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Writing About SCI and Extreme Heat with the Help of AI

In which I explore the possibilities, benefits, and pitfalls of using AI to understand climate and disability.

Cyberpunk-style image of a woman in a tank top sitting in a manual wheelchair and a man in a blazer, both wearing sunglasses with a large yellow sun behind them.
An AI "drawing" of a woman with SCI and a man sitting in the hot sun, developed using the AI program Midjourney

I recently signed up for Chat GPT-4, the language-learning model artificial intelligence (AI) product that’s gained huge recognition lately. Chat GPT-4 has basically scoured the Internet and learned a bunch from it, and is able to respond to prompts by using that knowledge. It’s by no means all-knowing and there are a lot of potential drawbacks, but it’s a helpful tool for people who know how to use it.

I’d been meaning to write a blog about a climate-disability connection that affects me personally: the impacts of extreme heat events on people with spinal cord injuries. But instead of writing it myself, I decided this would be a good opportunity to let Chat GPT-4 write a blog – and then provide my feedback and insights. What I learned is that Chat GPT-4 does a pretty good job understanding the basics and laying them out in bullet point form of a couple sentences per bullet point. Some of the points can be a bit vague or not address causality, and can require follow-up questions to get more clarity. Chat GPT-4 can provide some links to useful info if you ask, though those by no means represent the most scientifically valid list (and you should always double check the links it provides).

Here’s the prompt I used to write this SCI-and-heat blog. Importantly, I worked to be specific in my question, pointing out different “buckets” of things it should address. Under the prompt is Chat-GPT’s response, along with my thoughts in bold & brackets at the end of each bullet point. At the end of this blog, I’ll give some concluding thoughts and how this might be a useful tool for people interested in disability and climate justice.

My prompt: “Write a blog on the impacts of climate change-caused extreme heat on people with spinal cord injuries. Explain medical and social factors that make people with SCI more vulnerable to extreme heat. Give recommendations for things individuals can do to stay safe, and policy recommendations for the government.”

Four multicolor digital sketches of robots sitting in wheelchairs and at desks. One robot has a laptop, another has a corkboard with pieces of paper on it, 1/3 robot has a desktop, and a fourth robot is holding a tablet.
Midjourney's four attempts at drawing a "friendly robot sitting in a wheelchair and typing on a laptop."

Title: The Hidden Threat: Impacts of Climate Change-Induced Extreme Heat on People with Spinal Cord Injuries


Climate change is a global phenomenon with far-reaching consequences. Among its many effects, extreme heat events are becoming more frequent and intense, posing significant challenges to human health and well-being. One group that is particularly vulnerable to these events are people with spinal cord injuries (SCI). In this blog, we will delve into the medical and social factors that make individuals with SCI more susceptible to extreme heat, and offer recommendations for both individuals and policymakers to ensure their safety and well-being. [A good quick intro that reflects my prompt]

Medical Vulnerabilities

AI drawing of a skeleton and circulatory systems sitting in a wheelchair, with warm background colors.
SCI affects vasodilation, which is how the circulatory system helps control body temperature. (Image from Midjourney AI)

1: Impaired Thermoregulation

Thermoregulation is the body's ability to maintain its internal temperature within safe limits. For individuals with SCI, this ability may be significantly impaired due to damage to the spinal cord, which disrupts the communication between the brain and the body. Consequently, people with SCI may have difficulty sensing and responding to changes in temperature, leading to an increased risk of heat-related illnesses such as heatstroke, heat exhaustion, and heat cramps. [This is important info and a cornerstone of extreme heat concerns for people with SCI. However, it doesn’t address the significant differences in thermoregulation based on one’s level of injury or even allude to it. It also does not speak about the issue of extreme cold. A follow-up question about levels of injury did break that down in pretty good detail, though.]

2: Reduced Sweating and Vasodilation

Sweating and vasodilation are two critical mechanisms that help the body dissipate heat. However, individuals with SCI may experience reduced sweating and vasodilation due to disrupted nerve signals, making it harder for their bodies to cool down during extreme heat events. [Aside from sensation, this is another physiological cause of people with SCI’s extra vulnerability to extreme heat. There is a significant difference based on one’s level of injury, where people with higher levels of injury are less able to sweat and vasodilate. Chat GPT-4 covered those differences with a follow-up prompt.]

3: Limited Mobility

People with SCI often have limited mobility, which can make it difficult for them to remove themselves from hot environments or access cooler spaces. This can exacerbate their vulnerability to extreme heat, as they may be unable to avoid prolonged exposure to high temperatures. [ I would have loved more detail here, like an example or two of hot environments or cooler spaces and how moving between them is difficult. A follow-up prompt gave five examples including problems with limited public transit and excess fatigue pushing manual wheelchairs in the heat.]

Social Vulnerabilities

Drawing of a woman sitting in a manual wheelchair, looking despondent at a piece of paper
People with SCI experience disproportionately low income and high poverty; this may impact their ability to manage extreme heat (image from Midjourney AI)

1: Economic Disparities

Individuals with SCI may experience financial hardships due to medical expenses, unemployment, or underemployment. These financial constraints can hinder their ability to access and maintain resources necessary for staying cool during extreme heat events, such as air conditioning or transportation to cooling centers. [The basic explainer here is good, and I like that it gives a few examples of financial disparities and necessary resources. A follow-up prompt addressed unemployment rates, income disparities, and annual healthcare & rehabilitation costs.]

2: Social Isolation

People with SCI may face social isolation, which can result in reduced social support during times of crisis. This can make them more vulnerable to extreme heat events, as they may lack the necessary assistance and resources to cope with high temperatures. [This is absolutely a major concern for people with all sorts of disabilities during climate-related events, especially since inadequate government support can place more of the disaster-response burden on individuals and their support networks. It doesn’t point out the value of support networks in disaster response, which is a bit disappointing.]

3: Inadequate Emergency Planning

Emergency planning and response strategies often do not take into account the specific needs of people with SCI, making it difficult for them to access appropriate help during extreme heat events. This can lead to an increased risk of heat-related illnesses and even death. [This is one of the vaguer pieces of the AI blog. As plenty of organizations have pointed out, disaster planning neglects many areas of accessibility and disability inclusion, from advance warnings to shelter to independent living supports. Meanwhile, “appropriate help” in extreme heat events is vague and could include such things as accessible cooling shelters, emergency healthcare, or one-on-one assistance to say cool. And there’s no explanation of how that could lead to “an increased risk of heat related illness and even death.” This point alone could warrant its own blog, but Chat GPT-4 just gives a couple vague sentences.]

Recommendations for Individuals with SCI

AI drawing like an oil painting. Six people, including a woman in a manual wheelchair, at a backyard barbecue laughing.
A strong support network can help people with SCI during heat waves. (Image from Midjourney AI)

1: Stay Informed

Monitor weather forecasts and pay close attention to heat advisories or warnings. This will help you prepare and make necessary adjustments to your daily routine. [This is simple and straightforward – and I always recommend people with disabilities follow daily weather and long-term forecasts, plus sign up for local emergency alerts and follow relevant agencies on social media-note though this and all recommendations are important for everyone, regardless of if they have a disability or not].

2: Create a Personal Heat Plan

Develop a personal heat plan that outlines the steps you will take to stay safe during extreme heat events. This may include identifying cooler spaces to spend time in, staying well-hydrated, and wearing loose, light-colored clothing. [A personal heat plan is important and should include much more than the three things pointed out here, such as planning transportation to cooling shelters or investing in air conditioning. Additionally, people with higher-level SCI, like me, cannot sweat to cool down, so “staying well-hydrated” is useful for us but comes with a caveat that it’s not to replenish sweat.]

3: Connect with a Support Network

Establish a network of friends, family, or neighbors who can assist you during extreme heat events. Make sure they are aware of your specific needs and are prepared to help if necessary. [As Chat-GPT noted in the “social vulnerabilities” section, people with SCI deal with higher levels of social isolation than do able-bodied people. So, while this is a good recommendation, it may be tough for some people with SCI.]

4: Discuss Heat Risks with Healthcare Providers

Talk to your healthcare providers about the potential risks of extreme heat events and how they might affect your health. They can provide guidance on the best ways to manage these risks and maintain your well-being. [Of course, this is important. It’s also notable that many healthcare providers may NOT be familiar with issues of thermoregulation, sweating and vasodilation for their patients with SCI. So, this may be a two-way conversation depending on one’s doctor and access to specialists.]

Policy Recommendations for Government

Computer-generated image of a woman sitting in a manual wheelchair giving a presentation; the PowerPoint slide shows a red graph of increasing temperatures.
It's important for government agencies and disaster planners to learn about how extreme heat affects people with SCI, and include them in disaster plans. (image from Midjourney AI)

1: Improve Accessibility to Cooling Centers

Ensure that cooling centers are accessible to people with SCI, with appropriate facilities and resources to accommodate their needs. This may include providing ramps, accessible restrooms, and trained staff to assist with transfers. [Cooling centers should also be set up in locations that are easy for people to access by public transit, especially considering people with disabilities have lower rates of car ownership compared to people without disabilities].

2: Increase Public Awareness

Raise public awareness about the unique vulnerabilities of people with SCI to extreme heat events. Promote understanding and empathy within the community to encourage support and assistance for this vulnerable population during times of crisis. [I would turn this around and say that the awareness-raising should be targeted at people with SCI, their support networks, and relevant professionals, e.g. physicians and cooling center staff. The second piece about empathy for a “vulnerable population” is a bit patronizing and would rightly irk many people focused on disability rights.]

3: Develop Inclusive Emergency Planning

Include people with SCI and other disabilities in emergency planning processes, ensuring that their specific needs are addressed in preparedness and response strategies. This should involve conducting accessibility audits of emergency plans and facilities, as well as providing tailored training for first responders. [This is great and fits with the disability rights mantra of “nothing about us without us.” Of course, there could be plenty of additional details, but this is a good two-sentence summary.]

4: Enhance Public Transportation Options

Improve public transportation options for people with SCI, including making transportation services more accessible and affordable. This will allow individuals to more easily reach cooling centers, healthcare facilities, and other essential services during extreme heat events. [Another good, straightforward, brief recommendation. This task is easier said than done, though, and is more difficult in suburbs and rural areas where transit is insufficient and underfunded. Extreme heat can also raise dangers for people waiting outside for buses or riding in poorly-ventilated trains and vehicles. Additionally, high temperatures can interrupt transit service, as happened with my local rail network last summer when a heat wave warped some tracks. Stakeholders should keep those factors in mind when planning for transit accessibility during heat waves.]

5: Invest in Energy Assistance Programs

Expand energy assistance programs to ensure that people with SCI can afford adequate air conditioning and other cooling resources in their homes. These programs should be designed with the specific needs of people with SCI in mind, taking into account the additional energy costs associated with the use of assistive devices and medical equipment. [This is especially important given people with SCI have disproportionately low income and face barriers to quality housing, including housing with good insulation and AC. Any programs should ensure that renters have access to AC by working with property owners to retrofit buildings and/or add window units.]

6: Encourage Resilient Infrastructure

Promote the development of resilient infrastructure, such as green roofs, urban parks, and cool pavements, which can help mitigate the urban heat island effect and provide cooler spaces for people with SCI to seek refuge during extreme heat events. [This type of resilient infrastructure is important for everybody, regardless of disability. It’s important to note that public green spaces should be accessible.]

7: Conduct Research

Invest in research to better understand the specific needs of people with SCI during extreme heat events, and to develop targeted interventions and strategies for reducing their vulnerability to heat-related illnesses. [Research should especially address social factors and the effectiveness of different interventions, including policy changes.]

As climate change continues to increase the frequency and intensity of extreme heat events, it is crucial that we recognize and address the unique vulnerabilities of people with spinal cord injuries. By implementing the recommendations outlined in this blog, both individuals with SCI and policymakers can take important steps towards ensuring the safety and well-being of this vulnerable population during times of extreme heat.

By working together, we can build a more inclusive and resilient society, better equipped to face the challenges posed by climate change, and protect the health and well-being of all its members, including those with spinal cord injuries.

Alex’s Final Thoughts

Computer-generated drawing of a man sitting in a power wheelchair talking to a robot with wheels for feet.
In which I tell Chat-GPT what I think of its work (image from Midjourney AI)

What I found from this blog is similar to what other people have found from Chat-GPT: it’s a useful tool if you know how to use it right, but is by no means an all-knowing expert. A blog like this had two-sentence bullet points and I can think of several more bullet points that would be useful, so the info for a given prompt is limited. Follow-up prompts made Chat-GPT go into more detail. For example, I followed up with prompts saying “go into more detail about the economic disparities faced by people with SCI, and how that makes them vulnerable to extreme heat” and “how does thermoregulation change depending on the level of injury? Does the level of injury affect sweating and vasodilation?” Both of those gave helpful bullet points (albeit with some vagaries and repetition), which helped me dig deeper into this topic.

Notably, Chat-GPT has major flaws when it comes to climate change and research in general. For example, the software will outright make up quotes and references if you ask it to write an essay, and the websites it uses to train itself include things like Wikipedia (which has some inaccurate parts), plus climate-science-denying news outlets (like Breitbart) and “info” websites (like whatsupwiththat[dot]com). You should keep those caveats in mind when using the software, and always double-check any statistical claims, quotations, or references.

So, how can Chat-GPT be a useful tool for learning or writing about climate change and health and climate change and disability – including specifics like SCI and heat, climate migration, etc.? From what I’ve seen here, it can help identify areas-of-concern and useful mitigation and adaptation strategies. It can provide a layout for your own writing; you could pick-and-choose bullet points, do a bit more research online, and elaborate on those bullet points. It’s also important to make sure that your prompts are specific enough to get useful outputs, and to use follow-up questions where appropriate. And of course, try to understand exactly what this tool does and its pitfalls. I’ll surely be using this software more in the future, with however many grains of salt it deserves.

If you’ve used Chat-GPT or have thoughts about how it works, let us know in the blog comments! And let us know if you have any other topics you’d like us to explore in the future! Thanks as always for following along.

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