Wildfires and Health: Checking in with EMA Board Member Dr. Jay Lemery
"What we also see with wildfires is air quality degradation, which happens over swaths the size of a state or several states. Think about the wildfires in Quebec affecting the whole New York City region. In Denver, we were often in the summer, and the air quality was horrible because of wildfires in adjacent states, and that was hundreds, maybe even thousands of miles away."
For those who have attended our EMA IMPACT Summits, you know that Dr. Jay Lemery, co-director of the Climate & Health Program, is at the forefront of connecting climate change with public health. So it's no surprise he was one of the first people we contacted regarding the devastating wildfires in our hometown of Los Angeles.
We sat down with Dr. Jay to learn about wildfires' immediate and long-term effects on public health.
How do climate disasters like the wildfires in Los Angeles contribute to or exacerbate public health issues?
There's a lot to unpack, but the first thing to note is that wildfires are now occurring more frequently, with longer seasons and more intense fires. Climate change is worsening this.
For example, the wildfires in the Palisades have caused significant destruction, including the loss of homes and infrastructure.
Such events lead to physical trauma, but even more concerning is the mental health impact. The displacement and uncertainty people face are major health issues. The trauma of forced migration and the stress it causes can be just as significant as physical injuries.
Additionally, people displaced by these fires often struggle to find stable housing, impacting their finances, health, and overall well-being. A critical factor here is the disruption of access to healthcare. When weather events force people to leave their homes, they lose access to local pharmacies, doctors, and hospitals, which disrupts the management of chronic health conditions. While this is harder to quantify, it's essential to the overall health impact.
Finally, there's the direct loss of life. In the Palisades fire, for instance, there were fatalities. The destruction leads to both morbidity and mortality, further exacerbating public health concerns.
Wildfires release a variety of airborne pollutants, including particulate matter and chemicals. What are the long-term health risks of inhaling these pollutants, especially for vulnerable groups like children, older people, and those with pre-existing respiratory conditions?
What we also see with wildfires is air quality degradation, which happens over swaths the size of a state or several states. Think about the wildfires in Quebec affecting the whole New York City region. In Denver, we were often in the summer, and the air quality was horrible because of wildfires in adjacent states, and that was hundreds, maybe even thousands of miles away.
That's a lot of impact from wildfires. As I'm sure you know, wildfires release much pollution, particulate matter, and chemicals. What are the long-term health risks of inhaling these pollutants, especially for vulnerable groups like children, older people, and those with pre-existing respiratory conditions?
The health risks include reactive airway disease. If you're oxygen-dependent, that can throw you into crisis. I was in India for two weeks, and people who are on oxygen often come into the emergency room complaining of chest pain, shortness of breath, or even diabetic complications. We don't always attribute that to inhaling poor air quality for a long time.
So, when we think about this, we see it as a disease of vulnerability, particularly for the elderly, the physiologically vulnerable, or those with comorbidities. We also see it affecting people with socio-economic vulnerability because they're the ones who live next to highways and intersections, constantly exposed to exhaust from automobile and truck traffic.
How can cities like Los Angeles better prepare for and mitigate the public health risks of increasing wildfire (and climate disaster) frequency due to climate change?
Wildfires are a thorny issue. A lot of the problem is forest management. We know that warmer temperatures are creating drier forests. This gets a little dodgy, but forest management is integral to that. Ensuring the forest isn't full of dry kindling and doing controlled burns are key.
Of course, there's zoning and housing. We like to live where we want to live. It's considered the American dream and freedom, but the truth is, we must reimagine how we live in these areas. People won't do it unless forced to, and it will ultimately come from insurance companies saying they won't insure your house. So much of it is smart zoning, legislation, and understanding the communal costs of living next to wildland fire areas.
From an environmental standpoint, how do wildfires impact local ecosystems, and can the toxins left behind in the soil and air contribute to environmental health risks that indirectly affect human populations over time?
From an environmental standpoint, how do wildfires impact local ecosystems? In this case, the local ecosystem was wildfire-prone, and therein lies the risk.
It's about where people live, thinking about the fuel that will fuel the fires. The more significant issue is the world's warming. How do we continue to address the source, which is more carbon and greenhouse gases, and a warmer world?
As a doctor, where do you see these health risks? Do you see more of them now?
For sure! I'm in Colorado, so we have certain risks. We don't have tropical cyclones here, and we don't generally get extreme downpours, but we have extreme heat, wildfires, and degraded air quality. Those are the big ones.
With that, we see a lot of reactive airway disease, where people think they have asthma but have reactive airway disease from inhaling wildfire smoke.
How do you approach that as a healthcare provider?
You look for the teachable moments. First of all, there are a couple of things at the bedside. You look for the teachable moment, such as asking, "Hey, it's an extremely warm day. The air quality is terrible. Do you have air conditioning? Where do you live? Who is looking in on you? Do you have people to rely on?" Then you advise, "Don't go on your normal shopping trip walking across town at noon. Do it in the early morning. Is there someone who can drive you?"
You think about your patients and where they're headed and give them an understanding of the risks.
I'm also half doctor, half professor. I'm at the med school, so the professor part is straightforward. We run programs and talk to people like you. But at the bedside, we always think about how patients will do. I'm in the emergency department, so we no longer see them. Still, we consider how we will care for them, ensuring they have the knowledge and skills to prevent whatever brought them in and continue on the path to wellness.
What policies, technologies, or community-driven initiatives have you seen most effective in reducing wildfire risks and protecting public health, and how can residents actively contribute to these efforts?
The important thing is exposure. We think about greening communities, such as urban heat islands, where there's all blacktop and no place to cool off, and creating warmer areas. If you can put in parks and green spaces, that's important. Reducing traffic and having fewer freeways near people is really important because it reduces exhaust.
Also, how do we reduce traffic in dense urban areas? Bike lanes are a great example. They increase health and reduce pollution, making them an effective initiative.
Then, there's the transition to renewables. Changing our energy mix from carbon-based to cleaner energy sources reduces harmful outputs. This is important both locally and on a larger scale.
You can start by planting trees in your neighborhood at a micro level. Trees cool your area and make it less hot, promoting good walking areas. On a larger scale, renewable energy reduces exhaust and the demand for carbon-based fuels.
How can average everyday residents actively contribute to these efforts?
I think it's a bit weak to say, "Recycle, change your lightbulbs." The most important thing is being conscientious about the risks. These are increasing risks, not going away. They're getting worse and putting all of us at risk. No one's really safe.
For example, if you ever lived in Pacific Palisades, you might have felt as safe as anyone. It's a wonderful neighborhood, full of trees, but no one is safe. Bellevue Hospital, where I worked, is a safety-net hospital for New York City, and it wasn't safe after a tropical cyclone hit it. It knocked the hospital offline for six months. So, even in resource-rich places, these risks are real.
It's about talking to your neighbors, voting with your pocketbook, and incentivizing renewables if you can afford it. But understanding that we're leaving a worse place for our kids is key. This isn't a conservative or liberal issue, even though it's been portrayed that way. We need solutions, and both parties need to acknowledge the risks. Right now, one party has refused even to recognize that this is a problem, and that's a significant obstacle. The tragedy is that it doesn't matter; it's getting worse every year. It's terrible.
Please visit our list of wildfire resources for those living in the LA area. Further, see Dr. Jay at the 2025 EMA IMPACT Summit this May!