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Analyzing 2023, officials found that more people statewide than expected visited emergency rooms for respiratory illnesses and excessive heat effects and that people suffered mentally from natural disasters long after they occurred. The effect of poor air quality caused by wildfires was especially acute among the elderly, rural people and Oregonians of color. American Indians, Alaska Natives, Black residents, Native Hawaiians and Pacific Islanders were twice as likely to visit a health care facility for an air-quality related respiratory illness than the statewide average, according to the report.

But since the first annual report came out in 2020, as mandated by an executive order under former Gov. Kate Brown, the Legislature has invested in programs to help Oregonians adapt.

By 2030, the health authority aims to reduce smoke-related respiratory visits to emergency departments by 20%, heat-related hospitalizations by 60% and heat-related deaths by 70%.

To achieve the state targets, the 2023 Legislature allocated nearly $100 million to pay for climate adaptation and health resilience programs. This includes improving access to green spaces and healthy and sustainable foods and paying for home air filters and air conditioners. The health authority is also charged with educating the public about climate risks and modernizing health services to respond to climate challenges.

“Climate change poses a significant and growing threat to public health,� agency Director Sejal Hathi and Cara Biddlecom, the agency’s interim public health director, said in a letter in the report. “We can accept nothing less than building a public health system equipped, resourced and coordinated to prevent, mitigate and adapt to the health impacts of climate change.�

Smoke-related emergency room visits and hospitalizations for asthma are expected to add nearly $100 million to Oregon health care costs by the 2050s, according to the report.

Hottest year on record

Globally, 2023 was the hottest year on record, though Oregon was spared from exceptional wildfire events like those in 2020 and the excessive heat events like the summer heat dome in 2021, when temperatures reached triple digits from late June through mid-July. The Oregon Health Authority had not anticipated an event like that in the Portland metro area until 2050, the report said.

Between 2020 and 2023, 139 people died from heat-related causes in Oregon, including more than 100 in 2021. The toll over those years was three times that of the previous decade. Cardiovascular disease contributed to 25% of those deaths, and people 50 and older accounted for 87%, the report said.

It also looked at the lasting impacts of the 2020 wildfire season and 2021 heat dome.

The 2020 Labor Day fires burned more than 1 million acres, destroyed 5,000 homes, largely destroying the towns of Gates, Detroit, Phoenix and Talent, and left nine people dead.

Researchers found that mental health suffering, including uncontrollable worry, was acute among wildfire survivors years after the events. Officials said making communities resilient to climate change and adapting to heat and wildfire need to be baked into recovery and rebuilding efforts after such events.

The report said health authority officials are working on reaching people from different demographics in different parts of the state. Surveys have found that older Oregonians prefer to be alerted to upcoming extreme weather events through local television, while most other Oregonians prefer text messages. But more resources are needed, especially to help households obtain filters, emergency supplies for wildfires and upgraded doors and windows so they fully seal.