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Press release

Heat related illnesses dramatically on the rise among US Veterans

Philadelphia | August 22, 2023

Analysis of geographic and demographic patterns reported in The Journal of Climate Change and Health uncovered 18-year increase in heat related illness and suggests that targeted interventions can ease the health consequences of extreme weather 

Researchers report a statistically significant and clinically important increase in heat related illnesses among patients at US Department of Veteran Affairs (VA) health facilities across the United States between 2002 and 2019. The studyopens in new tab/window, which appears in The Journal of Climate Change and Healthopens in new tab/window, published by Elsevier, documents far-reaching negative consequences of extreme-weather. 

Lead investigator Thomas F. Osborne, MD, VA Palo Alto Healthcare System and Stanford University School of Medicine, commented, “Our goal is to provide the best care for our patients, and understanding health risk is critical to our mission. Our team has incredible analytics staff, which, combined with expertise from partners at the CDC, has empowered us to uncover important insights. The data are a call to action as they expose a steady increase in the incidence of severe heat related illnesses in our US Veteran patient population. Although no one is immune from this danger, those who are traditionally the most vulnerable face the greatest risk of heat related illnesses.” 

Not surprisingly, the study found that specific groups of patients, such as those with existing health conditions and within specific ethnic groups, experienced higher rates of heat related illness.  

Co-investigator Zachary Veigulis, MS, US Department of Veterans Affairs, Palo Alto Healthcare System, and Department of Business Analytics, Tippie College of Business, University of Iowa, noted, “The extensive electronic health records from the VA, the US’s largest healthcare system, made it possible to understand the scope and scale of the growing danger and predict and identify individuals at greatest risk so we can target interventions.”

HRI slope change by US state 2002 - 2019

Caption: Heat map of all 50 US states and District of Columbia. Color corresponds with slope change of heat related illness (HRI) diagnoses over our assessment period (red=larger positive slope, followed by orange, and the least slope change in yellow) (Credit: The Journal of Climate Change and Health). 

While every state had residents that suffered heat related illnesses during the study period, the state-by-state numbers did not mirror geographic climate trends, possibly because the traditionally warmer states had already adopted policies, procedures, and practices to mitigate the health consequences of environmental heat. Another finding that suggested interventions reduce the growing health risk was the declining rate of heat related illness for homeless US Veterans in the second half of the study’s timeframe, a period after the launch and expansion of additional VA homeless health and wellness programs.   

Dr. Osborne added, “This assessment represents a critical first step in understanding the challenge, which is required to inform optimal care and prevention strategies. However, there is much more work to be done. While the physical impact of environmental heat is critically important, it is only one of many climate-related health dangers. Climate change-related health risks such as the unprecedented spread of infectious disease, wildfires, migration, infrastructure damage, as well as food and water insecurity are now central issues of our time. Urgent collaborative action is required to avoid additional suffering.” 


Notes for editors

The article is Trends in heat related illness: Nationwide observational cohort at the US department of veteran affairs,” by Thomas F. Osborne, Zachary P. Veigulis, Ambarish Vaidyanathan, David M. Arreola, and Paul J. Schramm ( in new tab/window). It appears in The Journal of Climate Change and Health, volume 12 (July-August 2023), published by Elsevier

The article is openly available at in new tab/window

Full text of the article is also available to credentialed journalists upon request. Contact Eileen Leahy at +1 732 238 3628 or [email protected]opens in new tab/window to request the PDF of the article. To request an interview with the authors please contact Madison Coffey at [email protected]opens in new tab/window.  

Healthy adaptation and mitigation of climate change – the greatest public health concern of our time – will be the focus of the upcoming climatehealth2023.comopens in new tab/window, to be held October 21-22, 2023 at the Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY. This inaugural hybrid meeting is organized by The Journal of Climate Change and Health editorial board members. The conference is sponsored by Elsevier along with the CDC Foundation and the Climate & Health Foundation. 

About The Journal of Climate Change and Health

The Journal of Climate Change and Healthopens in new tab/window is a worldwide scientific peer-reviewed gold open access medical journal that publishes high quality scientific works related to acute and chronic climate related disasters, migration, changing patterns of disease and the impacts of climate change on individuals and health systems.

About Elsevier

As a global leader in scientific information and analytics, Elsevier helps researchers and healthcare professionals advance science and improve health outcomes for the benefit of society. We do this by facilitating insights and critical decision-making with innovative solutions based on trusted, evidence-based content and advanced AI-enabled digital technologies.

We have supported the work of our research and healthcare communities for more than 140 years. Our 9,500 employees around the world, including 2,500 technologists, are dedicated to supporting researchers, librarians, academic leaders, funders, governments, R&D-intensive companies, doctors, nurses, future healthcare professionals and educators in their critical work. Our 2,900 scientific journals and iconic reference books include the foremost titles in their fields, including Cell Press, The Lancet and Gray’s Anatomy.

Together with the Elsevier Foundationopens in new tab/window, we work in partnership with the communities we serve to advance inclusion and diversity in science, research and healthcare in developing countries and around the world.

Elsevier is part of RELXopens in new tab/window, a global provider of information-based analytics and decision tools for professional and business customers. For more information on our work, digital solutions and content, visit

Media contact


Eileen Leahy


+1 732 238 2628

E-mail Eileen Leahy