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                              Climate Change & Health Equity, and Environmental Justice at HHS
                              Climate Change and Health Equity
                              Climate and Health Outlook
                              Drought
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Drought








  
  
    

  
      



Drought Outlook for April 2024

The National Weather Service Climate Prediction Center's Monthly Drought Outlook is issued at the end of each calendar month and is valid for the upcoming month. The outlook predicts whether drought will persist, develop, improve, or be removed over the next 30 days or so.
***Figure:** The National Weather Service Climate Prediction Center's Monthly Drought Outlook is issued at the end of each calendar month and is valid for the upcoming month. The outlook predicts whether drought will persist, develop, improve, or be removed over the next 30 days or so. For more information, please refer to**drought.gov**.*

During April, drought improvement and removal is favored in portions of the Southeast, Midwest, Northern Great Plains, Southern Great Plains, and the Southwest. No drought development is predicted during April, but drought persistence is forecasted across drought areas of the Southwest, Northwest, Northern Great Plains, Southern Great Plains, the Midwest, and in parts of Hawaii, Puerto Rico, western New York and Nantucket Island, and eastern North Carolina. Drought can have direct and indirect impacts on health—increasing incidence of illness among those living in the affected area and worsening mental health outcomes as livelihoods are challenged.
                        Drought’s Impact on Mental Health: Outcomes and Particularly At-Risk Populations
    Drought is a slow-moving climate disaster with both direct and indirect impacts on mental health. Farmers and their families are of particular concern because drought affects their jobs and livelihoods which in turn leads to stress and other health impacts. A recent study looking at the association between drought exposure and the risk of death by suicide in the United States from 2000 to 2018 found an association between all drought types and increased firearm suicides among U.S. farmers – the more severe the drought, the greater the association. A systematic review identified additional vulnerable populations for the impact of drought on mental health including rural or remote populations and indigenous populations. A few of the factors that can be exacerbated by drought and lead to anxiety and/or depression are struggling economies, migrations of community members, feelings of humiliation, household tension, and increased workloads.

Keep It Together by Tammy West. Artist’s statement: Texas and much of the Western United States have been experiencing climate change-induced severe drought. This site-specific piece focuses on our collective climate grief.
***Figure:*** *Keep It Together by Tammy West**. Artist’s statement: Texas and much of the Western United States have been experiencing climate change-induced severe drought. This site-specific piece focuses on our collective climate grief.*
                        Average Drought Level Across the U.S. in 2023
    This map shows the Drought Severity and Coverage Index (DSCI) values for the U.S. from January 1, 2023–December 31, 2023. The DSCI is an experimental method for converting drought levels from the U.S. Drought Monitor map to a single value for a county.
***Figure:**This map shows the Drought Severity and Coverage Index (DSCI) values for the U.S. from January 1, 2023–December 31, 2023. The DSCI is an experimental method for converting drought levels from the U.S. Drought Monitor map to a single value for a county.*

The year 2023 was the 3rd driest for the contiguous U.S. on record. From January 1, 2023 - December 31, 2023, the majority of the U.S. experienced some level of abnormal dryness as measured by the Drought Severity and Coverage Index (DSCI). The DSCI values range from 0 to 500, where 0 means that none of the area was on average abnormally dry or in drought, and 500 means that all of the area was on average in exceptional drought. The Northwest, Midwest, Northern Great Plains, and Southern Great Plains generally had the highest levels of drought. 23 U.S. counties (six in Kansas, ten in Nebraska, and seven in Texas) had DSCI values in the highest range (>400), meaning they experienced exceptional drought. Additional counties in those states along with one in Oklahoma ranked in the top 50 for drought in the past year. Only 18 out of the 3,231 counties for which we have measurements experienced an average DSCI value of zero.
                        Drought Affects Health in Many Ways

Drought increases the risk for a diverse range of health outcomes. For example:

Low crop yields can result in rising food prices and shortages, potentially leading to **malnutrition**.

Dry soil can increase the number of particulates like **dust and pollen** that are suspended in the air, which can irritate the bronchial passages and lungs.

Dust storms can spread the fungus that causes coccidioidomycosis (**Valley Fever**).

If there isn’t enough water to flow, waterways may become stagnant breeding grounds for **disease vectors** like mosquitos as well as viruses and bacteria.

Drought's complex economic consequences can increase **mood disorders**, **domestic violence**, and **suicide**.

Long-term droughts can cause **poor-quality drinking water** and leave inadequate water for hygiene and sanitation.
                        Who is at high risk in the counties projected to have drought in March?
    As indicated in the map to the left, **274 counties** across **18 states** are projected to have persistent/remaining drought or drought development in November. In these counties, the total population at risk is **11,602,878 people** and, of those, **211,337 people** work in agriculture. Of these counties:

**106 (39%)** have a high number* of people aged 65 or over, living alone.

**81 (30%)** have a high number of people living in rural areas.

**70 (26%)**have a high number of people living in poverty.

**48 (18%)** have a high number of people with frequent mental distress.

**49 (18%)** have a higher number of adults with asthma.

**71 (26%)** have a high number of people without health insurance.

**108 (39%)** have a high number of uninsured children.

**8 (3%)** have a high number of Black or African American persons.

**63 (23%)** have a high number of people with severe housing cost burden.

**74 (27%)** have a high number of people in mobile homes.

**64 (23%)** have a high number of people with one or more disabilities.

**75 (27%)**are identified as highly vulnerable by CDC's Social Vulnerability Index.

**“A high number” indicates that these counties are in the top quartile for this indicator compared to other counties*
                        Notes from the Field: Alan Woolf, MD, MPH on Protecting Private Well Water in Times of Flood & Drought
    Climate change is affecting the frequency and severity of both flooding and drought in many areas of the US. Both conditions pose potential risks for well water, which are important considerations for healthcare and public health. To better understand the implications for families, we consulted Dr. Alan Woolf, an internationally-recognized environmental toxicologist, a practicing pediatrician for nearly 40 years, and a part of the Pediatric Environmental Health Center at Boston Children’s Hospital. In counseling families who have private wells, he has seen firsthand how climate-related hazards affect drinking water safety.

**Flooding**

Flooding is a common cause of private well contamination with bacteria and other pollutants that can cause illness. Rapidly flowing flood water can carry large debris that hits wells, loosening or dislodging well hardware, while coarse sediment in the flood water can erode pump components. If the well is not tightly sealed, the sediment and flood water can enter the well and contaminate it. Floods may even cause some wells to collapse.

*“Well water quality has been a concern for my patients’ families throughout the Northeast due to major flooding in the summer of 2023. I recently cared for a patient who was having neurologic symptoms whose family discovered that their leaves had a coppery sheen – it turned out their well cap had been breached during recent flooding and their well water was contaminated with manganese, which was the cause of the patient’s symptoms. Another child in my care had gastrointestinal symptoms after a flooding event – the family had their well water inspected and it showed high coliform bacteria, increased metals, and other evidence of contamination.”*- Dr. Woolf

**Drought**

During a drought, aquifers can get depleted from overextraction and inadequate replenishment, leading to a lack of potable water for families with wells. In addition, drought conditions can change the dynamics of groundwater, potentially leading to natural contaminants flowing into the water from bedrock such as arsenic, which can be harmful to health with chronic exposure. You can read more about these concerns from USGS: Groundwater Decline and Depletion and Drought May Lead to Elevated Levels of Naturally Occurring Arsenic in Private Domestic Wells*.*

*“Water quality concerns are elevated when children are drinking from private wells. I recommend my patients’ families with private well water get their water tested regularly and be aware of these extra challenges during times of flooding and drought.”* - Dr. Woolf

**Resources to protect well water**

While EPA does not regulate private wells, they do offer guidance to private well owners. To help protect your well during times when it may flood, make sure you can see and access your well cap to assess threats. Even without obvious damage, wells that are more than 10 years old or less than 50 feet deep are likely to be contaminated during a flood. If you suspect your well has been contaminated, EPA provides specific recommendations for well owners to follow in its short guide What to do After the Flood, and CDC provides recommendations for Disinfecting Wells After a Disaster.

The EPA does not have specific guidance for private wells during drought, but they recommend testing private wells****annually (or more frequently if small children, elderly adults, or somebody who is pregnant or nursing is drinking the water, as these segments of the population have elevated vulnerability to pollutants), immediately after significant flooding and other nearby activities, and if there are signs of drought impacts such as a change in taste or color of the water, sputtering faucets, sudden pressure changes, or air bubbles.

Dr. Woolf has also co-authored a policy statement for the American Academy of Pediatrics on Drinking Water From Private Wells and Risks to Children.
                        Drought and Arsenic in Domestic Wells
    Map showing the probability of having high arsenic in domestic wells during drought
***Figure**: Map showing the probability of having arsenic >10 μg/L (“high arsenic”) in domestic wells during drought. Arsenic occurs in groundwater due to chemical reactions between the rocks and water, lowering of water levels due to drought may cause chemical changes that release more arsenic from the rocks.  Less water could also concentrate existing arsenic in the water. Hotspots generally reflect areas in the U.S. with high observed concentrations including New England (predominantly Maine and New Hampshire), a band in the upper Midwest, the southwest (most notably Nevada, southern Arizona, southern and central California, and isolated regions in all western states), and southern Texas.*

Drought conditions can lead to elevated levels of naturally occurring arsenic in the water we drink. The risk of contamination increases the longer that a drought persists. In a study done by U.S. Geological Survey and Centers for Disease Control and Prevention in 2021, researchers estimated that over 9% (4.1 million) of the 44.1 million people in the lower 48 states who use private domestic wells were potentially exposed to unsafe levels of arsenic during drought conditions compared to about 6% (2.7 million people) during non-drought conditions. Chronic exposure to arsenic from drinking water is associated with an increased risk of several types of cancers, developmental issues, cardiovascular disease, adverse birth outcomes and impacts on the immune and endocrine systems.
                        Resources to Reduce Health Risks Associated with Drought

Drought poses many and far-reaching health implications. Some drought-related health effects occur in the short-term and can be directly observed and measured. But the slow rise or chronic nature of drought also can result in longer term, indirect health implications that are not always easy to anticipate or monitor.
                        General Preparedness
    The Centers for Disease Control and Prevention (CDC) Drought and Health site and Ready.gov Drought site have information on the health implications of drought and how to prepare. The U.S. Drought Portal provides data, decision-support products, resources, and information on drought.

Graphic showing the droughts are among the most harmful and costly of all natural disasters
*Image source: https://www.cdc.gov/nceh/hsb/cwh/docs/CDC_Drought_Resource_Guide-508.pdf*
                        For Farmers
    The Department of Agriculture offers programs that can help with drought recovery as well as those that can help farmers manage risk and build resilience. The Department’s Climate Hubs feature regional resources including vulnerability assessments and tools and a Climate, Agriculture, and Forest Science Webinar Series.

The U.S. Drought Monitor is an online, weekly map showing the location, extent, and severity of drought across the United States. The Department of Agriculture uses the Drought Monitor to determine a producer’s eligibility for certain drought assistance programs. You can report drought-related conditions and impacts within the U.S. and associated territories to the Drought Monitor.

The Department of Agriculture’s Natural Resources Conservation Service can help farmers conserve water and build resilience to drought, through conservation practices that improve irrigation efficiency, boost soil health, and manage grazing lands.

Graphic depiction of soil health building drought resiliency
*Image source: https://www.farmers.gov/blog/making-your-land-more-resilient-drought*
                        Mental Health
    Drought is a slow-moving hazardous event, so the psychological effects of living through this type of disaster are more subtle and last longer than with other natural disasters. The Substance Abuse and Mental Health Services Administration (SAMHSA) Helpline and Text Service is available 24/7, free, and staffed by trained crisis counselors. Call or text 1-800-985-5990 to get help and support for any distress that you or someone you care about may be feeling related to any disaster.

Funded by the Federal Office of Rural Health Policy within the Health Resources and Services Administration, the Rural Health Information Hub offers several resources about drought and other stressors farmers face, as well as information and resources about farmers' mental health and prevention of suicide among farmers.

Learn more about drought and mental health at the SAMHSA’s Drought site. SAMHSA also has other disaster behavioral health resources, including newsletters and tip sheets. Check out SAMHSA’s newly launched Climate Change and Health Equity site for more information on the behavioral health impacts of climate change, preparing for a disaster, and resources for disaster planning and climate change education.
                        Best Practices for Emergency Managers
    The CDC’s When Every Drop Counts: Protecting Public Health During Drought Conditions—A Guide for Public Health Professionals is intended to assist public health officials, practitioners, and other stakeholders in their efforts first to understand and then to prepare for drought in their communities. It provides information about how drought affects public health, recommends steps to help mitigate the health effects of drought, identifies future needs for research and other drought related activities, and provides a list of helpful resources and too.

The CDC’s Preparing for the Health Effects of Drought: A Resource Guide for Public Health Professionals supplements *When Every Drop Counts* and is based on the results of a qualitative analysis of in-depth interviews with public health professionals, a review of state drought plans, and a literature review.
                        Clinical Best Practices
    OCCHE’s Referral Guide summarizes resources that can address patients’ social determinants of health and mitigate health harms related to climate change. These resources include social services and assistance programs to which patients can be referred, as well as references for anticipatory guidance and counseling to help patients prepare for potential hazards.

                    
  


Content created by Assistant Secretary for Health (ASH) Content last reviewed April 3, 2024 Back to top
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