USA: We need to keep our elders safe from climate disasters

By Juanita Constible

I’ve been thinking a lot about how climate change harms our oldest citizens. Maybe that’s because my aging parents have been on my mind. Or maybe it’s because I’ll be 67 in 2040—the year the world could hit 1.5 degrees Celsius (2.7 degrees Fahrenheit) of warming unless we end our love affair with dirty fossil fuels.

Specifically, I’ve been fretting about older adults in the aftermath of Hurricane Michael.

You’ve surely seen pictures of the incredible devastation left by Michael’s 129+ mile per hour winds and 9 to 12 feet of storm surge. Official search and rescue operations ended nine days after the storm made landfall in Florida, but hundreds of people are still missing. At the same time, many hospitals and clinics are still closed, and some parts of the Panhandle still have no electricity or cell phone service.

These conditions particularly threaten older adults, who are especially vulnerable to injuries, illnesses, and death after climate-fueled disasters because they are more likely to:

• Have chronic conditions that need regular medical care, like diabetes;
• Rely on wheelchairs or other mobility aids;
• Have memory disorders; Have reduced sight or hearing; or
• Need the help of devices or other people to get through the day.

In 2012, for example, approximately 2,185 out of every 100,000 elderly people living at home in the United States relied on electricity for crucial medical equipment such as ventilators.

Furthermore, elderly people are often under-prepared for disasters. In a national study of more than 1,700 adults over 51, Hispanics, those who were over 85, those with low incomes, and those with functional limitations had the lowest level of disaster preparedness. But the government institutions that are supposed to keep people safe are also not fully prepared, particularly for a potential future of storms that rapidly intensify the way Hurricane Michael did.

Nowhere to go

For perspective, there are more than 281,000 older adults (60 years or older) who live in the 11 counties on Florida’s Panhandle that were hardest hit by Hurricane Michael. As the table below shows, roughly 40,000 of those elders have at least one disability that challenges their mobility, senses, thinking, or ability to care for themselves.

But unfortunately, most of the 11 counties don’t have enough space in “special needs shelters.” Special needs shelters are supposed to have air-conditioning supported by standby power, and more floor space per person than general population shelters to accommodate health care workers and medical equipment (recall that after Hurricane Irma, 12 nursing home residents in Florida died from heat exhaustion).

Older adults (60 years and up), shelters, and evacuation preparedness in the 11 Florida counties eligible for individual assistance from FEMA after Hurricane Michael. Shelter capacity assumes a Category 5 storm and "optimal" evacuation behavior.

No way to get there

Plenty of Panhandle residents couldn’t comply with evacuation orders because they didn’t have the money to leave. The median income for all ages in each of the 11 counties ranged from $34,510 to $50,340 in 2015—well below the national median of $58,889. Evacuating is expensive, even without hotels involved, and simply may not be possible for older adults on a fixed income.

And people without cars or the means to drive typically fall through the cracks of evacuation planning. In the 11 hard-hit counties, just over one-third of older adults have a driver’s license, and the percent of seniors living alone is roughly double the national average. But only three of the counties have strong levels of evacuation preparedness, according to preliminary results from a study at Florida Atlantic University. The weakly- to moderately-prepared counties are lacking in elements like official pick-up locations for people without cars and information from the county about transportation services for people with special needs.

One glimmer of good news: The Disaster Recovery Reform Act (DRRA) passed by Congress earlier this month directs the Federal Highway Administration to improve its evacuation guidance for states and localities and to take older adults, people in long-term care facilities, and other vulnerable populations into account.

No way to get care

If there’s one thing we learned in the months after Hurricane Maria, it’s that delayed or interrupted medical care can dramatically increase the death toll of a storm. Federal and state government officials have sent teams to special-needs shelters and hospitals to boost capacity after Hurricane Michael, but some of the same barriers to evacuation also complicate travel for medical treatment. And for those stuck at home without phone service—particularly in rural areas—calling a doctor’s office or 9-1-1 is out of the question.

DRRA also starts to address problems like these, including by mandating annual training for first responders, utility companies, and others on preparing for power outages.

After Hurricane Michael struck, firefighter Dominique Bartley said to the Florida Times-Union: "Preparation is everything. You never know what's going to happen."

Except we do know one thing: The threat of climate change to older adults is only going to get worse as sea levels rise, storms get more intense, and our elderly population more than doubles by 2060. We owe it to our present and future selves to urgently drive down climate-changing pollution and ready our public health and emergency response systems for the worst-case storms of the future—not the past.

Clare Morganelli provided research help for this blog post.