Tackling Environmental Health Risks: Strategies for Health Plans, Health Systems, and Population Health Improvement Organizations

Introduction

Environmental factors significantly influence health outcomes, particularly for vulnerable populations. Excessive heat, poor air quality, pest infestations, and other environmental hazards can lead to severe health conditions like heatstroke, asthma, cardiovascular events, and more. Health plans , health systems , and population health improvement organizations can help mitigate the adverse effects of the environment on members’ health and well-being as part of their population health objectives.

Weather and environmental factors are associated with several health risks.

Environment-Related Health Risks

Heat-Related Health Risks Extreme heat poses a serious threat, particularly to older adults, individuals with chronic conditions, and those in low-income communities. Socially vulnerable groups and unhoused people are more likely to experience the adverse effects of extreme weather events and are less able to recover from them.

Air Quality Increased air pollution, particularly ground-level ozone and particulate matter, can affect respiratory health . People with pre-existing respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD) are especially vulnerable. Allergies, hypertension, cardiovascular disease, heart attacks, and stroke have been associated with poor air quality. Cardiovascular health can be affected by air quality, extreme temperatures, ground-level ozone, and weather events.

Pest Infestation and Allergies Cockroach infestations are a known trigger for asthma, particularly in urban areas where housing conditions may be suboptimal. Between 17% and 41% of people are allergic to cockroaches.

Food Insecurity and Nutritional Health Droughts and floods can disrupt food supplies, leading to food insecurity, foodborne illnesses, and malnutrition.

Population Health Strategies

Here are some population health strategies health plans should consider:

Implement Heat Alert Programs

• Notify vulnerable populations of upcoming heat events.
• Provide guidance on staying safe during extreme heat.
• Partner with community organizations to distribute cooling devices and ensure access to air-conditioned spaces.

Address Air Quality Alerts

• Use data analytics to predict air quality-related health risks.
• Proactively manage care for patients with respiratory conditions like asthma and COPD.
• Offer resources such as air purifiers or cover preventive medications during high-risk periods.
• Support changes to living spaces for the highest-risk members.

Address Pest Infestation and Allergies

• Support Integrated Pest Management (IPM) techniques for members affected by pest infestation.??
• Collaborate with housing authorities and community organizations to manage pest control.
• Educate members on reducing exposure to allergens.
• Cover home visits by pest control specialists as part of asthma management programs.

Support Cardiovascular Health

• Offer screenings and monitoring for at-risk populations during periods of heightened environmental risk.
• Use remote monitoring technology to track cardiovascular health metrics in real-time.
• Enable timely interventions based on environmental stressors.

Promote Food Security and Nutrition

• Support sustainable agricultural practices and local food systems.
• Partner with food banks to ensure access to nutritious food.
• Offer food delivery services for members in food deserts to provide balanced meals during environmental disruptions.
• Introduce Food is Medicine programs.
• Provide refrigeration to manage perishable foods and support access to nutritious shelf-stable foods.

Examples In Action

Here are a few examples of various efforts designed to address the population health impacts?associated with environmental factors.

• Elevance Health - Commitment to Climate and Health
• CareOregon Community Investments to address food insecurity.
• Blue?Zones? approach to improving population health.
• The Food Trust activities to support healthy food access.
• AIR Louisville: Addressing Asthma with Technology, Crowdsourcing, Cross-Sector Collaboration, And Policy
• Denver Department of Public Health & Environment's Love My Air program with grant funding from Kaiser Permanente
• IEHP's Community Supports Program
• United Healthcare Food Delivery program

Conclusion

Implementing targeted interventions and collaborating with community organizations, health plans, health systems, and population health organizations can help mitigate the impact of environmental factors on their members – especially the vulnerable. Taking a population health approach to addressing environmental-related risks will benefit individual members and reduce morbidity, mortality, and avoidable healthcare costs across the populations served.

Let us know what your organization is doing to address the impact of environmental factors on population health.

Michael S. Barr, MD, MBA, MACP, FRCP | Senior Director, Population Health Improvement Population Health Alliance (PHA)

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