The Commonwealth Fund analysis looked at metrics including air quality, health risks from extreme heat, greenhouse gas emissions, and facility risks from flooding. Kentucky ranked 50th overall, scoring lowest on health impacts from electric generation emissions.
Matthew Eckelman, professor of civil and environmental engineering at Northeastern University and the study's co-author, said there are policy improvements to be made at the federal, state, and healthcare organization levels.
"At the state level, those policies that help Kentucky use less energy," Eckelman pointed out. "Policies around energy efficiency, for example, are very beneficial. Typically, they can also save a lot of money. And then those policies that help transition towards cleaner fuels, better pollution control."
The state ranks 48th on health care sector greenhouse gas emissions and 47th on emissions due to health care worker commutes.
Higher-ranked states often have a lower environmental risk and more robust decarbonization and clean energy policies. Health effects from air pollution include asthma and other respiratory conditions. Eckelman noted that researchers use methods to quantify the health impact of pollution.
"The metric we used is disability-adjusted life years lost," Eckelman explained. "This is a really standard metric that's used in public health to quantify premature death, and also years of life lived with a disability like asthma, for example, or severe respiratory disease."
He added that in Kentucky, health damages mostly come from soot from coal-fired power plants.
Kentucky’s health system is seen as relatively less vulnerable to extreme weather compared to other states, but researchers observed how the increase of strong hurricanes, more frequent “hundred-year” floods, and extreme heat or cold snaps can impact health systems.
Lovisa Gustafsson, vice president of the Making Healthcare Affordable program for The Commonwealth Fund, said that extreme weather is making healthcare facilities increasingly vulnerable.
"When these extreme events happen, they also take out infrastructure within the system," Gustafsson stressed. "They can cripple hospitals. They can take power out, so hospitals and clinics can’t operate. They can flood them. They take out roads so people can't get to the hospitals if they need care."
She added that the effects on health systems during extreme weather events can last for days or weeks afterward.