Expert Q&A: Bell on preparing health care systems and researchers for climate impacts

Climate change has implications for health and health care systems, including disruptions in care and access caused by extreme weather. As a nurse practitioner who deploys to disaster zones and a researcher studying long-term impacts, Sue Anne Bell, Ph.D., FNP-BC, FAAN, has observed how these events shape health needs and strain health system capacities.

Bell is an associate professor at the U-M School of Nursing and a nationally recognized expert in disaster preparedness and response policy. Her research examines the health impacts of climate-related disasters and explores ways to improve readiness across health systems and the workforce. She was recently named the director of the IHPI’s Sandy-Hassmiller Climate & Health Initiative, which supports interdisciplinary research, clinician-scholar training, and policy-relevant approaches to climate-related health challenges.

In this Q&A, Bell discusses how this new initiative supports climate and health research, how climate-related disasters disrupt health care delivery, and what approaches may help health care professionals and communities better prepare for future extreme weather events.

Why is it important to understand how changes in the environment can impact health?

Shifts in our climate affect all aspects of our environment—and our ability as humans to live, work, and stay healthy. Warmer temperatures, rising sea levels, and more frequent and severe weather events all translate into measurable health impacts.

More extreme weather caused by a changing climate can disrupt communities through power outages, damaged infrastructure, and difficulty accessing health care. Higher temperatures increase the risk of heat-related illness, while environmental changes affect ecosystems that people depend on for food, water, and safety. Together, these factors make climate change a significant and growing public health issue.

What concerns you most about the health risks associated with extreme weather events?

What concerns me most is that many communities are facing repeated disruptions from extreme weather events, including hurricanes, severe storms, wildfires, or extreme heat. These events can overlap or compound one another, such as extreme heat layered on top of severe storms or occurring alongside wildfires. These ongoing disruptions make it much harder for people to meet their health needs and place sustained strain on the communities where they live.

Another major concern is how prepared health care systems and the workforce are to meet these challenges. There are significant gaps not only in how nurses, physicians, and other providers are trained for large-scale disasters, but also in how broader health systems are organized and equipped to respond effectively. Improving coordination and preparedness across health systems is one area where focused effort could make a substantial difference as extreme weather events become more frequent.

How do extreme weather events strain health care systems and the workforce?

Disasters affect health care systems in several ways. They disrupt supply chains and place added pressure on health care providers. One of the most significant impacts of a disaster is a surge in patient volume: people seek care from disaster-related injuries or illness while still needing routine services, such as scheduled surgeries and chronic condition management. These challenges are intensified by the disruptions that often accompany disasters, including loss of power and transportation and staffing shortages when health workers are unable to report to work or when available providers cannot meet community needs. All of these factors combine to place immense strain on the health care system during and after disasters.

Your research provides valuable insights into the needs of older adults and other vulnerable groups. What unique challenges do they face after disasters?

Certain populations, including older adults, people with disabilities, children, and people facing economic challenges, experience greater difficulty meeting their health needs in disrupted environments. When accessing care is already challenging in everyday life, those difficulties are magnified during a disaster.

For some older adults, factors such as having multiple chronic health conditions, living on a fixed income, being socially isolated, or experiencing cognitive issues can make it especially difficult to meet health care needs during a disaster. Addressing these challenges requires thoughtful, proactive approaches, such as improving access to care, enhancing training for health care workers to manage chronic disease during disasters, clarifying what effective preparedness looks like, and helping people prepare for weather emergencies. It also requires exploring ways to strengthen communities so they can support one another and developing a better understanding of what makes a community resilient as environmental conditions change.

Where do you see the biggest unanswered questions in climate and health research?

There are many unanswered questions, spanning a wide range of issues where research can make a difference. Broadly, there are important questions about how to make health care systems more resilient in the face of climate change, while also reducing their environmental impact. Researchers are also examining how repeated disasters take a toll on communities over time and how different groups of people are affected in different ways. Too often, responses to climate-related emergencies are reactive, focusing on recovery rather than preparation. Moving toward earlier, proactive planning can help better protect health and improve care for communities.

The IHPI Sandy-Hassmiller Climate & Health Initiative is an important new effort focused on the intersection of climate and health. What is this initiative, what is your role, and what does the initiative aim to achieve?

The IHPI Sandy-Hassmiller Climate & Health Initiative is a multi-year effort focused on strengthening climate and health research, education, and policy engagement, with particular attention to supporting clinician-scientists early in their careers. By investing in clinicians who also conduct research at this stage, the initiative aims to equip them with the tools, skills, and networks needed to address climate-related health impacts.

Through pilot funding, mentorship, and cross-institutional collaboration, the initiative supports clinician-scientists in studying climate-related health challenges, applying findings in clinical settings, and contributing to policy-relevant solutions. The broader goal is to build a strong, connected cadre of researchers working together to advance climate and health impact.

As director, I am focused on serving as a connector, helping shape research directions, mentoring emerging scholars, and integrating climate and health into existing training and programs. I also aim to share insights from my own work and support early-career clinician-scientists in translating evidence into practice and policy.
 

Are there promising policies or strategies for addressing climate and health issues?

There are a number of encouraging strategies emerging to address climate and health issues. One recent example is the Belém Health Action Plan For The Adaptation Of The Health Sector To Climate Change from the 30th United Nations Climate Change Conference held in November 2025. This plan outlines concrete actions to improve health system preparedness, particularly in low- and middle-income countries, to address climate-related health challenges, starting with strengthening the health care workforce. What makes this plan especially promising is that it’s not just a set of recommendations, it’s backed by a pledge from funders who are committed to supporting its implementation.

We have a growing body of knowledge and interventions about how climate change and extreme weather events affect health, and we’ve identified many strategies that could make a difference. What’s often missing is the connection between evidence and real-world change, and we have opportunities to bridge the gaps, helping translate what we know into action that improves preparedness and resilience.

More about Bell’s work and expertise

• IHPI Policy Impact Snapshot: Improving Readiness for Disasters Across the Lifespan
• Do natural disasters have long-term impacts on mortality in older adults? | EurekAlert!
• In crisis, nurses step up in health system resilience
• People living with dementia during natural disasters
• Weather emergencies affect older adults’ views on climate and health
• Most older Michiganders worry about climate change’s effects on health – especially if they’ve experienced extreme weather

More about the IHPI Sandy-Hassmiller Climate & Health Initiative