USA TODAY International Edition
Rising temperatures take increasingly deadly toll
Warming climate that helps drive them unlikely to leave any major US city untouched
Jack Esry died alone in his metro Phoenix home on July 25, 2019.
As temperatures soared close to 110 degrees, his son Bill, who lived out of state, worried that his aging father, who had been injured in a serious fall, would be affected by the extreme heat.
His dad’s air- conditioning unit had failed and Jack had delayed getting it fixed. He kept his windows closed, fearful his cats would escape. Finally, a friend called Bill to say his dad had missed a weekly chat.
Bill called authorities and asked for a welfare check.
When police arrived, the house was a scorching 99 degrees inside.
Jack Esry had succumbed to the heat. Esry, 80, was one of a record 197 people in Maricopa County who died from heat- related causes in 2019. That surpassed the previous record of 182 deaths in 2018, which surpassed the record of 179 deaths in 2017.
As of Tuesday, the Maricopa County Health Department has confirmed 106
“My husband said that if we put an airconditioner on the house, that he’d have to get another job,” said Blanca Abarca of Phoenix.
heat- related deaths this year. The agency is investigating 234.
The death toll rises in a way that would drive dramatic headlines if tied to a single weather event. Hurricane landfalls typically claim far fewer lives.
Instead, heat deaths happen one at a time, over the growing number of weeks and months each year when the weather turns dangerous. They are tied not to a single event but to an ongoing one, the rising temperatures that affect all seasons.
Over the past 30 years, heat has accounted for more fatalities on average than any other weather- related disaster in the U. S., according to the National Weather Service.
And while heat deaths may be more acute in the desert city of Phoenix, the warming climate that helps drive them is not likely to leave any major American city unscathed.
Hot days, hot nights
In the undeveloped desert, temperatures fall when the sun goes down, but in Phoenix, the heat seems relentless.
More than once this summer in Phoenix, the official thermometer still read 100 degrees at midnight and for more than seven days in July, the temperature never dropped below 90 degrees, setting a new record.
The region also contends with longer summers as days grow hotter earlier, sometimes as soon as April, and stay hot well into October.
And summers won’t grow more temperate any time soon. Climate change has increased the average temperature in Phoenix by 4.35 degrees since 1970, according to a 2019 report by Climate Central.
The expanding urban heat island hoards heat in asphalt, concrete and tall buildings during the day and releases it at night, which has resulted in nighttime temperatures soaring as much as 10 degrees above historical records.
These factors contributed to Phoenix’s status in the report as the fourth fastest- warming city in the U. S. With an average of 169 days per year with temperatures of 90 degrees or higher and an average midsummer high temperature of 106.1 degrees, Phoenix was also ranked as the hottest big city in the U. S.
As if to underscore the trend, the average temperature in Phoenix during July was 98.9 degrees, which made July the hottest month on record. The record was broken 31 days later when August ended with an average temperature of 99.1 degrees. The summer was also the hottest ever recorded.
But it’s not just desert cities like Phoenix that are threatened by hotter summer temperatures. Deadly heat is on the rise across the United States. Cities including Burlington, Vermont; Chattanooga, Tennessee; and Helena, Montana, are right behind Phoenix as members in Climate Central’s top 10 fast- warming cities list, experiencing temperature rises of more than 4 degrees.
Chattanooga experienced what one meteorologist called a “death ridge” during a May 2019 heat wave. The city and surrounding region experienced record temperatures – Chattanooga’s high temperature was more than 10 degrees above normal for late May. The Tennessee Valley city’s summer temperatures stretched into fall, reaching 100 degrees in October for the first time since weather records have been kept.
Even Minneapolis, known as the coldest large city in the U. S., has seen a 3.72 degree temperature rise.
“We are seeing more intense and longer heat waves, and while everywhere is used to dealing with seasonal extreme heat events for their given city, many northern areas may not able to adapt fully to extended periods of heat the same way as the south,” said Jennifer Vanos, professor of sustainability at Arizona State University.
“When heat combines with humidity over many days, like we see in much of the Great Lakes region,” Vanos said, “it can become particularly dangerous.”
As highs and lows continue their inexorable rise, long- running factors including poverty, homelessness and isolation for the elderly have begun to intersect with new effects of the COVID- 19 pandemic, which may limit incomes and shutter the facilities that help some people escape the heat. The combined effects could lead to a higher death toll this year.
‘ Like being in a steam room’
As the air temperature rises, so does the body’s temperature, said Mona Sarfaty, director of the Program on Climate and Health in the Center for Climate
Change Communication. In response, a person begins to sweat.
“The sweat evaporates from the skin as long as the air isn’t too humid,” Sarfaty said. “So you would expect that sweat to evaporate and cool things. It’s the body’s way of cooling itself.”
Without an opportunity to cool the body down, she said, people begin to feel the first symptoms of heat illness.
“You get headaches,” Sarfaty said. “You may just start to feel kind of dizzy or lightheaded. You may have some cramping, either abdominal cramping or muscle cramping.”
The longer someone is overheated, the worse the body’s response. If a body’s core temperature reaches 104 degrees or higher, the heart starts to pound and breathing speeds up. Eventually, the heart, lungs, kidneys, liver and brain will become damaged.
When that occurs, without immediate medical treatment, lifelong damage or death can occur within 24 hours.
‘ Like being in a steam room’
Rising humidity also factors into more dangerous summer days across the nation. The intersection of temperature and humidity can turn deadly with a thermometer reading as low as 100 degrees if the humidity rises to 35% or higher.
Weather and climate experts measure the effects of heat and humidity with what’s called a heat index. Excessive heat warnings are issued when the heat index is expected to reach 105 or higher for at least two days, and nighttime temperatures will be 75 degrees or higher.
Colin Raymond, a researcher at the Jet Propulsion Laboratory in California, said adding humidity into a hot day affects the body’s ability to cool itself.
“It’s like being in a steam room,” Raymond said. Days of higher temperatures coupled with higher concentrations of water vapor in the air can cause people to fall ill in large numbers, although he said more research is underway to more fully understand the effects.
A report by the Union of Concerned Scientists said if warming proceeds without any action to reduce heat- trapping emissions, one- third of the nation’s 481 urban areas with populations of more than 50,000 people will experience an average of 30 or more days per year with a heat index registering more than 105 degrees.
“We know that we are the hottest county in the U. S.,” said Vanos, at ASU. “We’re also the fastest- growing county in the U. S., so we should have the smartest policies and programs for reducing public health impacts that are associated with heat.”
Vanos said existing programs don’t seem to be effective at protecting the area’s most vulnerable, like people who don’t have air conditioning. Seniors and homeless people are also succumbing at increased rates. And transit riders in the metro area are greatly challenged as they deal with little shade and heat radiating off asphalt.
Too costly to stay cool
Summer in Phoenix typically starts with stifling heat with low humidity. Once the summer monsoon pattern sets in, that sense of being dry- roasted gives way to steamy, oppressive heat that is inescapable even at night.
Most people would rely more on their air- conditioners, but many low- income families don’t have that luxury.
Tucked into a largely Latino neighborhood in south Phoenix, one family has struggled to keep cool yet not run out of money during the torrid summer monsoon.
Blanca Abarca, her husband and 14year- old daughter, Isabella, lack the means to cool off that many people take for granted: air- conditioning. The Abarcas rely on a different technology – two evaporative coolers – in their 1950sera brick home.
The coolers reduce air temperature by blowing water- charged air through the house. But a swamp cooler, as it’s often called, becomes ineffective once the dew point, a combination of temperature and moisture in the air, reaches 55. Abarca’s husband, a handyman, installed ventilators in the ceiling and floor to circulate more air, but during the monsoon, being indoors can be almost unbearable.
Abarca showed off her outdoor kitchen and dining area in a backyard alive with big shade trees, three dogs, several chickens, a vegetable garden shaded to keep the hot sun off her tender plants. The kitchen is essential when it’s too hot to cook indoors, she said through an interpreter.
The Abarcas take at least three showers a day to cool off. And, Abarca said, “We drink about 6 or 7 gallons of water a week just to hydrate.”
They purchased two tiny room airconditioners for the bedrooms, but Abarca said they carefully ration their usage to just a few hours at night, so they can sleep.
“During the summers, we pay $ 200 a month at most,” said Abarca, a stay- athome mom. That’s still a lot of money to a family with just one breadwinner.
“Some people pay $ 400 or $ 500 a month,” she said. “One lady got a $ 1,500 bill, but even after talking to the company and finding there was a mistake, they still had to pay $ 600. Oh my gosh, I don’t have that kind of money!
“My husband said that if we put an air- conditioner on the house, that he’d have to get another job,” she said. “I see other families that finally got AC units, but now both parents have to work just to afford the electric bills.”
Heat on the street
Nearly half of victims of heat- related or heat- caused illness in 2019 were homeless, with another 14 who likely lacked a place to call home but whose housing status wasn’t clearly stated in medical examiner’s reports.
Some of the victims had burns from lying on hot concrete or asphalt, while first responders reported body temperatures of up to 112 degrees in people who were still alive when they arrived at the scene.
Rebecca Legate counts herself lucky to not be such a statistic. In 2016, Legate was struggling to survive what, at the time, was the third- hottest year in Phoenix. Daytime temperatures reached as high as 118 degrees, and 19 days hit record high temperatures.
More dangerous were the 16 nights during that hellish summer when temperatures never dipped below 89 degrees. To add to her misery, Legate was pregnant.
After a traumatic experience that caused her to flash back to when she was trafficked as a child, Legate said she regressed from a long- term period of sobriety.
“I ended up living in a condemned house with no electricity, no water, in the middle of the summer, pregnant,” she said. “I had three of my older kids with me at the time.”
The heat also affects transit riders in Phoenix. Rosetta Walker, 60, has been using public transit for the past eight years as she pursues her post- retirement passion of volunteerism. She’s unable to drive because diabetes- related glaucoma left her legally blind. She takes the bus and light rail to the federal courthouse every Friday to register new voters after the weekly naturalization ceremony.
She faces up to a 20- minute walk to a bus stop, depending on which direction she’s heading that day. There’s very little shade along the way and rarely any at the bus stops she frequents.
The city needs “more shade at the stops,” she said. “The shade is welcome when it’s 110 degrees out.”
David Hondula, assistant professor at ASU’s School of Geographical Sciences and Urban Planning, agrees that shade structures can make a difference to pedestrians in the summer. Hondula also notes that quality of life issues could be more closely explored to develop heat mitigation and adaptation.
“Is our ice cream not melting as we’re walking home from the grocery store? Can people choose active modes of transportation like public transportation?” he said.
Beating the heat
Over the past several years, public and private agencies have begun to take a more coordinated approach to addressing what has become an invisible, slow- moving public health crisis.
One such approach is the Maricopa Coalition on Climate Change and Public Health. Since 2015, the coalition has worked to build a strategic plan to address the ever- growing issue of hotter summers and how to support those who are most vulnerable.
The coalition includes the Heat Relief Regional Network, a county- wide system of emergency cooling centers and water distribution sites. The cooling centers – at community centers, libraries and churches – operate on the hottest days. Many are located along bus routes, but some can only be accessed by walking several blocks.
The cooling centers have their limits. They close when the facility does, usually during the hottest part of the day.
Phoenix is looking at how to improve the cooling centers, said Mark Hartman, chief sustainability officer for the city.
“We want to ensure that our cooling centers are actually in places that people will want to go,” Hartman said.
In December 2019, the Institute for Sustainable Communities, an organization that helps build resiliency and economic sustainability, received an environmental community action grant that it will use to help facilitate the coalition’s implementation of its strategic plan.
“Maricopa County is more advanced compared to other regions in dealing with extreme heat,” said Steve Adams, director of urban resilience at the institute. He said many programs to address climate change tend to operate at local jurisdictional levels; he likened such programs to how local governments respond to citizen calls to fix potholes in a pragmatic fashion.
One such public- private partnership is beginning to bear fruit, or, rather, mesquite beans. Tucked in the shadow of glittering new development in downtown Phoenix, the Edison- Eastlake neighborhood swelters during the summer.
ASU partnered with the Nature Conservancy, county and city agencies, and local residents to develop a plan to make this working- class neighborhood more walkable and less hazardous to health.
“Phoenix is one of the hottest areas around the world,” said Diana Bermudez, director of special projects for the Nature Conservancy. “But this is one of the hottest areas in terms of temperature in Phoenix.”
After holding workshops with residents, the coalition identified 12 “hot spots” that needed to be addressed. One such corner recently was the site of the first installation to relieve the heat: planting mesquite trees and other indigenous plants at the Trans Queer Pueblo on a corner in South Phoenix.
Jonathan Beebe Giudice with the Pueblo said not only will the trees and cactuses provide needed shade for pedestrians, they also symbolize a return to ancestral foods and show people in the community how they can continue to self- develop on their own terms.
“I think one of the things that is very important is that people feel that there is not much that they can do when it comes to heat,” said Bermudez. “But the truth of the matter is that there are things that can be done, and that nature can play a very important role in that.”