Will a Rising Tide Sink All Boats? Examining the Unequal Distribution and Health Impact of Extreme Weather Events

Background: Climate change is intensifying and poses an increased threat to health. However, limited attention has been paid to the social patterning of exposure to extreme weather events, specifically among socially marginalized communities such as people with disabilities, LGBTQ people, those in rural areas, and racialized minorities. Methods: Data from the 2023 California Health Interview Survey, a survey of California adults, were used to examine if exposure to any extreme weather events varied across a range of sociodemographic and health-related characteristics (e.g., sexual orientation, race/ethnicity, gender, rurality, have any health conditions), and if these exposures to these weather-related events were associated with physical or mental health impacts for anyone in the household. Multivariable logistic regression models were used. Results: Respondents who identified as American Indian or Alaska Native, bisexual and pansexual, lower income, completed some college or more, living in rural areas, had a health condition, having experienced psychological distress, or had a disability had higher odds of reporting that someone in their household had experienced an extreme weather event. In terms of health harm from weather events, bisexual people, pansexual people, transgender people, people with disabilities, people with health conditions, and those living in rural areas were more likely to experience harm. Discussion: Human-fueled climate change is set to have devastating impacts on health in the coming decades. This study suggests that these impacts will disproportionately fall on structurally marginalized communities.