2025 Theses Doctoral

Shedding light on power outages as a climate change-related health-relevant exposure

Do, Vivian

Electrical interruptions—during which access to electricity becomes unavailable—are prevalent in the United States (US). I refer to power outages as periods of prolonged electrical interruptions and electrical interruptions as a broader category of electricity inaccessibility. Electricity has become an essential service to power public infrastructure and individual housing needs. Given such reliance on electricity, power outages can threaten health in several ways.

As an example, power outages are life-threatening for those using electricity-dependent durable medical equipment, such as oxygen concentrators. Power outages can also precipitate adverse health outcomes by increasing exposure to extreme temperatures. Moreover, power outages during severe weather events can act synergistically to negatively impact health. It is also important to recognize that power outages disproportionately occur in and affect marginalized communities, possibly shaped by historical discriminatory patterns in differential investment in electricity infrastructure, grid maintenance, and housing stock quality.

The health effects of power outages do not affect everyone equally. For example, impact of power outages on cardiovascular outcomes could be worse for older adults due to the subgroup’s high prevalence of cardiovascular disease. Despite these factors, power outages remain an understudied health exposure.I frame power outages as a climate change-related exposure since most US power outages are driven by severe weather events, especially in recent years. Severe weather events (e.g., tropical cyclones, winter storms, extreme heat) caused over half of all electrical interruptions and approximately 80% of major power outages—events impacting over 50,000 customers or resulting in a loss of 300MW of electricity.

Framing power outages as an exposure both related to climate change and health is crucial for protecting population health in the future. By explicating the links among power outages, climate change, and health, I seek to show that power outages (a) are a growing threat as they likely will increase in frequency, (b) occur in conjunction with other climate change-related exposures (i.e., severe weather events), and (c) have potential differential patterns in exposure and health effects. These considerations are vital for evaluating power outages’ health impacts comprehensively and ultimately informing interventions to minimize related health consequences.

The overall goal of this dissertation is to frame and present power outages as a climate change-related exposure with potential public health implications. In Chapter 1, I introduce the pathways linking power outages to climate change and health. I discuss the ways in which power outages have disparate exposure patterns that inequitably burden marginalized communities.

Additionally, I present current gaps in the power outage literature about documenting small-scale power outages that our work aims to address. In Chapter 2, I characterize power outages, introducing definitions for discrete outage events (e.g., small-scale and large-scale) nationwide. I also evaluate county-level patterns of power outages across levels of social vulnerability and in conjunction with severe weather events. I discuss the importance of furthering power outage exposure assessment and collecting data in areas lacking reliable electricity information.

In Chapter 3, I describe the co-occurrence of power outages and severe weather events spatially and temporally. For this study, I considered individual severe weather events and multiple simultaneous weather events. I discuss the implications of understanding patterns of power outages co-occurring with severe weather events for appropriate preparedness and response efforts. In Chapter 4, I quantify the impact of power outages on cardiovascular hospitalizations among older adults in New York State (NYS).

This study considers individual- and area-level sociodemographic characteristics while also accounting for urbanicity levels. I discuss the need to continue research on the effects of power outages on health, especially for vulnerable subgroups. Lastly, in Chapter 5, I conclude this dissertation with a summary of key findings, a discussion of remaining gaps that are important to address, and a presentation of potential strategies to reduce power outages and mitigate related health consequences. These proposed potential strategies are grounded in the context of climate change and environmental justice.