In a 60-page report sent Monday to the legislature, the California Department of Housing and Community Development recommended lawmakers set a maximum safe indoor air temperature of 82 degrees Fahrenheit for the Golden State’s estimated 14.6 million residential dwelling units.

“This is a big deal,” said C.J. Gabbe, an associate professor of environmental studies at Santa Clara University. “We’re seeing more and more concerns about the increase in heat-related morbidity and mortality in California, which is leading to these kinds of maximum indoor temperature guidelines.”

If the housing proposal is adopted, California could have the most comprehensive requirements in the nation, Gabbe said. Some local jurisdictions, including Phoenix, Dallas, and New Orleans, have set their own standards, and the city and county of Los Angeles are exploring their own protections.

Last year was the planet’s warmest on record, and extreme weather is becoming more frequent and severe, according to the National Oceanic and Atmospheric Administration. Even though most heat deaths and illnesses are preventable, about 1,220 people in the United States are killed by extreme heat every year, according to the Centers for Disease Control and Prevention. Heat stress can cause heatstroke, cardiac arrest, and kidney failure, and it’s especially harmful to the very young and the elderly.

State law protects renters in the winter by requiring all rental residential dwelling units to include functioning heating equipment that can keep the indoor temperature at a minimum of 70 degrees, but there is no similar standard giving renters the right to cooling.

The release of this report is a key milestone, but it’s just the first step of a long road, vulnerable to legislative politics and an influential housing industry that has successfully delayed similar proposals in the past. In 2022, state lawmakers directed the housing department to issue cooling recommendations after proposed legislation stalled when landlords, real estate agents, and builders raised concerns such a standard would be cost-prohibitive.

Those concerns remain. Many California rental units are older homes, sometimes 90 to 100 years old, and installing air conditioning would require expensive changes, including upgrading the electrical system, said Daniel Yukelson, CEO of the Apartment Association of Greater Los Angeles.

“These types of government mandates, absent some kind of financing or significant tax breaks, would really put a lot of smaller owners out of business,” said Yukelson, who added that he’s concerned it would lead to housing getting bought by large corporations that would spike rent prices.

The report recommends lawmakers provide incentive programs for owners to retrofit residential units so the cost isn’t passed along to renters. It also suggested a variety of strategies that could be deployed to keep homes cool: central air conditioning, window units, window shading, fans, and evaporative room coolers.

For new construction, housing officials suggested new standards incorporating designs to keep indoor temperatures from topping 82 degrees, such as cool roofs and cool walls designed to reflect sunlight, or landscaping to provide shade.

Whether the legislature will take up the housing department’s recommendations is unclear. Spokespeople for Democratic Assembly Speaker Robert Rivas and Sen. Henry Stern, Democrats who co-authored the 2022 cooling standard bill, declined to comment.

Californians largely stand behind the idea, according to a 2023 poll from the University of California-Berkeley Institute of Governmental Studies and co-sponsored by the Los Angeles Times. Sixty-seven percent of voters said they supported the concept of the state establishing cooling standards for residential properties.

As temperatures rise and heat waves become longer and more intense, the report cautions, deaths in California could rise to 11,300 a year by 2050. And deaths from all causes “may be up to 10% higher on hot nights compared with nights without elevated temperatures,” according to a February presentation by the Los Angeles County Department of Public Health.

That’s because it can be particularly dangerous when people can’t cool off at night during extended heat waves, said David Konisky, a professor of environmental policy at Indiana University.

“When you can’t count on evening cooling off and allowing the body to readjust,” he said, “that’s when things get really dangerous for people’s health.”

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

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En un informe de 60 páginas enviado el lunes 3 de febrero a la Legislatura, el Departamento de Vivienda y Desarrollo Comunitario de California recomendó a los legisladores establecer una temperatura máxima segura del aire interior de 82 grados Fahrenheit para las cerca de 14,6 millones de unidades de vivienda residencial del estado.

“Es un gran problema”, dijo C.J. Gabbe, profesor asociado de estudios ambientales en la Universidad de Santa Clara. “Estamos viendo cada vez más preocupaciones sobre el aumento de la morbilidad y la mortalidad relacionadas con el calor en California, lo que está llevando a este tipo de pautas de temperatura máxima interior”.

De adoptarse la propuesta de vivienda, California podría tener los requisitos más completos del país, dijo Gabbe. Algunas jurisdicciones locales, incluidas Phoenix, Dallas y Nueva Orleans, han establecido sus propios estándares, y la ciudad y el condado de Los Ángeles están explorando sus propias protecciones.

El año pasado fue el más cálido registrado en el planeta, y los fenómenos meteorológicos extremos se están volviendo más frecuentes y severos, según la Administración Nacional Oceánica y Atmosférica (NOOA). Aunque la mayoría de las muertes y enfermedades causadas por el calor se pueden prevenir, alrededor de 1.220 personas mueren cada año en el país por esta causa, según los Centros para el Control y Prevención de Enfermedades (CDC). El estrés térmico puede causar insolación, paro cardíaco e insuficiencia renal, y es especialmente perjudicial para los muy jóvenes y los adultos mayores.

La ley estatal protege a los inquilinos en el invierno al exigir que todas las unidades residenciales de alquiler incluyan equipos de calefacción que funcionen y puedan mantener la temperatura interior a un mínimo de 70 grados, pero no existe una norma similar que otorgue a los inquilinos el derecho a la refrigeración.

La lanzamiento de este informe es un hito clave, pero es solo el primer paso de un largo camino, vulnerable a la política legislativa y a una influyente industria de bienes raíces que ha retrasado con éxito propuestas similares en el pasado. En 2022, los legisladores estatales ordenaron al departamento de vivienda que emitiera recomendaciones sobre refrigeración después que la legislación propuesta se estancara cuando propietarios, agentes inmobiliarios y constructores plantearan la preocupación de que la norma resultaría prohibitiva en términos de costos.

Esas preocupaciones persisten. Muchas unidades de alquiler de California son casas antiguas, a veces de entre 90 y 100 años, e instalar un sistema de aire acondicionado requeriría cambios costosos, incluida la actualización del sistema eléctrico, dijo Daniel Yukelson, director ejecutivo de la Apartment Association of Greater Los Angeles.

“Este tipo de mandatos gubernamentales, en ausencia de algún tipo de financiación o exenciones fiscales significativas, realmente dejarían sin trabajo a muchos propietarios más pequeños”, dijo Yukelson, quien agregó que le preocupa que esto lleve a que las grandes corporaciones compren viviendas, lo que aumentaría los precios de los alquileres.

El informe recomienda que los legisladores ofrezcan programas de incentivos para que los propietarios modernicen las unidades residenciales para que el costo no se traslade a los inquilinos. También sugirió una variedad de estrategias que podrían implementarse para mantener las casas frescas: aire acondicionado central, unidades en ventanas, persianas, ventiladores y enfriadores de habitación por evaporación.

Para las nuevas construcciones, los funcionarios de vivienda sugirieron nuevos estándares que incorporen diseños para evitar que las temperaturas interiores superen los 82 grados, como techos y paredes frescos diseñados para reflejar la luz solar, o paisajismo para tener sombra.

No está claro si la Legislatura aceptará las recomendaciones del departamento de vivienda. Voceros del presidente de la Asamblea demócrata Robert Rivas y del senador Henry Stern, demócratas que fueron coautores del proyecto de ley de estándares de refrigeración de 2022, no quisieron hacer comentarios.

Los californianos en gran medida respaldan la idea, según una encuesta de 2023 del Instituto de Estudios Gubernamentales de la Universidad de California-Berkeley y co-patrocinada por Los Angeles Times. El 67% de los votantes dijeron que apoyaban el concepto de que el estado estableciera estándares de refrigeración para propiedades residenciales.

Según el informe, a medida que las temperaturas aumenten y las olas de calor se hagan más largas e intensas, las muertes en California podrían aumentar a 11.300 al año para 2050. Y las muertes por todas las causas “pueden ser hasta un 10% más altas en las noches calurosas en comparación con las noches sin temperaturas elevadas”, según una presentación de febrero del Departamento de Salud Pública del condado de Los Ángeles.

Esto se debe a que puede ser particularmente peligroso cuando las personas no pueden refrescarse por la noche durante las olas de calor prolongadas, dijo David Konisky, profesor de política ambiental en la Universidad de Indiana.

“Cuando no se puede contar con que las personas se refresquen por la noche y permitan que el cuerpo se reajuste, es cuando las cosas se ponen realmente peligrosas para la salud de las personas”, agregó.

Esta historia fue producida por Kaiser Health News, que publica California Healthline, un servicio editorialmente independiente de la California Health Care Foundation.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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From rolling back drug pricing policies to limiting gender-affirming care, President Donald Trump signed several health-related executive orders in the first hours of his second presidency. Here’s a roundup of the changes and what they mean.

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He pulled to the side of the road and cried at the sight of residents trying to save their homes.

“I could see people standing on the roof, watering it, trying to protect it from the fire, and they just looked so hopeless,” said Ramirez, a community outreach worker with the Pasadena Public Health Department.

That evening, the 49-year-old volunteered for a 14-hour shift at the city’s evacuation center, as did colleagues who had also been activated for emergency medical duty. Running on adrenaline and little sleep after finding shelter for homeless people all day, Ramirez spent the night circulating among more than a thousand evacuees, offering wellness checks, companionship, and hope to those who looked distressed.

Local health departments, such as Ramirez’s, have become a key part of governments’ response to wildfires, floods, and other extreme weather events, which scientists say are becoming more intense and frequent due to climate change. The emotional toll of fleeing and possibly losing a home can help cause or exacerbate mental health conditions such as anxiety, depression, post-traumatic stress disorder, suicidal ideation, and substance use, according to health and climate experts.

Wildfires have become a recurring experience for many Angelenos, making it difficult for people to feel safe in their home or able to go about daily living, said Lisa Wong, director of the Los Angeles County Department of Mental Health. However, with each extreme weather event, the county has improved its support for evacuees, she said.

For instance, Wong said the county deployed a team of mental health workers trained to comfort evacuees without retraumatizing them, including by avoiding asking questions likely to bring up painful memories. The department has also learned to better track people’s health needs and redirect those who may find massive evacuation settings uncomfortable to other shelters or interim housing, Wong said. In those first days, the biggest goal is often to reduce people’s anxiety by providing them with information.

“We’ve learned that right when a crisis happens, people don’t necessarily want to talk about mental health,” said Wong, who staffed the evacuation site Jan. 8 with nine colleagues.

Instead, she and her team deliver a message of support: “This is really bad right now, but you’re not going to do this alone. We have a whole system set up for recovery too. Once you get past the initial shock of what happened — initial housing needs, medication needs, all those things — then there’s this whole pathway to recovery that we set up.”

The convention center in downtown Pasadena, which normally hosts home shows, comic cons, and trade shows, was transformed into an evacuation site with hundreds of cots. It was one of at least 13 shelters opened to serve more than 200,000 residents under evacuation orders.

The January wildfires have burned an estimated 64 square miles — an area larger than the city of Paris — and destroyed at least 12,300 buildings since they started Jan. 7. AccuWeather estimates the region will likely face more than $250 billion in economic losses from the blazes, surpassing the estimates from the state’s record-breaking 2020 wildfire season.

Lisa Patel, executive director of the Medical Society Consortium on Climate and Health, said she’s most concerned about low-income residents, who are less likely to access mental health support.

“There was a mental health crisis even before the pandemic,” said Patel, who is also a clinical associate professor of pediatrics at Stanford School of Medicine, referring to the covid-19 pandemic. “The pandemic made it worse. Now you lace in all of this climate change and these disasters into a health care system that isn’t set up to care for the people that already have mental health illness.”

Early research suggests exposure to large amounts of wildfire smoke can damage the brain and increase the risk of developing anxiety, she added.

At the Pasadena Convention Center, Elaine Santiago sat on a cot in a hallway as volunteers pulled wagons loaded with soup, sandwiches, bottled water, and other necessities.

Santiago said she drew comfort from being at the Pasadena evacuation center, knowing that she wasn’t alone in the tragedy.

“It sort of gives me a sense of peace at times,” Santiago said. “Maybe that’s weird. We’re all experiencing this together.”

She had been celebrating her 78th birthday with family when she fled her home in the small city of Sierra Madre, east of Pasadena. As she watched flames whip around her neighborhood, she, along with children and grandkids, scrambled to secure their dogs in crates and grabbed important documents before they left.

The widower had leaned on her husband in past emergencies, and now she felt lost.

“I did feel helpless,” Santiago said. “I figured I’m the head of the household; I should know what to do. But I didn’t know.”

Donny McCullough, who sat on a neighboring green cot draped in a Red Cross blanket, had fled his Pasadena home with his family early on the morning of Jan. 8. Without power at home, the 68-year-old stayed up listening for updates on a battery-powered radio. His eyes remained red from smoke irritation hours later.

“I had my wife and two daughters, and I was trying not to show fear, so I quietly, inside, was like, ‘Oh my God,’” said McCullough, a music producer and writer. “I’m driving away, looking at the house, wondering if it’s going to be the last time I’m going to see it.”

He saved his master recording from a seven-year music project, but he left behind his studio with all his other work from a four-decade career in music.

Not all evacuees arrived with family. Some came searching for loved ones. That’s one of the hardest parts of his shift, Ramirez said. The community outreach worker helped walk people around the building, cot by cot.

A week in, at least two dozen people had been killed in the wildfires.

The work takes a toll on disaster relief workers too. Ramirez said many feared losing their homes in the fires and some already had. He attends therapy weekly, which he said helps him manage his emotions.

At the evacuation center, Ramirez described being on autopilot.

“Some of us react differently. I tend to go into fight mode,” Ramirez said. “I react. I run towards the fire. I run towards personal service. Then once that passes, that’s when my trauma catches up with me.”

Need help? Los Angeles County residents in need of support can call the county’s mental health helpline at 1-800-854-7771. The national Suicide & Crisis Lifeline, 988, is also available for those who’d like to speak with someone confidentially, free of charge.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

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With supermajorities in both houses, Democrats in the California Legislature passed — and Democratic Gov. Gavin Newsom signed — laws taking effect this year that will erase medical debt from credit reports, allow public health officials to inspect immigrant detention centers, and require health insurance companies to cover fertility services such as in vitro fertilization.

Still, industry experts say it was a relatively quiet year for health policy in the Golden State, with more attention on a divisive presidential election and with several state legislators seeking to avoid controversial issues as they ran for Congress in competitive swing districts.

Newsom shot down some of legislators’ most ambitious health care policies, including proposals that would have regulated pharmaceutical industry middlemen and given the state more power to stop private equity deals in health care.

Health policy experts say advocates and legislators are now focused on how to defend progressive California policies such as sweeping abortion access in the state and health coverage for immigrants living in the U.S. without authorization.

“I think everyone’s just thinking about how we’re going to enter 2025,” said Rachel Linn Gish, a spokesperson with the consumer health advocacy group Health Access California. “We’re figuring out what is vulnerable, what we are exposed to on the federal side, and what do budget changes mean for our work. That’s kind of putting a cloud over everything.”

Here are some of the biggest new health care laws Californians should know about:

Medical debt

California becomes the eighth state in which medical debt will no longer affect patients’ credit reports or credit scores. SB 1061 bars health care providers and debt collectors from reporting unpaid medical bills to credit bureaus, a practice that supporters of the law say penalizes people for seeking critical care and can make it harder for patients to get a job, buy a car, or secure a mortgage.

Critics including the California Association of Collectors called the measure from Sen. Monique Limón (D-Santa Barbara) a “tremendous overreach” and successfully lobbied for amendments that limited the scope of the bill, including an exemption for any medical debt incurred on credit cards.

The Biden administration has finalized federal rules that would stop unpaid medical bills from affecting patients’ credit scores, but the fate of those changes remains unclear as Trump takes office.

Psychiatric hospital stays for violent offenders

Violent offenders with severe mental illness can now be held longer after a judge orders them released from a state mental hospital.

State officials and local law enforcement will now have 30 days to coordinate housing, medication, and behavioral health treatment for those parolees, giving them far more time than the five-day deadline previously in effect.

The bill drew overwhelming bipartisan support after a high-profile case in San Francisco in which a 61-year-old man was charged in the repeated stabbing of a bakery employee just days after his release from a state mental hospital. The bill’s author, Assembly member Matt Haney (D-San Francisco), called the previous five-day timeline “dangerously short.”

Cosmetics and ‘forever chemicals’

California was the first state to ban PFAS chemicals, also known as “forever chemicals,” in all cosmetics sold and manufactured within its borders. The synthetic compounds, found in everyday products including rain jackets, food packaging, lipstick, and shaving cream, have been linked to cancer, birth defects, and diminished immune function and have been increasingly detected in drinking water.

Industry representatives have argued that use of PFAS — perfluoroalkyl and polyfluoroalkyl substances — is critical in some products and that some can be safely used at certain levels.

Immigration detention facilities

After covid-19 outbreaks, contaminated water, and moldy food became the subjects of detainee complaints and lawsuits, state legislators gave local county health officials the authority to enter and inspect privately run immigrant detention centers. SB 1132, from Sen. María Elena Durazo (D-Los Angeles), gives public health officials the ability to evaluate whether privately run facilities are complying with state and local public health regulations regarding proper ventilation, basic mental and physical health care, and food safety.

Although the federal government regulates immigration, six federal detention centers in California are operated by the GEO Group. One of the country’s largest private prison contractors, GEO has faced a litany of complaints related to health and safety. Unlike public prisons and jails, which are inspected annually, these facilities would be inspected only as deemed necessary.

The contractor filed suit in October to stop implementation of the law, saying it unconstitutionally oversteps the federal government’s authority to regulate immigration detention centers. A hearing in the case is set for March 3, said Bethany Lesser, a spokesperson for California Attorney General Rob Bonta. The law took effect Jan. 1.

Doctors vs. insurance companies using AI

As major insurance companies increasingly use artificial intelligence as a tool to analyze patient claims and authorize some treatment, trade groups representing doctors are concerned that AI algorithms are driving an increase in denials for necessary care. Legislators unanimously agreed.

SB 1120 states that decisions about whether a treatment is medically necessary can be made only by licensed, qualified physicians or other health care providers who review a patient’s medical history and other records.

Sick leave and protected time off

Two new laws expand the circumstances under which California workers may use sick days and other leave. SB 1105 entitles farmworkers who work outdoors to take paid sick leave to avoid heat, smoke, or flooding when local or state officials declare an emergency.

AB 2499 expands the list of reasons employees may take paid sick days or use protected unpaid leave to include assisting a family member who is experiencing domestic violence or other violent crimes.

Prescription labels for the visually impaired

Starting this year, pharmacies will be required to provide drug labels and use instructions in Braille, large print, or audio for blind patients.

Advocates of the move said state law, which already required translated instructions in five languages for non-English speakers, has overlooked blind patients, making it difficult for them to monitor prescriptions and take the correct dosage.

Maternal mental health screenings

Health insurers will be required to bolster maternal mental health programs by mandating additional screenings to better detect perinatal depression, which affects 1 in 5 people who give birth in California, according to state data. Pregnant people will now undergo screenings at least once during pregnancy and then six weeks postpartum, with further screenings as providers deem necessary.

Penalties for threatening health care workers (abortion clinics)

With abortion care at the center of national policy fights, California is cracking down on those who threaten, post personal information about, or otherwise target providers or patients at clinics that perform abortions. Penalties for such behavior will increase under AB 2099, and offenders can face felony charges, up to three years in jail, and $50,000 in fines for repeat or violent offenses. Previously, state law classified many of those offenses as misdemeanors.

Insurance coverage for IVF

Starting in July, state-regulated health plans covering 50 employees or more would be required to cover fertility services under SB 729, passed and signed last year. Advocates have long fought for this benefit, which they say is essential care for many families who have trouble getting pregnant and would ensure LGBTQ+ couples aren’t required to pay more out-of-pocket costs than straight couples when starting a family.

In a signing statement, Newsom asked legislators to delay implementation of the law until 2026 as state officials consider whether to add infertility treatments to the list of benefits that insurance plans are required to cover.

It’s unclear whether legislators intend to address that this session, but a spokesperson for the governor said that Newsom “clearly stated his position on the need for an extension” and that he “will continue to work with the legislature” on the matter.

Plans under CalPERS, the California Public Employees’ Retirement System, would have to comply by July 2027.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

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At least one medical clinic burned down. Senior patients were evacuated by ambulance from nursing facilities as embers swirled around them and their providers. Medical offices have closed, and routine appointments have been canceled. Some providers have lost homes or had to evacuate their neighborhoods, keeping them from work in many cases and making it a challenge for some health care centers to maintain sufficient staffing.

Amid the maelstrom, doctors, nurses, and other caregivers did their jobs.

On Tuesday night, Ravi Salgia, an oncologist at City of Hope National Medical Center in Duarte, saw the house above his Eaton Canyon home go up in flames. As debris and sparks fell, he, his wife, and their older daughter estimated they had no more than seven minutes to get out. In the middle of the night, Salgia got a call that the hospital had become an emergency command center and was at risk of evacuation, meaning he needed to help evaluate patients and make discharge preparations.

Salgia arrived at the hospital at 2:30 a.m. Wednesday. He was joined by colleagues, many of whom had also evacuated their homes.

“We all felt very strongly that we needed to take care of our patients — no matter what’s happening to us physically and emotionally, what’s happening to our houses — that we need to make sure that the people we serve were taken care of,” Salgia said in an interview.

He doesn’t know if his house is still standing.

In Pacific Palisades, St. John’s Physician Partners, a primary care and pediatric clinic affiliated with Providence Health & Services, burned down, said Patricia Aidem, a spokesperson for the large Catholic hospital chain based in Renton, Washington.

Not far from the eastern edge of the Palisades Fire, Providence St. John’s Health Center in Santa Monica, one of the group’s major LA-area hospitals, was so close to evacuating that it called other hospitals in the area to find space for patients who would be displaced, Aidem said. USC Verdugo Hills Hospital, in Glendale, also faced potential evacuation, along with other hospitals in the region.

“All hospitals in close proximity to the fires remain on high alert and are prepared to evacuate if conditions worsen,” the Hospital Association of Southern California said in a statement. “The fires are creating significant operational hurdles,” the association added.

The association also said emergency services have been strained by high call volumes, while road closures have impeded the transport of patients, supplies, and health care workers. Some health facilities have been hit by power outages, the association said, while “many staff members are directly impacted by evacuations and fire-related disruptions, further complicating operations.”

The California Department of Managed Health Care on Thursday ordered health plans to ensure enrollees affected by wildfires have access to all needed medical services, including prescription drug refills.

Aidem said some doctors and other health workers at Providence St. John’s in Santa Monica and Providence Holy Cross Medical Center in the San Fernando Valley have lost homes or been evacuated, making them miss work and creating challenges to ensure adequate staffing.

Hospitals across the county said their emergency rooms had treated patients for burns, smoke inhalation, and eye irritation.

Over 700 people — and possibly far more — have been evacuated from nursing homes and other care facilities, according to the California Department of Public Health.

On Wednesday, West Valley Health Center, operated by Los Angeles County’s Department of Health Services, closed due to a power outage, the department said. And UCLA Health said the closure of some of its clinics in Pasadena and on L.A.’s Westside was due partly to “utility shutoffs.”

Children’s Hospital Los Angeles said two of its specialty care clinics, in Encino and Santa Monica, were closed Thursday “due to the impacts from the wind storm, power outages and wild fires.”

Providence also has shut several clinics this week.

The two biggest blazes, the Palisades Fire in the parched coastal hills of western L.A. County and the Eaton Fire on the Eastside, have together torched more than 50 square miles, burned thousands of structures, reduced beloved cultural landmarks to ashes, killed at least 10 people, and severely injured many more.

The monster winds that fueled the explosion of the fires on Tuesday and Wednesday have begun to quiet down, though significant gusts are still expected to complicate the task of firefighters for the next several days.

Routine medical care will likely be disrupted for thousands in the days ahead.

Kaiser Permanente, the giant HMO and medical provider, said it closed multiple medical sites Thursday due to the fires, including a pharmacy and laboratory and an eye clinic.

Huntington Hospital in Pasadena, close to the Eaton Fire, said some of its outpatient offices were affected by evacuation notices and heavy smoke.

Dignity Health, another large health system, said some of its hospitals were operating on generator power due to high winds, and some, including Glendale Memorial Hospital, had canceled elective surgeries. Other hospitals, including USC Verdugo Hills and Providence St. John’s, temporarily halted nonemergency surgeries due to the impact of the wildfires.

Christine Kirmsse, a registered nurse, evacuated her Santa Monica home on Wednesday night and is staying at a hotel an hour away. But she said she feels strongly that she needs to come into work.

“There’s obviously so much help that’s needed,” Kirmsse said. “And it’s important to me because I have the skills to be able to help. In times like this, this is when community is the most powerful.”

KFF Health News’ Chaseedaw Giles and Tarena Lofton contributed to this report.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Al menos una clínica médica se ha incendiado por completo. Pacientes mayores han sido evacuados de hogares de vida asistida en ambulancias, mientras las brasas volaban alrededor de ellos y de sus proveedores. Consultorios médicos han cerrado y se han cancelado citas de rutina.

Algunos proveedores han perdido sus hogares o han tenido que ser evacuados, lo que en muchos casos les impide trabajar y dificulta que algunos centros de salud tengan el personal suficiente para atender.

Pero en medio del caos, médicos, enfermeros y otros cuidadores no dejaron de hacer su trabajo.

El martes 7 de enero por la noche, Ravi Salgia, oncólogo del City of Hope Duarte Cancer Center, vio cómo la casa situada más arriba de la suya, en Eaton Canyon, se incendiaba. Mientras caían escombros y chispas, él, su esposa y su hija mayor calcularon que solo tenían unos siete minutos para salir.

En plena noche, Salgia recibió una llamada informándole que el hospital se había convertido en un centro de comando de emergencias y que corría el riesgo de tener que evacuar, lo que significaba que debía ayudar a evaluar a los pacientes y preparar las altas.

Salgia llegó al hospital a las 2:30 am del miércoles. Lo acompañaron sus colegas, muchos de los cuales también habían sido evacuados de sus hogares.

“Todos sentimos con fuerza que necesitábamos cuidar a nuestros pacientes, sin importar lo que nos estuviera pasando física y emocionalmente, o lo que les estuviera pasando a nuestras casas. Necesitábamos asegurarnos de que las personas a las que servimos recibieran atención”, dijo Salgia en una entrevista.

Al cierre de este artículo, todavia no sabia si su casa seguía en pie.

En Pacific Palisades, se quemó por completo la St. John’s Physician Partners, una clínica de atención primaria y pediátrica afiliada a Providence Health & Services, según informó Patricia Aidem, vocera de la gran cadena de hospitales católicos con sede en Renton, Washington.

No lejos del extremo este del incendio de Palisades, Providence St. John’s Health Center en Santa Mónica, uno de los principales hospitales del grupo en el área de Los Ángeles, estuvo tan cerca de evacuar que llamó a otros hospitales de la zona para encontrar espacio para pacientes que iban a ser desplazados, dijo Aidem. El hospital USC Verdugo Hills, en Glendale, también enfrentó una posible evacuación, junto con otros centros de salud de la región.

“Todos los hospitales ubicados cerca de los incendios siguen en alerta máxima y están preparados para evacuar si las condiciones empeoran”, dijo la Hospital Association of Southern California en un comunicado.

“Los incendios están creando obstáculos operativos significativos”, agregó la entidad.

También informó que los servicios de emergencia se han visto afectados por un alto volumen de llamadas, mientras que los cierres de carreteras han dificultado el traslado de pacientes, suministros y trabajadores de salud.

Algunas instalaciones de salud se han quedado sin luz, a la vez que “muchos miembros del personal están directamente afectados por las evacuaciones y las interrupciones relacionadas con los incendios, lo que complica aún más las operaciones”.

El jueves, el Departamento de Atención Médica Administrada de California ordenó a los planes de salud que garantizaran el acceso de sus miembros afectados por los incendios a todos los servicios médicos necesarios, incluido el surtido de medicamentos recetados.

Aidem dijo que algunos médicos y otros trabajadores de salud de Providence St. John’s en Santa Mónica y Providence Holy Cross Medical Center en el Valle de San Fernando han perdido sus casas o han sido evacuados: por todo esto tener suficiente personal se ha vuelto un desafío.

Hospitales en todo el condado informaron que sus salas de emergencia habían atendido pacientes con quemaduras, problemas por inhalación de humo e irritación en los ojos.

Más de 700 personas —y posiblemente muchas más— han sido evacuadas de hogares de adultos mayores y de otras instalaciones de atención, según el Departamento de Salud Pública de California.

El miércoles, el West Valley Health Center, operado por el Departamento de Servicios de Salud del condado de Los Ángeles, cerró a causa de un corte de luz, dijo el departamento. Y UCLA Health informó que el cierre de algunas de sus clínicas en Pasadena y en el lado oeste de Los Ángeles se debió en parte a “cortes de servicios públicos”.

El Hospital Infantil de Los Ángeles informó que dos de sus clínicas de atención especializada, en Encino y Santa Mónica, estuvieron cerradas el jueves “a causa de los impactos de la tormenta de viento, los cortes de luz y los incendios”.

Providence también cerró varias clínicas esta semana.

Los dos incendios más grandes, el de Palisades en las áridas colinas costeras del oeste del condado de Los Ángeles y el de Eaton en el lado este, han quemado juntos más de 50 millas cuadradas, destruido miles de estructuras, reducido a cenizas importantes sitios culturales, matado al menos a 10 personas y herido gravemente a muchas más.

Los vientos descomunales que alimentaron la explosión de los incendios el martes y miércoles han comenzado a menguar, aunque se esperan ráfagas significativas que seguirán complicando la tarea de los bomberos.

Por todo esto, es probable que miles de personas no puedan recibir atención de rutina en los próximos días.

Kaiser Permanente, el gigante proveedor de atención médica, dijo que el jueves tuvo que cerrar múltiples sitios médicos por los incendios, incluidas una farmacia, un laboratorio y una clínica oftalmológica.

El Hospital Huntington en Pasadena, cerca del incendio de Eaton, informó que algunas de sus oficinas ambulatorias se vieron afectadas por avisos de evacuación y por el denso humo.

Dignity Health, otro gran sistema de salud, informó que algunos de sus hospitales estaban operando con generadores debido a los fuertes vientos, y algunos, como el Glendale Memorial Hospital, habían cancelado cirugías electivas.

Otros hospitales, como USC Verdugo Hills y Providence St. John’s, suspendieron temporalmente las cirugías no urgentes a causa del impacto de los incendios forestales.

La enfermera Christine Kirmsse evacuó su hogar en Santa Mónica el miércoles por la noche y está en un hotel a una hora de distancia. Pero dijo que siente la necesidad de ir a trabajar.

“Obviamente se necesita mucha ayuda”, dijo Kirmsse. “Y es importante para mí porque tengo la capacidad para poder ayudar. En momentos como este, es cuando la comunidad es más poderosa”.

Chaseedaw Giles y Tarena Lofton de KFF Health News colaboraron con este artículo.

Esta historia fue producida por Kaiser Health News, que publica California Healthline, un servicio editorialmente independiente de la California Health Care Foundation.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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This story can be republished for free (details).

As California wildfires stretch into the colder months and hurricane survivors sort through the ruins left by floodwaters, let’s talk about an underreported victim of climate change: the emotional well-being of young people.

A nascent but growing body of research shows that a large proportion of adolescents and young adults, in the United States and abroad, feel anxious and worried about the impact of an unstable climate in their lives today and in the future.

Abby Rafeek, 14, is disquieted by the ravages of climate change, both near her home and far away. “It’s definitely affecting my life, because it’s causing stress thinking about the future and how, if we’re not addressing the problem now as a society, our planet is going to get worse,” says Abby, a high school student who lives in Gardena, California, a city of 58,000 about 15 miles south of downtown Los Angeles.

She says wildfires are a particular worry for her. “That’s closer to where I live, so it’s a bigger problem for me personally, and it also causes a lot of damage to the surrounding areas,” she says. “And also, the air gets messed up.”

In April, Abby took a survey on climate change for kids ages 12-17 during a visit to the emergency room at Children’s Hospital of Orange County.

Rammy Assaf, a pediatric emergency physician at the hospital, adapted the survey from one developed five years ago for adults. He administered his version last year to over 800 kids ages 12-17 and their caregivers. He says initial results show climate change is a serious cause of concern for the emotional security and well-being of young people.

Assaf has followed up with the kids to ask more open-ended questions, including whether they believe climate change will be solved in their lifetimes; how they feel when they read about extreme climate events; what they think about the future of the planet; and with whom they are able to discuss their concerns.

“When asked about their outlook for the future, the first words they will use are helpless, powerless, hopeless,” Assaf says. “These are very strong emotions.”

Assaf says he would like to see questions about climate change included in mental health screenings at pediatricians’ offices and in other settings where children get medical care. The American Academy of Pediatrics recommends that counseling on climate change be incorporated into the clinical practice of pediatricians and into medical school curriculums, but not with specific regard to mental health screening.

Assaf says anxiety about climate change intersects with the broader mental health crisis among youth, which has been marked by a rise in depression, loneliness, and suicide over the past decade, though there are recent signs it may be improving slightly.

A 2022 Harris Poll of 1,500 U.S. teenagers found that 89% of them regularly think about the environment, “with the majority feeling more worried than hopeful.” In addition, 69% said they feared they and their families would be affected by climate change in the near future. And 82% said they expected to have to make key life decisions — including where to live and whether to have children — based on the state of the environment.

And the impact is clearly not limited to the U.S. A 2021 survey of 10,000 16- to 25-year-olds across 10 countries found “59% were very or extremely worried and 84% were at least moderately worried” about climate change.

Susan Clayton, chair of the psychology department at the College of Wooster in Ohio, says climate change anxiety may be more pronounced among younger people than adults. “Older adults didn’t grow up being as aware of climate change or thinking about it very much, so there’s still a barrier to get over to accept it’s a real thing,” says Clayton, who co-created the adult climate change survey that Assaf adapted for younger people.

By contrast, “adolescents grew up with it as a real thing,” Clayton says. “Knowing you have the bulk of your life ahead of you gives you a very different view of what your life will be like.” She adds that younger people in particular feel betrayed by their government, which they don’t think is taking the problem seriously enough, and “this feeling of betrayal is associated with greater anxiety about the climate.”

Abby believes climate change is not being addressed with sufficient resolve. “I think if we figure out how to live on Mars and explore the deep sea, we could definitely figure out how to live here in a healthy environment,” she says.

If you are a parent whose children show signs of climate anxiety, you can help.

Louise Chawla, professor emerita in the environmental design program at the University of Colorado-Boulder, says the most important thing is to listen in an open-ended way. “Let there be space for kids to express their emotions. Just listen to them and let them know it’s safe to express these emotions,” says Chawla, who co-founded the nonprofit Growing Up Boulder, which works with the city’s schools to encourage kids to engage civically, including to help shape their local environment.

Chawla and others recommend family activities that reinforce a commitment to the environment. They can be as simple as walking or biking and participating in cleanup or recycling efforts. Also, encourage your children to join activities and advocacy efforts sponsored by environmental, civic, or religious organizations.

Working with others can help alleviate stress and feelings of powerlessness by reassuring kids they are not alone and that they can be proactive.

Worries about climate change should be seen as a learning opportunity that might even lead some kids to their life’s path, says Vickie Mays, professor of psychology and health policy at UCLA, who teaches a class on climate change and mental health — one of eight similar courses offered recently at UC campuses.

“We should get out of this habit of ‘everything’s a mental health problem,’” Mays says, “and understand that often a challenge, a stress, a worry can be turned into advocacy, activism, or a reach for new knowledge to change the situation.”

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

USE OUR CONTENT

This story can be republished for free (details).