulnerable to such events, including those with certain medical conditions, like heart failure. This study aimed to improve understanding of heat-related vulnerabilities and opportunities to enhance adaptive capacity of patients within an ambulatory heart failure clinic.

Methods: Heart failure clinic patients at the Clement J. Zablocki VA Medical Center in Milwaukee, Wisconsin, voluntarily completed a 25-question multiple-choice survey. We present descriptive statistics of the survey responses with count and percentage for categorical responses.

Results: We found that out of 60 survey respondents, 46.55% agreed or strongly agreed they would benefit from discussing heat illness risks with their physician, and 31.58% were not aware their heat illness risk is higher on days hotter than 90 °F (32.2 °C). Several vulnerability factors were common: 70.69% follow a prescribed fluid restriction, 33.33% live alone, 20.34% lack a car with air conditioning, and 20.00% worry about their ability to pay electric bills. Notable knowledge gaps included 65% do not check forecasted temperatures, 60% do not plan activities for the coolest times of day, 43.10% lacked awareness of cooling centers, 33.33% were unsure of heat illness symptoms, and 27.12% lacked awareness of Wisconsin's Focus on Energy program.

Conclusions: A sizable portion of survey respondents indicated they would benefit from discussing their heat illness risk with their clinicians, and many underestimated their personal risk of heat illness. Additionally, multiple vulnerability factors were highly prevalent and knowledge gaps were demonstrated in this population. Our findings support adaptive capacity opportunities through heat illness education, anticipatory guidance, and increased resource awareness for patients with heart failure in an ambulatory setting.