The potential impacts of climate variability and change on health impacts of extreme weather events in the United States

Extreme weather events such as precipitation extremes and severe storms cau se hundreds of deaths and injuries annually in the United States. Climate c hange? may alter the frequency, timing, intensity, and duration of these ev ents. Increases in heavy precipitation have occurred over the past century. Future climate scenarios show likely increases in the frequency of extreme precipitation events, including precipitation during hurricanes, raising t he risk of floods. Frequencies of tornadoes and hurricanes cannot reliably be projected. Injury and death are the direct health impacts most often ass ociated with natural disasters. Secondary effects, mediated by changes in e cologic systems and public health infrastructure, also occur. The health im pacts of extreme weather events hinge on the vulnerabilities and recovery c apacities of the natural environment and the local population. Relevant var iables include building codes, warning systems, disaster policies, evacuati on plans, and relief efforts. There are many federal, state, and local gove rnment agencies and nongovernmental organizations involved in planning for and responding to natural disasters in the United States. Future research o n health impacts of extreme weather events should focus on improving climat e models to project any trends in regional extreme events and as a result i mprove public health preparedness and mitigation. Epidemiologic studies of health effects beyond the direct impacts of disaster will provide a more ac curate measure of the full health impacts and will assist in planning and r esource allocation.