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We’ve made tremendous progress in our understanding of how climate change affects our bodies. But acting to mitigate its consequences is where we have failed.CHAD HIPOLITO/Reuters

“Most of the deceased were older adults with compromised health due to multiple chronic diseases and who lived alone.”

That is the single most important sentence in the 59-page report of the B.C. Death Review Panel, which examined how 619 people in the province died of heat-related causes in a single week in the summer of 2021. Two-thirds of those who died during the “heat dome” that battered B.C. from June 25 to July 1 of last year were over the age of 70.

How this could happen in a province of one of the wealthiest countries on Earth is not explained. No one is called to account. Still, it’s a grim reminder that when catastrophes strike – from extreme heat to once-in-a-century pandemics – the impact is always felt much more acutely by the vulnerable, and elders in particular.

Tuesday’s report, titled “Extreme Heat and Human Mortality: A Review of Health-Related Death in B.C. in Summer 2021,” identifies five common factors among the decedents (to use a coroner word): age, chronic health conditions, low income, substandard housing and isolation.

Far too many elders in our society live in poverty. Even more live lonely lives. When a “weather event” such as a gruelling heat wave strikes, those on the margins of society are disproportionately harmed, for a number of reasons.

Cheap housing tends to be substandard. That means no air-conditioning, maybe even no windows that open. (Of the 619 people who died, only 7 per cent had air-conditioning, and only 24 per cent even had a fan.) Living alone, as 59 per cent of the B.C. heat-dome victims did, means that there is often no one to check up on them.

When people read that those who died had chronic conditions – and 80 per cent had three or more – the “they were going to die anyhow” reflex kicks in, as it did in dismissing COVID-19 deaths. But we need to recognize that as we age, chronic conditions such as high blood pressure, osteoarthritis, depression, diabetes are the norm, not the exception. You can be treated for several and still have a relatively healthy life.

However, events such as a heat dome can be a deadly gut punch.

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The physiological reality is that older bodies hold more heat. Elders don’t sweat as much, especially if they have cardiac or glandular problems. Medications can contribute to heat intolerance. Cognitive decline and mobility problems can make recognizing overheating difficult, and hamper the ability to get help.

We’ve made tremendous progress in our understanding of how climate change affects our bodies. But acting to mitigate its consequences is where we have failed.

Too bad the report from the Chief Coroner doesn’t say that as bluntly as it needs to be said. Instead, it offers some practical, if vague, suggestions such as “ensuring vulnerable populations are identified and supported” and better “public messaging on self-care.”

During weather events such as heat waves, we must systematically do wellness checks on vulnerable seniors, especially if they live alone. We need to make air-conditioning mandatory, especially in congregate settings, along with other changes to building codes.

(One of the most appalling tidbits of information in the Death Review Panel is that about four dozen elders died of heat-related causes in long-term-care homes.)

Such a report should not have been necessary – because the catastrophe was avoidable. Climate change is not a secret. Neither is the need to take preventive measures.

A devastating heat wave killed more than 15,000 people in France in 2003, mostly isolated elders. In response to public outrage, governments adopted a broad swath of measures, including mandatory “cool rooms” in nursing homes, registries to allow systematic wellness checks, massive ad campaigns triggered when temperatures rise, and mandatory training for health workers on preventing and treating heat-related illness.

When another heat dome engulfed France in 2019, the country’s National Heat Wave Plan paid dividends, with heat-related deaths falling tenfold to 1,462. Planning pays off.

In the coming years, climate change will likely prove our single biggest public-health challenge. In our aging society, that will be especially dangerous to elders.

We owe them more than retrospective reports cataloguing the body count. We need to invest in prevention and mitigation – and urgently.

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