Disabled, Overheated, and Overlooked 

CW: Mental Illness

As climate change drives more frequent and intense heat waves, many disabled people, especially wheelchair users, face a disproportionate risk. In New Jersey, a recent article reveals how structural and logistical barriers prevent many from staying safe during dangerously high temperatures. 

Public transit may be unreliable or inaccessible, and cooling centers can be difficult to reach. Those that are available often lack features needed to accommodate disabled people. These obstacles can make the difference between discomfort and a life-threatening emergency.

Disabled people are at higher risk of heat-related illness for a number of reasons. Many people have conditions that interfere with the body’s ability to regulate temperature. This includes people with spinal cord injuries, multiple sclerosis, or those taking medications that reduce the ability to sweat. For example, antipsychotic medications such as quetiapine, haloperidol, and risperidone, which are commonly prescribed to treat schizophrenia can impair thermoregulation. 

Antipsychotic medications disrupt central temperature control by blocking dopamine pathways in the brain and impair sweating through anticholinergic effects. Some also reduce the sensation of thirst, increasing the risk of dehydration in hot weather.

In these cases, heat can build up rapidly in the body. Therefore increasing the danger of heat exhaustion or even stroke. These physiological realities combine with social and economic disadvantages to create a layered risk profile during extreme weather events.

Various studies support these findings.  People on antipsychotics, anticholinergics, (a class of drugs that block the neurotransmitter acetylcholine in the central and peripheral nervous systems), or anxiolytics (a class of medications primarily used to treat anxiety disorders and related conditions) face a greater risk of heat-related hospitalization. Sometimes even outside officially declared heat waves. 

In one documented case, a patient on a combination of Olanzapine, trihexyphenidyl, and trazodone developed heat stroke and required intensive care. This shows how medication side effects can escalate rapidly.

Mobility barriers make these problems worse. For wheelchair users, getting to a cooling center might require navigating uneven sidewalks, inaccessible entrances, or long trips in the heat with few shaded areas along the way. Public transportation options may not have working lifts or appropriate seating. Even when centers are reachable, they may be closed during the hottest hours or lack air conditioning entirely. In some cases, buildings designated for relief have narrow doorways, no ramps, or no restrooms equipped for disabled individuals.

Economic hardship compounds the issue. Disabled people are more likely to live in poverty, and cooling costs can represent a significant portion of a fixed income. Air conditioning units may be outdated or too expensive to run continuously. In public housing, tenants may have limited control over temperature or maintenance, and portable cooling devices like fans or misters may not be allowed. This leaves many people with little recourse but to endure dangerous conditions at home.

Cognitive or sensory disabilities also factor into the equation. For those with mental health conditions, developmental disabilities, or cognitive impairments, recognizing the early signs of heat exhaustion can be challenging. They may be unable to communicate their discomfort or to seek help on their own. Caregivers can play a crucial role in monitoring symptoms and ensuring safety, but not all disabled people have support systems in place.

Wheelchair users face unique physical challenges during heat waves. The constant contact between their bodies and the chair can cause heat and moisture to build up, leading to discomfort and the potential for pressure injuries. New technologies like backrest ventilation systems or cooling pads offer relief, but they are often expensive and not covered by insurance. Some users rely on creative, low-tech strategies like frozen water bottles, misting fans, or chilled towels. While effective, these methods are short-term solutions to what is increasingly becoming a structural problem.

In New Jersey, urban areas such as Newark and Camden suffer from the urban heat island effect, where dark surfaces and limited green spaces cause city temperatures to rise significantly higher than surrounding areas. Residents in these communities are often low-income and disproportionately disabled. While initiatives like the state’s “Extreme Heat Resilience Action Plan” and the “Chill Out NJ” program have made strides in mapping resources, the reach of these programs is limited when they fail to consider physical accessibility and transportation challenges.

During power outages, the stakes become even higher. Disabled people who rely on m electricity to operate medical devices face life-threatening risks when the electricity goes out. Generators are expensive and not always safe to use indoors. Emergency response systems like New Jersey’s “Register Ready” database are valuable, but underused and sometimes poorly promoted. Without preemptive planning, the results can be deadly.

Despite these challenges, community members have found ways to share solutions. Online forums and social media groups offer tips and tricks for staying cool, ranging from using cold packs to choosing breathable fabrics. However, community knowledge is not a substitute for comprehensive public policy. Government agencies must prioritize accessible infrastructure, expand support for cooling costs, and incorporate disabled voices into emergency planning.

The increasing frequency of extreme heat events makes this issue more urgent every summer. Disability must be part of the climate resilience conversation, not an afterthought. Without intentional design and inclusive planning, the most vulnerable members of society will continue to bear the brunt of a changing climate. Staying safe and comfortable in the heat should not depend on ability, income, or zip code.

Sources:

Ali, Amina. “NJ Cooling Centers Struggle to Reach Vulnerable Residents amid Extreme Heat.” New Jersey Urban News, New Jersey Urban News, 14 July 2025, njurbannews.com/2025/07/14/nj-cooling-centers-vulnerable-residents-heat-wave/.

Bark, Nigel. “Deaths of Psychiatric Patients During Heat Waves.” Psychiatric Services, vol. 49, no. 8, American Psychiatric Publishing, Aug. 1998, pp. 1088–1090, https://doi.org/10.1176/ps.49.8.1088.

Fuentes, David, et al. ‘Anxiolytics’. Encyclopedia of Toxicology (Third Edition), edited by Philip Wexler, Academic Press, 2014, pp. 280–286, https://doi.org/10.1016/B978-0-12-386454-3.00241-4. 

Griggs, Katy E., and Frederique J. Vanheusden. “Integrated Fan Cooling of the Lower Back for Wheelchair Users.” Journal of Rehabilitation and Assistive Technologies Engineering, vol. 9, SAGE Publications Ltd STM, June 2022, p. 20556683221126994, https://doi.org/10.1177/20556683221126994.

Jung, Youn Soo, et al. “Extreme Heat and Hospital Admissions in Older Adults: A Small-Area Analysis in the Greater Boston Metropolitan Area.” Environmental Epidemiology (Philadelphia, Pa.), vol. 9, no. 3, May 2025, p. e395, https://doi.org/10.1097/EE9.0000000000000395.

Lee, Chin-Pang, et al. “Heat Stroke during Treatment with Olanzapine, Trihexyphenidyl, and Trazodone in a Patient with Schizophrenia.” Acta Neuropsychiatrica, vol. 27, Dec. 2015, pp. 380–385, https://doi.org/10.1017/neu.2015.29.

Martin-Latry, Karin, et al. “Psychotropic Drugs Use and Risk of Heat-Related Hospitalisation.” European Psychiatry, vol. 22, no. 6, Cambridge University Press, 2007, pp. 335–338, https://doi.org/10.1016/j.eurpsy.2007.03.007.

Myers, Gene. “Beating the Heat Isn’t so Easy with a Disability. NJ Wheelchair User Share Tips.” NorthJersey.com, North Jersey Media Group, 29 July 2025, www.northjersey.com/story/news/2025/07/29/wheelchair-users-face-barriers-to-staying-cool-in-new-jersey/85361512007/.

Page, Lisa A., et al. “Relationship between Daily Suicide Counts and Temperature in England and Wales.” British Journal of Psychiatry, vol. 191, no. 2, Cambridge University Press, 2007, pp. 106–112, https://doi.org/10.1192/bjp.bp.106.031948.

Sabe, Michel, et al. “Antipsychotics for Negative and Positive Symptoms of Schizophrenia: Dose-Response Meta-Analysis of Randomized Controlled Acute Phase Trials.” Schizophrenia, vol. 7, no. 1, Sept. 2021, p. 43, https://doi.org10.1038/s41537-021-00171-2.