Joie Acosta and Regina Shih, RAND Corporation: California utility companies are increasingly triggering power outages by their own accord to try to prevent wildfires. But the practice may endanger elderly people and individuals with power-dependent medical devices.
California utility companies are increasingly triggering power outages by their own accord to try to prevent wildfires. But the practice may endanger elderly people and individuals with power-dependent medical devices.
While intentionally shutting off power may be a practical way to prevent power lines from sparking wildfires, is it worth the risks?
Indeed, planned power outages may be hurting the very populations they seek to protect.
California has had the 10 costliest wildland fires in the United States, with damage ranging from $1.3 billion to $10.5 billion.
These wildfires disproportionately affected older adults because older adults are more likely than other age groups to be socially isolated, to face challenges with evacuating, and to have chronic health conditions.
Likewise, when the power gets turned off to prevent wildfires, older adults are likely to be at-risk for injury or death. While the impacts on individuals unprepared for a power outage are unknown, other weather events indicate that health risks for the elderly are significant.
For example, during 2017’s Hurricane Irma, the most common causes of death were related to power outages that exacerbated existing medical issues. Among the power-outage-related deaths, most were heat-related deaths of older adults, followed by a much smaller number of deaths among patients on electricity dependent medical treatment, such as ventilators and dialysis machines.
Within California there are at least 176,483 electricity dependent individuals.
Despite the fact that these individuals are unlikely to be enrolled in a registry with their county or city or with their electric company, this population is frequently included in public health and health care emergency plans, where they receive education on how to create a personal preparedness plan to best preserve medications and, in some instances, access back-up power generators.
However, the same is not true for older adults, particularly those who are aging in place. There is no national level agency identified in policy or by legal frameworks that is directly accountable for older adults’ protection and resilience.
Nearly 6 million Californians are over 65 years of age. This is the fastest growing population in California.
By 2030, there will be 10.9 million older Californians. most of whom are likely to prefer aging in place if national surveys are any indication.
This presents a challenge for public health authorities: how and who should locate older adults during emergencies. This should also be a consideration for utility companies.
Utility companies are most likely to order a power outage to prevent wildfires on days with high heat, high winds, and low humidity. Yet even short periods of extreme heat caused by lack of air conditioning can aggravate health conditions, as older adults are less heat tolerant, may rely on refrigerated medication, and are therefore at an increased risk of heat-related morbidity and mortality.
With the large and growing population of older adults, an expected increase in the frequency and intensity of hot days due to climate change, and the possibility that power outages can last for up to five days, planned power outages to prevent wildfires could have grave public health implications for older adults.
Our prior research suggests public health and emergency management departments within states rarely coordinate when it comes to preparing older adult, disabled, or medical device-dependent populations for weather-related disasters.
There also appears to be a lack of communication and planning with the private sector for intentional power outages. This is a potentially disastrous recipe.
California law requires that electric utilities make attempts to notify and coordinate with local communities before and after a shutdown event. Reaching older adults, particularly those aging in place, will require a new type of outreach by public health authorities.
Public health authorities, in partnership with utility companies and emergency management agencies, could rely on existing aging-in-place efforts to locate and reach older adults.
For instance, there are almost 400 communities enrolled in AARP’s Age-Friendly Network. And more than 200 villages in 45 states and the District of Columbia that facilitate social support and community connections for older adults.
Groups such as these can bring critical expertise on the needs of and access to older adults across the spectrum, from those with multiple vulnerabilities to those that are high functioning. This expertise is needed to ensure that older adults are protected during planned as well as unplanned power outages.
We recently designed a toolkit based on our research to promote older adults’ resilience and to provide operational guidance on aligning public health departments with other agencies to protect the health and well-being of older adults; utility companies might also benefit from these collaborations.
Older people stand to suffer when the power goes out. Until more thoughtful and comprehensive decisions are made, planned power outages need to be planned better.