The Impacts of Extreme Weather on Older Adults

Communities are facing “polycrises” from the COVID-19 pandemic to unpredictable economies, where rising inflation and interest rates are affecting prices from the gas pump to the dinner table. People are facing food and energy scarcity, political instability, multiple wars, and other external disruptions that create uncertainty.

Meanwhile, climate-related extreme weather events are increasing in frequency, severity, and cost. Billion‑dollar natural disasters are becoming the new normal. Concurrent weather events challenge federal, state, local, tribal, and territorial emergency management agency (EMA) resources and community resilience.

As older adults account for a larger share of our population, EMAs will have to consider these additional at‑risk individuals during  disaster planning, response, and recovery. An increase in older adults will likely result in a greater number of individuals at risk during a natural disaster. The growing older adult population will increase demand on resources and strain critical sectors (e.g., health care, housing, emergency services) and support services. Understanding their distinct needs and expectations is critical to ensuring their safety and will help them to rebuild following a natural disaster.

In this report, CNA’s Center for Vulnerable Population Protection examines how climate-related extreme weather events affected the health, housing, and economic security of older adults over the past 10 years. This report defines extreme weather by the type of hazard (e.g., drought, heat wave, flooding, severe storm, wildfire, winter weather, tropical cyclone (hurricane)) and level of risk (at the county level). CNA examined counties in four states—Arizona, California, Florida, and Missouri—focusing on health, housing, and economic effects and how governments (including emergency management) supported older adults during the planning for, response to, and recovery from natural disasters.  

Because of the increasing frequency, severity, and cost of weather events; the increasing number of older adults in the US; and the enhanced vulnerability of older adults during severe weather, this report explores the effects of climate-related extreme weather events on older adults and the current state of federal, state, and local emergency management agencies’ planning, response, and recovery efforts to include and assist this population.

Key assumptions

• A growing older adult population will increase demand on resources and strain critical sectors (e.g., health care, housing, emergency services) and support services.
• Polycrises and concurrent disasters challenge federal, state, and local EMAs and communities.
• Continued social polarization, social unrest, political instability, and upcoming 2024 national elections will affect climate policy and continue to delay urgent climate mitigation strategies needed to protect communities.
• At-risk communities will continue to face climate-related health, housing, and economic effects without prioritized and rapid federal, state, and local government intervention.

Key insights

Climate-related extreme weather events

• Natural disasters and extreme weather events rank as the top two most severe global risks to the world in the upcoming two-year period.
• Climate-related extreme weather events are increasing in frequency, severity, and cost. Extremely high disaster activity and billion‑dollar natural disasters are becoming the new normal.
• State and local governments may be more vulnerable and less prepared for extreme weather events.

Growing aging population

• As older Americans account for a larger share of the population, more people will likely face vulnerabilities and increased risk during natural disasters.
• A growing older adult population, increasing extreme weather events, and a gap in the health care workforce will increase demand on resources.
• More targeted research on the effects of extreme weather events on older adults is needed to help EMAs and communities better plan for emergencies and disasters.

Health

• Due to aging immune systems and chronic and underlying conditions, older adults face vulnerabilities and increased risk of injury and mortality during extreme weather.
• Older adults with disabilities face higher risks of injury and mortality during extreme weather events. 
• Older adults are especially vulnerable to climate-driven decreases in air quality.
• Extreme heat is the greatest climate risk to the older adult population.
• Climate change may increase exposure to pathogens in older adult populations.
• More people will likely be affected by acute mental health effects as a result of increasing natural disasters and extreme weather events.
• Existing shortages of health care workers exacerbate risks to individuals who require immediate care during disasters.

Housing and location

• Older adults are particularly vulnerable to climate change–related health effects based on the characteristics of their homes, such as the  age, quality of construction, and amenities.
• Multiple factors disincentivize older adults from making home improvements to prepare for extreme weather.
• Geographic location is a factor in how extreme weather events affect older adults.
• Social isolation increases risk during natural disasters, since the population living alone increases with advanced age.

Economic effect

• The increase in extreme weather events is resulting in significant social and economic costs to older adults.
• Insurance costs have increased, but in some states, insurance options have decreased, putting older adults at risk of being uninsured. 

Emergency management

• A lack of inclusive disaster mitigation and preparedness planning can have devastating effects on older adults during extreme weather events. 
• Despite the dangers of extreme heat on older adults, it is not listed as a qualifying event in the statutory definition of major disasters.
• State laws do not provide specific guidance on how counties should plan for and include older adults and individuals with access and functional needs in evacuation plans.
• Older adults have distinct medical needs that make them less likely to evacuate in disasters. 
• Households with older adults are likely to be tied to their communities and their homes and are less likely to evacuate. 
• Many households with older adults have limited resources, a lack of transportation, and other barriers to evacuation. 
• Early warning systems are not always designed for older adults.
• Disaster communications may not reach older adults, causing gaps in information‑sharing and trust. 
• Older adults who shelter in place are susceptible to cascading effects of disaster impacts, such as physical damage and loss of access and power. 
• Evacuation shelters may not fully accommodate the needs of older adults.

Key recommendations

Federal recommendations

• Congress should update the Stafford Act and introduce legislation to add extreme heat to the list of disasters for which states can  request an emergency or disaster declaration, making them eligible for assistance from the Federal Emergency Management Agency's  (FEMA's) individual assistance and public assistance programs and other federal government support. 
• Congress should pass legislation to improve the inclusion of older adults and individuals with disabilities in the mitigation, preparation, response, and recovery phases of natural disasters.
• Congress should update the Stafford Act to help states better prepare for multiple disasters.
• Congress should issue a review of early warning systems to standardize the systems and embed accountability.
• Congress should appropriate funds to FEMA for the express purpose of ensuring that evacuation shelters provide accommodations to ensure the safety of older adults. 
• The President should sign an executive order charging federal agencies to develop or update emergency management plans to 
  allow for an increase in concurrent extreme weather events.

Federal agency recommendations

• FEMA should bolster its Building Resilient Infrastructure and Communities program to help communities increase resilience to heat  waves, droughts, wildfires, floods, hurricanes, and other hazards by preparing before disaster strikes.
• Federal agencies should review, consolidate, and enhance existing guidance for effective communications before, during, and after disasters. A comprehensive guide should be regularly updated and distributed across all response agencies and nongovernmental organizations to foster consistency in communication.
• The Centers for Medicare and Medicaid Services Quality, Safety & Oversight Group should review and update the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule to ensure it adequately addresses the risk of compound, consecutive extreme weather events.

Federal, state, and local government recommendations

• Federal, state, and local EMAs must clearly identify and better understand the distinct needs of the growing older adult population; adopt evidence-informed, uniform, and collaborative emergency preparedness interventions for all older adults, particularly for those  who live alone and use medical equipment requiring electricity; and ensure programs tailored to older adults are adequately resourced and available before, during, and after disasters. 
• Federal, state, and local EMA emergency management plans should include tailored interventions to support older adults, particularly those with economic barriers to evacuating or relocating.
• Federal, state, and local EMAs must ensure transportation and sheltering resources are available, plentiful, and free for evacuees to encourage evacuation compliance. The evacuation needs of older adults and other at-risk groups must also be identified and met.
• Federal, state, and local EMAs should fund and coordinate with community organizations, including faith-based organizations, to build trust and reach older adults during and after a disaster.
• Emergency management plans should include tailored interventions to support older adults, particularly those who live alone and are electricity dependent.
• Federal, state, and local governments should conduct scenario planning and other mitigation tools to better understand the key drivers of polycrises and to develop a framework to better prepare for polycrises.

State recommendations

• State and local governments should collaborate and exchange climate data and best practices with other state and local entities with  higher hazard risk, including extreme heat, and/or vulnerable populations.
• State laws should require detail in evacuation plans concerning older adults and individuals with access and functional needs and  specify funding amounts to be dedicated to inclusive planning for this growing population.