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. 2025 Mar 18;51(2):e70068. doi: 10.1111/cch.70068

Weathering the Storm: Climate‐Related Weather Event Experiences of Families of Children With Medical Complexity

Jennifer Baumbusch 1,✉, Vanessa Fong 1, Esther Lee 2, Nilanga Aki Bandara 3, Koushambhi Basu Khan 1
PMCID: PMC11919613  PMID: 40102035

ABSTRACT

Background

Climate change is increasingly an urgent concern because of the catastrophic and irreversible impacts on the planet and society as a whole. In recent years, there have also been more frequent and extreme weather events such as heatwaves, droughts, floods and wildfires across the globe. Although families of children with medical complexity may be particularly vulnerable to the impacts of extreme weather events, few studies exist that address this topic.

Methods

Drawing upon a subset of data from two qualitative studies, we explored the experiences of families during climate‐related weather events in British Columbia, Canada. During the summer and fall of 2021, this area experienced a series of extreme weather events (e.g., heat dome, wildfires and atmospheric rivers causing flooding) in rapid succession. Semistructured interviews were conducted with 30 parents between July 2021 and April 2022. Descriptive content analysis was used for data analysis.

Results

Participants described their lived experiences during the heat dome, wildfires and flooding of 2021. Across all of the weather events, children with medical complexity experienced social isolation and, for some, increased anxiety. Participants also shared adaptive measures, or strategies, they used during these events. In the absence of government supports, families drew upon their informal peer networks in some situations.

Conclusions

The unique needs of children with medical complexity are not accounted for in existing government policies and supports related to climate‐related weather events. Families are self‐reliant and draw upon their informal peer network for supports. There is an urgent need for inclusive programs and supports across emergency management, health, education and social care to address the needs of this group.

Keywords: children with medical complexity, climate change, lived experience, qualitative research

Summary.

  • Children with medical complexity and their families have unique needs during climate‐related weather events.

  • Children with medical complexity are vulnerable during climate‐related weather events because of individual health needs and also poor infrastructure and lack of disability‐inclusive supports.

  • Clinicians can support families through anticipatory care planning and ensuring families have contingency plans for adequate medical supplies and medications.

  • Climate policies and related programs must be inclusive of and accessible for disabled populations such as children with medical complexity.

  • Future research should focus on the needs of diverse groups within this population as well as differences among geographic settings.

1. Introduction

Climate change is increasingly an urgent concern because of the catastrophic and irreversible impacts on the planet and society as a whole. In recent years, there have been more frequent and extreme weather events such as heatwaves, droughts, floods and wildfires across the globe (Centre for Research on the Epidemiology of Disasters 2020). Climate change is also exacerbating existing health disparities, posing a significant threat to vulnerable populations including racialized, low‐income, Indigenous Peoples and people with disabilities (Benevolenza and Derigne 2019; Berberian et al. 2022; Gaskin et al. 2017; Quilty et al. 2022). Children with disabilities may be particularly vulnerable to the impacts of climate change because of underlying health conditions, social and economic factors and service access barriers (Kosanic et al. 2022; Lindsay et al. 2022). Despite this, existing literature examining the experiences and perspectives of families of children with disabilities is sparse (Hipper et al. 2018; Mann et al. 2021). The few studies that have explored this topic have primarily focused on the preparedness of families for future weather emergencies and outcomes of children with disabilities following natural disasters (Hamann et al. 2016; Newman and Leochico 2022; Wolf‐Fordham et al. 2015).

The bulk of the research examining the preparedness of families of children with disabilities for future weather emergencies indicates that the majority of families are underprepared. For example, a study conducted in the United States by Baker and Baker (2010) assessed the disaster preparedness of 145 families of children with special health care needs and found that although families express high levels of concern, they are significantly less prepared compared to the general population. Families often cited information barriers and not knowing how best to prepare themselves as key reasons for their lack of preparedness. Extending these findings, another study in the United States comprising 314 parents of children with developmental disabilities found that not only are families underprepared for natural disasters but they also report taking fewer of the recommended action steps (e.g., having an evacuation bag) (Wolf‐Fordham et al. 2015). Given the importance of technology for families of children with medical complexity, research has also evaluated the preparedness of families for electricity failure during natural disasters. A survey conducted by Sakashita et al. (2013) comprising 166 parents of children with special health care needs found that only 54% of families confirmed that they had a battery backup for their child's medical devices (e.g., feeding pump) and only 44% of families had a prolonged power failure preparedness plan.

Among the few studies that have explored the impact of natural disasters on children with disabilities and their families, adverse consequences have been found related to children's access to services, behaviours and mental health. A study by Rath et al. (2007) found that children with chronic conditions reported higher rates of missed hospital visits, disruptions in care and shortages of medication compared to children without chronic conditions following Hurricane Katrina. The impacts of natural disasters on child behaviours and mental health have also been assessed. Valenti et al. (2012) examined the impact of a 6.3 earthquake in central Italy on the adaptive behaviours of children with disabilities. Results indicated that children experienced negative impacts on their adaptive behaviour and social skills following the earthquake. Similar findings were obtained in a study by Rath et al. (2007), which found higher levels of sadness, withdrawal, behavioural problems, mental health difficulties and fear in children with chronic conditions compared with children without chronic conditions. Findings from qualitative research have also confirmed and extended these results by providing detailed descriptions of the impact of natural disasters on children. For example, one study by McAdams Ducy and Stough (2011) explored inclusive education teachers' perspectives on the impact of Hurricane Ike in the United States on their students with disabilities. Teachers perceived negative impacts on students related to their academics, behaviours and social skills. These findings also indicated the need for greater physical and emotional supports for children with disabilities following natural disasters.

Together, this body of research indicates that children with disabilities and their families face unique challenges in preparing for and coping following natural disasters and climate‐related weather events. Although the existing literature has broadly focused on children with disabilities, few studies have specifically examined the experiences of families of children with medical complexity. These children may be particularly vulnerable to the impacts of climate change because of their specialized healthcare needs, dependency on medical technology and supplies and underlying health conditions, which are characteristics of medical complexity (Niu et al. 2021). Thus, there is a pressing need to understand the impact of climate‐related weather events on families of children with medical complexity and identify strategies to support them. To help address this gap, the purpose of our research was to explore the lived experience of families during climate‐related weather events (e.g., heat dome, wildfires and flooding) and the strategies they employed to manage during these events.

2. Methods

This paper draws upon data from two consecutive studies conducted in British Columbia (bc), Canada, between August 2020 and June 2023. The first study was a multimethod study about families' experiences during the COVID‐19 pandemic involving a cross‐sectional survey and semistructured interviews (Baumbusch et al. 2022; Fong et al. 2023). The second study was a continuation of this inquiry and was a longitudinal, qualitative study. During the first study, three major climate‐related weather events occurred in bc in quick succession. We therefore added a question to the interview guide about families' experiences during these events. In this paper, we analysed the subset of interview data from these studies that focused on families' experiences during these climate‐related weather events. Ethics approval for this research was obtained from the University of British Columbia's Behavioural Research Ethics Board.

2.1. Setting

The research was conducted in bc, the westernmost province in Canada. According to a report in 2016, there were approximately 802 children and youth aged 0–24 years with medical complexity per 100 000 in bc (Canadian Institute for Health Information 2020). In 2021, bc experienced three climate‐related weather events in rapid succession. Between 25 June and 1 July 2021, there was an extreme heat event, also known as a heat dome, where a high‐pressure system stagnates over an area and traps very warm air underneath it for days to weeks (BC Coroners Service 2022). In bc, this resulted in unrelenting heat for 7 days with temperatures reaching over 40°C in many parts of the province (Henderson et al. 2022). Along with the heat dome came one of the worst forest fire seasons in recorded history; many areas of the province were engulfed in uncontrolled wildfires, resulting in evacuations and wildfire smoke that reached hundreds of kilometres away (Lee and Parfitt 2022). Then, in the fall, there was greater precipitation than average and on 13 November a dangerously sized ‘atmospheric river’ made landfall in the southern region of BC (Schmunk 2021). Torrential rain fell for 2 days with some areas getting between 200 and 300 mm (Lee & Parfitt). This event led to a State of Emergency with roads and highways washed away, contributing to supply chain issues (Baker 2021; Watterodt and Doberstein 2023).

2.2. Participants and Recruitment

Recruitment entailed a range of strategies. First, we drew upon a sample of parents of children with medical complexity who completed a cross‐sectional survey about their experiences during the COVID‐19 pandemic in August 2020 (Baumbusch et al. 2022). On the survey, respondents could indicate if they wanted to be contacted in the future for a semistructured interview. Examining socio‐demographic data collected from the survey, we specifically invited participants from underrepresented groups including non‐White parents and families from rural and remote areas. From this group, we recruited 16 parents. Then, as we moved into the longitudinal, qualitative study, we shared recruitment advertisements in a private Facebook group for parents of children with medical complexity. From this group, we recruited a further 14 parents. This resulted in a sample of 30 participants who provided data for this paper. The inclusion criteria specified that parents must have at least one child with medical complexity who shared their residence and be fluent in English. Medical complexity was operationalized as being on The At Home Program (Government of BC 2023). This program requires a stringent assessment process that is reflective of the characteristics of medical complexity.

2.3. Data Collection

Semistructured interviews were conducted between July 2021 and November 2022. The interviews explored participants' experiences of caring for their child with medical complexity during the COVID‐19 pandemic and included a specific question about their experiences during the climate‐related weather events. The interview question was ‘during the pandemic our province also had a number of weather emergencies like the heat dome in July and the wildfires and flooding. Was your family impacted in any way by any of these different weather events? And if so, how?’

Seven interviews were conducted by J.B., and 23 were conducted by V.F., who are doctoral‐trained researchers with advanced skills in conducting qualitative research. The interviews were an average of 45 min long and ranged from 27 to 60 min. Socio‐demographics were also collected. The interviews were conducted via Zoom because of the geographic diversity of the participants and ongoing COVID‐19 precautions related to in‐person data collection. Recordings of the interviews were transcribed verbatim.

2.4. Data Analysis and Trustworthiness

We used an inductive approach to descriptive content analysis (Vaismoradi et al. 2013). Following transcription, we used NVivo12, a qualitative software program, to manage the data and enter the codes. The codebook was developed by authors J.B., V.F. and K.B.K., who are all doctoral‐trained researchers. Data related to climate‐related weather events were coded as ‘impact of weather on families’ with subcodes ‘impact on access to care’ and ‘any other impacts’. Data were then also categorized according to the type of weather event (i.e., heat dome, wildfires/air quality and flooding) in order to describe the participants' experiences in each of these situations. A cross‐cutting theme from the experiences were impacts on the mental health of children with medical complexity and the participants themselves. We also identified adaptive measures for each type of weather event. Adaptive measures are responses to expected or actual climate events (United Nations Climate Change n.d.).

In order to ensure the trustworthiness of our findings, we utilized Lincoln and Guba's (1986) criteria to establish credibility, dependability and transferability. Credibility was sought by actively seeking to understand participants' responses during the interviews and comparing their accounts with other interviews. To ensure dependability, our team meticulously collected raw data, taking detailed notes (memoing) and carefully documenting iterations of the codebook. In terms of transferability, our analysis was substantiated by incorporating direct quotes from participants that are presented in Section 3.

3. Findings

Participants described two main themes. First, they shared their lived experiences of each of the weather events in 2021: the heat dome, wildfires and flooding. An issue that cut across these events was the increase in social isolation and, for some, mental health impacts associated with the weather events, referred to in the literature as eco‐anxiety (Batara and Gallardo 2019; Pihkala 2018). Second, participants identified adaptive measures, or strategies, that they used during each of the weather events.

3.1. Participants

The sample was comprised of 30 participants of whom 28 (93%) were mothers. Most (N = 26, 87%) had one child with medical complexity. The ages of the children ranged from 1 to 19 years, with an average age of 10 years. Almost half of the participants (N = 12, 40%) had an annual household income of $101 000–$150 000. Eight (26%) were employed full‐time and 13 (43%) had a Bachelor's degree as their highest level of education. Most (N = 24, 80%) of the participants were White. Twenty (67%) of participants lived in urban communities, four (13%) lived in suburban communities, and six (20%) lived in rural areas. In the findings, each participant is given a code (e.g., P01 and P02) and in the first instance of a quote, a brief descriptor is provided.

3.2. Experiencing Climate‐Related Weather Events

3.2.1. Heat Dome

Participants shared their experiences across the range of weather events experienced in bc during the summer and autumn of 2021. The heat dome was the first time in living memory that the temperatures approached or exceeded 40°C. Some children with medical complexity can have difficulty with thermoregulation, which affected some of the families in the study. For example, P20 (mother of 16‐year‐old daughter) shared ‘the high heat was difficult, especially for my daughter who's—part of her health condition—she can't handle heat changes, so she was pretty miserable during that period of time.’ Managing during the heat dome was also impacted by ongoing public health measures related to the COVID‐19 pandemic:

The heat dome was difficult. [Son] does not regulate his temperature very well. So that was—we do not have, like, central air or anything. We're not fancy. It was difficult. And because of COVID, we could not just go to the mall or something. (P02, mother of 6‐year‐old son)

Participants shared their families' experiences and how they managed during the extreme heat. A participant said:

the heat wave was difficult to deal with at home. We could not even buy a fan because there were not fans available anywhere. So it was—it was just more work, trying to keep the kids cool—and a lot of wet towels. And sleeping became harder. So, yeah, so during the heat wave, we did experience a few problems. (P24, mother of 7‐year‐old son).

Another shared ‘the heat dome just sucked because it was really hot and we live in a townhouse so, of course, all the bedrooms are on the top floor. It impacted us because we all slept in the same room because we have one portable air conditioner’ (P16, mother of 4‐year‐old son). At the time of the heat dome, only about 40% of homes in bc had air conditioning (bc Hydro 2022). Another participant (P18, mother of 6‐year‐old daughter) described their experiences during the extreme heat, ‘the heat wave was intense. My husband and I saw it coming, watching weather. And I was, like, looking on my phone, I'm, like, “babe, it's saying it's gonna be, like, 40.” Like, that's crazy. We didn't have A/C. We just had fans.’ She went on to describe their efforts to get a portal air conditioner, ‘[husband] right away ordered an A/C from Amazon. And it never came. I think that they had let too many orders through. So it never came.’ Demand for portable air conditioning units also drove up prices during this period, making them inaccessible to many, ‘And two or three days before he's then on, like, Craigslist and everything's spiked prices and whatever and going within seconds.’

3.2.2. Flooding

During flooding, families experienced both flooding of their homes and also disruptions in transportation as roads were washed out and they could not leave their communities. For instance, P15's (mother of 19‐year‐old daughter) family was not able to leave their community:

… not being able to access the hospital for [flooding] was a bit scary. And then also, you know, just the worry that if our youngest daughter—when she gets sick she tends to go very fast from being fine to nothing and she's critically ill. And so I was very anxious, the thought that if anything happened we would not be able to get to where we needed to be and I did not know how we were gonna handle that.

In addition to concerns about being trapped, the participant was also concerned about potential flooding in their home and keeping their stockpile of medical supplies dry:

… it was more about the area [of the house] that flooded was where all our medical supplies are kept, you know, formula and tube feeds and things like that. And so trying to get all of that equipment out of the basement and keep it safe knowing that there was a good chance we would not be able to get more if we did not save it … Yeah, it was a horrible, horrible time.

The flooding disrupted transportation routes due to washed‐out highways, which caused concerns about the timely delivery of medical supplies. In bc, medical supplies for children with medical complexity are delivered once per month through a government program called The At Home Program (Government of BC 2023). P02 said ‘I was a little concerned if we were gonna get, like, our medical supplies and things. But they did come. They just came kind of not as soon as they would have.’

Another participant (P25, mother of 6‐year‐old daughter) talked about the importance of her peer network when formal systems were disrupted by flooding, ‘We had some delays with, like, our medical supplies that we get from [Health Initiative 2]. But nothing that was—nothing that put us, like, in a bind.’ She went on to share how their peer network provided assistance: ‘But even on the Facebook group, people were like, ‘Hey. I need this. I'm over here. Can anybody get this to me?’ You know, so families were helping each other out for sure.’

3.2.3. Wildfires

Wildfires were also an issue for participants. Although none of the families in the study had to evacuate, several did adjust their activities because of the poor air quality that resulted from the fires. For example, P28 (mother of 9‐year‐old daughter) shared, ‘there were some days where we weren't able to go outside with my complex kiddo as a result of just the poor air quality.’ Another participant (P01, mother of 1‐year‐old son) talked about the impact of poor air quality, ‘we basically closed all the windows and doors and turned on the air conditioner and didn't leave. I think it was probably at least, like, at least a week last year just because for him—because, like, he can't handle that.’ Another participant (P18) also shared how air quality impacted activities, ‘we don't go outside when the air quality is that bad. So we stayed inside a lot last summer. Like when it's so smoggy and stuff outside, we don't go there. Not with her trach.’

3.2.4. Social Isolation During Climate‐Related Weather Events

An issue cutting across all of the weather events was the potential for increased social isolation, particularly for the child with medical complexity. Participants noted that the extreme weather was the reason for keeping their child home from school and daycare:

the flooding that day it was like that major downpour. [Child] could not sleep that night because he kept waking up because it was raining so hard … so I just kept him home the next day for school because I was like, well, you are not going to function because you are so tired and I'm glad I did because like he would not have enjoyed like being in a wheelchair and then like going to school, you know, it might just downpour. (P09, mother of 9‐year‐old son)

Another participant shared: ‘[son] would normally go to day camp but he's at such high risk for heat prostration and stroke just because he's not moving, he's in the [wheel]chair, he's not drinking … So he did have to miss a few days because it was too hot’ (P13, mother of 15‐year‐old son). P09 also kept their child home, ‘there was a few days that was really hot, so we did keep him from school … and then during, like—there was that pouring rain where the highway got washed off. It was one of our raining days. I also kept him that day from school.’ At times, it was not the family's choice to keep the child home, but rather programs closed because of severe weather, ‘[Son]'s in a wheelchair. And so he's‐he's way more vulnerable. So, like I say, when it was really hot, the programs that he was in were just completely cancelled’ (P13).

3.2.5. Mental Health Impacts

Two of the participants discussed the mental health impacts on their children, specifically eco‐anxiety that resulted from experiencing a weather event. P13 shared,

[Son's] wheelchair overheated like the literally when it went into the high forties, it would not run. It impacted his mental health huge because he's terrified of, like the thing actually that's happened now is he's in bed at night, he cannot get out and he's terrified of fire or an earthquake, right? And so there's so much talk about fire, fire, fire.

And P26 (mother of 3.5‐year‐old daughter) talked about the stress and worry for the whole family, ‘it just caused heightened anxiety for everybody. And, like, you're just trying to figure out how to reprioritize what's a priority in your mind.’ For several participants, there was concern and anxiety for family and community members who did live in areas harder hit by the weather events: ‘The flooding was an inconvenience mostly because of the gas but, it didn't really impact us per se, it's just more I, more emotionally felt, you know, worried for the people that were directly impacted’ (P16, mother of 4‐year‐old son). Another family was also restricted from seeing their relatives because of wildfires,

We were impacted by the wildfires for sure because our family's in [wildfire region]. And so for about six months there we could not go see them. At the end of the summer, everything was on fire, so we really could not go up there. And a couple of our family members were evacuated even. So, you know, you could not go up there with a kid in a wheelchair. (P13)

3.3. Adaptive Measures

For each of the climate‐related weather events, participants described the strategies, or adaptive measures, that they used. During the heat dome, in addition to the strategy of keeping their child at home mentioned in the previous section, participants also used other approaches. This included shifting to ‘quiet’ activities to avoid heating up their bodies unnecessarily. For example, P09 shared ‘for videos and stuff like that, I just kept like the minimum energy level like we just kept it very low, you know, we didn't do any dancing, we didn't do anything and I just kept them very low’ and she also avoided using heat‐producing appliances like the stove, ‘food wise for that meal, it was just mostly fruits and deli meat. I didn't even turn on the stove.’ Similarly, P18 said ‘all four of us slept in the living room right beside the portable A/C. We kept all the blinds closed and everything for three days. We just watched movies and stayed inside, and that's how we got through the heat wave.’ Participants who lived in multi‐storey homes were also able to make use of their basements, which were cooler, as in the case of P10 (mother of 4‐year‐old daughter) and P12 (mother of 9‐year‐old daughter). Several families also used fans or air conditioners, if available. One participant's family (P20) paid out of pocket to stay in a hotel in order to have air conditioning because all local portable air conditioners were sold out.

The wildfires caused poor air quality in the areas where many participants lived. P01 family paid out of pocket to rent air purifiers, which are currently not included as medical equipment in government programs for people with disabilities in bc. Another strategy her family used was replacing the furnace filters regularly during wildfire season.

Families used several strategies during flooding. Because of transport disruptions due to road flooding, many families needed to stockpile medical supplies. Although bc does not officially provide stockpiles, families are used to needing to be prepared for unexpected events and many informally keep extra supplies on hand. P14 (mother of 8‐year‐old son) explained the importance of these supplies, ‘we do try to stay a little bit ahead on our vital supplies just because [son], if he doesn't have a tube feed like we'll have to go into the ER and be like “I can't feed my child.” I never want to be in that position.’ As described previously, participants also relied on the informal peer network of families of children with medical complexity connected through social media to obtain medical supplies that were supposed to come by delivery from the government program. Another participant, in anticipation of potential road closures, worked out a plan with another family living close by,

I remember I made emergency bins, and I restocked on things. We made sure that we had extra. And we had just recently met another family nearby with a similar child. And so it was helpful to know, like, if we needed supplies, they might have some of the same supplies. (P26)

One participant needed to purchase tube feed formula because of delayed delivery, ‘There was one time where her food was potentially not going to arrive on time and I was going to run out. So then I had to purchase through the pharmacy, formula, which is very expensive’ (P29, mother of 6‐year‐old daughter). In response to the flooding, at least one participant kept their child at home because of concerns about road safety and their child's comfort in being outside in heavy rains.

Across all of the weather events, participants identified a variety of strategies they used; however, none identified government supports either generally or specifically related to having a child with medical complexity. Participants did, though, have recommendations for government planners, including ‘Get people A/Cs. Don't tell them that there's a water park down the street. People need A/C in their house, and we should be changing our building codes. Like, if you require heat, you should require A/C’ (P18). Another participant also emphasized the need for building codes to be updated to reflect weather events, ‘there's a need to change those building codes because it doesn't look like things are getting better’ (P20).

4. Discussion

4.1. Main Findings

Our study contributes to the small but important body of literature about the experiences of children with disabilities and their families during climate‐related weather events. Past research has largely focused on family preparedness for weather events and outcomes for children; our study provides valuable insights from lived experiences during three weather events occurring in rapid succession. We found that families' experiences during weather events were consistent with their ongoing experiences, that is, formal supports were very limited leaving them to navigate the situations, and that peer support played a valuable role.

4.2. Strengths and Limitations

Our research does have limitations. Although we used a variety of strategies to recruit a diverse sample, our participants were mainly women who were White and relatively affluent. In the area of climate change and its impacts, it is particularly important to recruit a diverse sample of participants to ensure that the needs of equity‐deserving groups are identified and addressed. Climate change vulnerability disproportionately impacts people based on social location (e.g., gender, race and class), and this needs to be accounted for in planning adaptation measures. We also noted that existing research cited in Section 1 was largely conducted in the United States, reflecting a lack of geographic diversity in this body of knowledge. Future research, therefore, ought to focus on increasing the diversity of participants (e.g., age, gender, accessibility needs and family size) as well as geographic settings (e.g., urban and rural) to provide a more fulsome understanding of the issues affecting these families.

4.3. Interpretation

Previous research has demonstrated that parents of children with medical complexity are often navigating situations with minimal formal supports (Page et al. 2020). We found that climate‐related weather events follow the same pattern in that the families had to be self‐reliant in managing their child's health and well‐being during these times. Moreover, families relied on an informal peer network to share medical supplies, which is also a common strategy in this population (Lahaije et al. 2023). Yet it is not a sufficient response to leave families to navigate weather events in the absence of formal supports. A recent review of the literature about communication with families of children with medical complexity during natural disasters advocates for including families in predisaster planning and using a formalized, proactive outreach approach during disasters. They also emphasize the importance of the post‐disaster period and the need to ensure minimal disruptions in care delivery and the provision of mental health supports (Smith et al. 2024).

Our study highlights the absence of government supports for families of children with disabilities during climate‐related weather events. A global review of 217 climate adaptation policies from 147 countries found that people with disabilities were identified as vulnerable by only 17% of countries and children and youth were identified by 59% (Lesnikowski et al. 2023). Although bc, the setting for our study, has not historically encountered frequent weather events (Canada Climate Institute 2023), this is rapidly changing; however, existing policies do not address the impacts of climate‐related weather events. As new policies, programs and supports are developed or updated, there is a pressing need to ensure that the needs of vulnerable and equity‐deserving groups, such as children with disabilities, are well integrated into population‐level adaptation planning and measures.

In the absence of such government supports, in our research, we found that there were noticeable disparities among the participants. Families with financial resources were able to purchase or rent equipment such as air conditioners, air purifiers and fans during the heat dome; one family even stayed in a hotel. Past research has indicated that families of children with medical complexity often pay out‐of‐pocket for medical and accessibility‐related costs (Teicher et al. 2023). To move towards a more equitable system of supports, reconsideration of coverage of medical supplies and equipment in the context of climate change is urgently needed, such as allowing families to have a stockpile of supplies and medications in case of emergency situations where they cannot receive such items.

Based on our research, we have the following key recommendations:

  • As climate‐related weather events occur at increasing intervals, it is imperative that governments create inclusive policies that address the needs of vulnerable populations, including children with medical complexity. This should include strengthening emergency response infrastructure to address the needs of this population.

  • Health and social care programs ought to include contingencies and supports for common climate‐related weather events in their jurisdictions. Planning should include formalized communication plans and assistance in creating care plans for weather emergencies.

  • Education and childcare providers should provide children with medical complexity who cannot attend in‐person classes and activities because of extreme weather with virtual or at‐home activities that facilitate social connections and support mental well‐being (Figure 1).

FIGURE 1.

FIGURE 1

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Recommendations and practical strategies.

In conclusion, our research is among the first to explore the experiences of families of children with medical complexity during climate‐related weather events. Because of their children's unique needs, these families adopt strategies that account for their child's medical conditions and also ensure that their medical supplies and equipment are available and functional. Policy‐makers need to develop inclusive approaches to supporting citizens during climate‐related weather events to minimize the disproportional impacts experienced by vulnerable groups.

Author Contributions

Jennifer Baumbusch: conceptualization, investigation, funding acquisition, writing – original draft, methodology, writing – review and editing, formal analysis, project administration, supervision. Vanessa Fong: investigation, writing – original draft, methodology, writing – review and editing, formal analysis, conceptualization. Esther Lee: conceptualization, writing – review and editing, formal analysis. Nilanga Aki Bandara: writing – original draft, writing – review and editing, formal analysis. Koushambhi Basu Khan: writing – review and editing, formal analysis, methodology.

Ethics Statement

This study was approved by the University of British Columbia's Behavioural Research Ethics Board (Certificate H21‐03867).

Conflicts of Interest

The authors declare no conflicts of interest.

Acknowledgements

We are grateful to the study participants for sharing their experiences.

Funding: This work was supported by the Canadian Institutes of Health Research and UBC School of Nursing's Lyle Creelman Endowment Fund.

Data Availability Statement

Data are available upon reasonable request of the corresponding author.

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