Rising Temperatures, Rising Health Risks with Deanna Benner and Dr. Himabindu Lanka

Every summer, emergency departments across Delaware see patients who didn't realize how dangerous the heat had become until it was too late. Yet heat-related illness is largely preventable. 

Extreme heat is the leading cause of weather-related death in the United States, and the problem is getting worse: heat-related deaths among adults over 65 have increased 85% since the 1990s, with projections showing they could rise by 370% by mid-century. Delaware, one of the fastest-warming states in the country, is on the front lines.

The challenge in preventing heat-related illness is recognizing the risk before it becomes an emergency. In this episode, recorded ahead of Delaware's first official Heat Awareness Week (May 18–22, 2026), we're joined by ChristianaCare environmental health and sustainability manager Deanna Benner and ChristianaCare hospitalist and board-certified geriatrician Dr. Himabindu Lanka to talk about what extreme heat actually does to the body, who's most vulnerable and what clinicians, caregivers and community members can do to stay ahead of it.

Dr. Lanka walks through how to evaluate at-risk patients using a structured clinical framework, from medication reviews to subtle signs of dehydration that often get missed. Deanna shares practical guidance from her work as a women's health nurse practitioner and connects heat awareness to ChristianaCare's broader commitment to upstream, community-centered health.

Whether you're a clinician, a caregiver or someone looking out for a loved one this summer, this conversation is for you.

Deanna Benner, MSN, APRN, is ChristianaCare's environmental health and sustainability manager and president of the Mid-Atlantic Alliance for Climate and Health. A women's health nurse practitioner, she works to connect environmental health to clinical care and community well-being.

Himabindu Lanka, MD, FACP, FHM, is a hospitalist physician at ChristianaCare with board certification in internal medicine and geriatrics. Her clinical focus is on the intersection of aging, chronic disease and environmental health threats.

Links:

• ChristianaCare News: Don’t Go Out Without Your Water Bottle
• Delaware Heat Awareness Week
• Lancet Countdown on Health and Climate Change
• Heat Waves and Annual Death Rates in Older Adults — Harvard T.H. Chan School of Public Health
• Delaware 211
• Delaware Aging and Disability Resource Center

Thanks for listening and subscribing! Follow us on Facebook, Instagram, X and LinkedIn.

Transcript

SPEAKER_02 0:01

And

Heat Is Preventable

SPEAKER_02 0:02

heat illness is predictable and preventable.

SPEAKER_00 0:10

You're listening to For the Love of Health, a podcast about delivering care and creating health, brought to you by Christiana Care. Hello everyone, I'm Jason Tekarski.

SPEAKER_01 0:21

And I'm Megan McGurman. Welcome to For The Love of Health, brought to you by Christiana

Why Heat Awareness Week Matters

SPEAKER_01 0:25

Care.

SPEAKER_00 0:25

According to the CDC, heat events or heat waves are one of the leading causes of weather-related deaths in the United States.

SPEAKER_01 0:31

And a recent study from Climate Central shows Delaware and New Jersey as two of the fastest warming U.S. states from 1970 to 2025.

SPEAKER_00 0:40

Christiana Care is joining forces with the University of Delaware and the State of Delaware to recognize Heat Awareness Week and draw attention to heat illness.

SPEAKER_01 0:48

Here to talk more about how heat impacts health. Deanna and Bindu, thank you for being here today. So happy to be here. Thank you for having us. So this episode comes out a few days before Heat Awareness Week. This is the first year in Delaware for Heat Awareness Week. Deanna, talk to us about why Christiana Care wanted to be part of this state initiative.

SPEAKER_02 1:16

It's really exciting, and I'm so proud of Christiana Care. The backstory is, you know, Delaware likes being first. And we are one of the first states, thanks to Governor Meyer, to proclaim Heat Awareness Week. And five University of Delaware students, they asked the governor to proclaim it, and he did. And I took the idea to Christiana Care and right away they ran with it because they know that heat is affecting our the health of our community. And they were right on board from the beginning. They just said, go, go, go, let's do this.

SPEAKER_01 1:46

So before we get into the clinical aspects of heat safety, Deanna, talk to us about why heat, of all the things going on right now, even in the environment, what makes heat that thing that you wanted to focus on, that University of Delaware wants to focus on, and the state?

Extreme Heat Is Harming Patients

SPEAKER_01 2:02

Extreme heat is not a future problem.

SPEAKER_02 2:04

It is harming our patients now. We can really save lives by focusing on heat-centered clinical care. You know, we said do no harm. And while we do preventive heat medicine, we can make sure that we're protecting our patients and doing no harm at the same time.

SPEAKER_01 2:22

Bendu, Deanna said this is impacting our patients now. You are a hospitalist with Christiana care, so you are in that hospital every day. How big of an issue is heat right now clinically?

SPEAKER_03 2:32

It is a pretty big problem because I believe we're underestimating how much heat is impacting our patients right now. I'm a board-certified geriatrician. So not only am I hospitalist, but I'm also looking at these patients from a geriatric lens. What I mean by that is not just above 65 years old, but those with chronic medical conditions, because a geriatric patient, by definition, is one who has decreased ability to respond to physiological stressors. And the more and more stressors we add, the more and more medical conditions we add, the less and less they're physiologically be able to handle that stress for their body. And what I mean by the physics the compensatory stressor mechanisms in the body. And with that, we are seeing more and more patients with who come come to our emergency rooms and to our floors with dehydration, syncope, falls. And a lot of this can be solved by just simply giving them IV fluids. And when I say simply, I'm saying it's as simple as just recognizing that they're having dehydration and provide them with IV fluids and the appropriate education to prevent dehydration and prevent them from coming to ED and review of medications and whatnot. For example, if they're on diuretics, the dehydration and the diuretic combination can make them more dehydrated, which could lead them to more dire consequences.

SPEAKER_02 3:56

The problem is with medical diagnosing in this country, you know, we don't really have the diagnosis codes to really connect the dots between climate and health. So many times this issue is left in the dark. For example, you know, an outdoor worker who's been exposed all day who ends his shift in chest pain, uh, you know, he comes in and the diagnosis is chest pain. But really, what caused that chest pain was the heat that he was exposed to all day while he was working.

SPEAKER_00 4:23

So looking at heat awareness from that clinical perspective, what are the kinds of tips and hints and suggestions you give to other providers, to other clinicians that they should be looking for to help prevent it, but also how to treat it when it actually does show up and present in front of them?

SPEAKER_03 4:40

So as

The Clinician Checklist For Heat

SPEAKER_03 4:41

a clinician, we have a structure on how we evaluate our patients. We do have we have just a basic structure, a subjective, objective assessment and plan. In the subjective session, we have the history of present presenting illness, past medical history, et cetera, et cetera. So in the subjective section, what we really want to focus on are the medications, medications, medications, medications. A perfect example I can give you is if someone's coming to you in the office or even in the emergency room setting saying, I'm feeling very dehydrated. And the first thing that should be coming to your mind is are they taking any other medications that is causing them dehydration? A perfect example is a diuretic. This is one example. Dehydration, are they on diuretics? Are they on decongestions? Because decongestions can also dry you out. Like for example, Zyrtech, Allertech, or Pseudafet, you know, they can also dry you out. Diving into any and every chronic medical conditions that you could possibly have is important because that helps you keep in mind how to give a holistic global approach on prevention, right? So, for example, a couple of conditions to name in mind are like hypertension, heart failure, diabetes, COPD, asthma. So those are important things. Now, when it comes to the physical exam, what are what are we looking for? How is their cognition? You know, are they able to take care of themselves? Are they able to answer questions? Are they able to take their own medications? Are they able to recognize that their body's thirsty or hungry and able to get adequate nutrition and uh hydration? How are their vital signs? You know, are the how's the heart rate? Is it elevated? How's the blood pressure is it is it decreased? If they're feeling dizzy, how are their blood pressures in different positions? Checking the orthostatic vitals and supine sitting and standing, physical exam-wise, check, check their strength, you know, their mobility. Those are different things that can help us determine how their baseline functionality is and get and then we can appropriately give them prevention strategies, especially in the in the heat month. And then obviously in the assessment and plan, we based on the answers we get, we want to we want to put together a plan on adjusting medications, providing any kind of referrals to consultants if needed. For example, if they have heart failure or chronic kidney disease, like referring them to cardiology or nephrology. I always recommend, especially for our geriatrics population, to see a geriatrician for a comprehensive geriatric assessment where they do a global assessment of all the geriatric syndromes, and that can help us formulate a better prevention plan as well. Last but not least, prevention strategies and things that they can look for when they go home. Provide them with a handout so that they have it at home with them.

Cooling Plans For Home And Family

SPEAKER_00 7:32

That handout sounds like a great resource for people. What are some of those strategies that we're talking about that the individual community user, the individual patient would be able to handle when they go home?

SPEAKER_02 7:42

I'm a women's health nurse practitioner. So I am privileged to care for pregnant and postpartum women, which are both a vulnerable population to heat. So it means they're more affected by heat. So when I have a visit with them before they go, I give them discharge instructions and I make sure that they are drinking enough water. And I said, Hey, for preterm labor, you really want to drink water. And then I ask them about their housing situation. I said, Hey, do you have air conditioning at home? Because that's really important for preventing heat illness. And then we talk about strategies if they don't have air conditioning, maybe going over to a family member's house or spending a majority of the hot day in a place that are cool, like cooling centers, libraries, or the mall. And then I also give them risk factors for heat illness. We talk about preterm labor, we talk about high blood pressure pregnancy. And for our postpartum moms, talk about newborn babies and how they are not able to regulate their body temperature yet. So it's so important that we're making sure that they are staying cool and that they have, you know, a fan on them if possible, if it's hot in a if they're in a hot apartment and just to make sure that they're paying attention to their baby's temperature.

SPEAKER_03 8:50

So I echo everything Deanna is saying as a geriatrician, I would encourage caregivers of patients above 65 or with chronic medical condition to look for subtle signs. You know, do daily check-ins um with their loved ones and look for subtle signs of dehydration or confusion. If they if they're saying something like, I'm feeling confused or I'm feeling off, I mean, they're not going to come out and say, I'm thirsty and I'm dehydrated. So look for look for subtle signs like I'm feeling off, I'm feeling confused, or they're not that you know you do a check-in with them and they tell you they haven't had anything to eat or drink in in like 24 hours. Those are warning signs. Those are the kind of things that we should be, they should be looking out for. Those are like early signs of heat exhaustion, and and we can intervene right away at that time by giving them water or apple juice or any anything that they can find and before it turns into a heat stroke. And this can definitely prevent anything more dire from happening, and it also can prevent uh a visit to the ED. You know, uh, it can be simply solved by doing preventive measures at home.

When Heat Becomes An Emergency

SPEAKER_01 9:59

And at what point is it time to go to the hospital? You know, we've talked about everyone from babies to those over 65. But what are those key takeaways listeners should be thinking about to say, okay, this is more than I can handle. We need to go see a professional about this.

SPEAKER_02 10:16

Altered mental status, I would say, would be a big red flag. Somebody that definitely is unconscious would be a 911. But people that are confused, disoriented, agitated, seizures, those would be ones that we'd be calling 911 or getting to the emergency room.

SPEAKER_03 10:33

And extreme hyperthermia, temperatures greater than 102, 103 that were not able to cool effectively at home.

SPEAKER_01 10:43

Deanna, at the start of this conversation, we talked about Christiana care getting involved in this larger initiative. Talk about the importance of Christiana care caring about the things that happen in the community outside of the four walls of the health system.

SPEAKER_02 10:58

Well, health has many dimensions from physical health to mental health to spiritual health and environmental health. Health that we know is connected to the way that we interact with the environment. And Christiana Care cares about all aspects of health and well-being. So environmental health and heat, it's so important. And heat illness is predictable and preventable. You know, it's taking care of our patients before they even make it to the hospital so they don't need the hospital. So, in a way, it's upstream, community-centered health.

SPEAKER_01 11:40

Well, thank you so much for having us again. Thank you.

SPEAKER_00 11:43

Check out the show notes for more information on how heat impacts health.

SPEAKER_01 11:46

And you can always keep up with For the Love of Health on social media. Just search Christiana Care on your favorite platform.

SPEAKER_00 11:51

We'll be back in two weeks with another great conversation.

SPEAKER_01 11:54

Until then, thanks for joining us for The Love of Health.