Without data, ‘you don’t solve the problem’
The elderly, people with heart disease, lung disease, diabetes, people with mental health issues,” he said.
While vulnerable people can handle short periods of extreme heat, they can’t cool themselves as well during a heatwave. The heat builds inside their bodies and surpasses their capacity to cope. “Somebody who has a weak heart and is exposed to high temperatures for a couple of days, they tend to have heart attacks because it just is an additional stress on a system that is already strained,” he said.
The people who died from the heat last summer were predominately low-income, elderly and living alone, and many had severe mental health illnesses, alcohol dependency or chronic heart or lung disease.
Kaiser, who heads a team of specialists planning for Montreal’s next heat wave, says cities across the country cannot address the problem of heatrelated deaths unless they’re counting them correctly.
“If you don’t have the data, then you don’t solve the problem. And you can only solve problems for things you can measure, right? So if you’re not measuring, you’re not going to do anything about it,” he said.
Ontario’s chief coroner’s office declined to comment for this article.
Most cities have protocols that kick in when heat waves strike. But in addition to standard measures extending hours at public pools and opening cooling centres, Montreal implements “active surveillance” for heat-related deaths across the heath-care system.
For every death they encounter, emergency room workers, paramedics and coroners fill out forms that ask about preexisting health conditions, whether the patient had air conditioning, and even what the room temperature is when people are found dead at home.
The questionnaires provide key information that allows public heath workers to determine whether heat played a role in the death. By tracking heat deaths in real time, Kaiser and his team can identify neighbourhoods or even buildings where there’s an elevated risk.
“The primary objective is to identify where people are dying during heat waves, so that we can deploy resources,” Kaiser said. “If we’re able to use unfortunate deaths that occur during a heat wave to identify specific buildings, specific locations where more people are at risk, we can have an impact.”
This active surveillance system was put in place in the early 2000s after the European heat waves that killed tens of thousands in Paris. There are already signs of improvement. During the last heat wave in 2010, Montreal recorded 103 deaths — a rate of 9.3 deaths per million people per day. Last summer, even though the heat wave was longer and more intense, the death rate dropped by 31 per cent, down to 6.4 deaths per million people per day.
While it’s impossible to definitively credit a single program, the active surveillance, improved public awareness and outreach to vulnerable areas all played a role in limiting the number of heat deaths.
Seen that way, the deaths in Montreal aren’t a reflection of failure, but of improvement.
Yet, these kinds of publichealth emergency actions will not suffice on their own. In the long run, the city itself must change to handle the heat.
Montreal public health plotted last summer’s deaths on the map and found that people living in the heat islands were twice as likely to perish as those living in the cooler areas, which were often right across the street.
These heat borders occur across the city, dividing the cool, treed areas from the hot concrete-covered ones. They also tend to follow demographic lines that separate the poorest and most vulnerable to heat from their air-conditioned neighbours.
Boulevard de l’Acadie separates Parc Extension (known as Parc Ex), one of the poorest neighbourhoods in Canada, from the Town of Mount Royal (known as TMR), one of the wealthiest.
A chain-link fence, its top sharpened into points, lines the west side of the street, running for almost two kilometres. Behind the fence, well-manicured lawns and stately houses are well shaded by copses of mature evergreens. This was Pierre Trudeau’s riding from the 1960s to the ’80s. Across the street, a few scraggly young trees choke in the dust and heat beneath concrete apartment towers. This riding has been held by Justin Trudeau since 2008. TMR had no heat-related deaths last summer. But in the first dozen blocks of Parc Ex, three perished.
The reasons why people are dying in Parc Ex and not TMR are both social and environmental. Many in Parc Ex can’t afford A/C. But their need for A/C is greater because of the lack of tree cover and cooling greenery.
No heat-wave response will make Parc Ex any cooler. That’s why Kaiser at Montreal public health says we have to think beyond improving emergency procedures and work between heat waves to reduce the impact of the next.
“The best strategies you can put in place today are the ones that will reduce — even by one degree — the maximum heat that we’re going to have in our cities 30 years from now,” he said.
This means dramatically reducing global emissions, but also reducing heat locally, so the hot neighbourhoods are a few degrees cooler.
“From a public-health perspective, it’s an important strategy to be able to link environmental interventions to health,” Kaiser said.
Two summers ago in Phoenix, Ariz., it was so hot they had to close the airport because planes couldn’t get the lift they needed to take off.
With temperatures hitting 48 degrees every summer, the city is coping with the most extreme effects of urban heat waves in North America.
And in a place where virtually everyone has A/C, the limitations of the “best way” to beat the heat are becoming evident.
Maggie Messerschmidt, a local organizer with the Nature Conservancy, said: “Here, in this neighbourhood, we’ve had issues with the power, because everyone wants to crank up their A/C … and it’s too much power, so the power falls off.” Then no one has A/C, and those whose lives depend on it are in peril. Messerschmidt has been working with marginalized communities in Phoenix as part of the environmental organization’s efforts to link ecological concerns with public health. This dovetails with the efforts the local public-health authority has been making to depoliticize climate change.
Their strategy: don’t make it about the environment. Make it about saving lives. The Nature Conservancy (which works in Canada through Nature United) has been holding workshops in Phoenix and asking people how they cope with heat and what they need to cope better.
At one meeting, Messerschmidt was told: “There’s no power. Sometimes it goes out for hours. Or, it could be minutes. We don’t know how long it’s going to last. We had to make sure to keep our kids and our elderly people safe … But there’s no cool areas in this neighbourhood. The parks, they’re hot because there’s no shade over the playground.”
This is when Messerschmidt talks about the research they have done on greening and how outdoor spaces can be made cooler so they’ll be more useful during a power outage.
“We’re thinking about naturebased solutions,” she said. “We built a shade structure in the community garden and did some tree plantings at people’s homes.”
The group also installs green roofs, or if that’s not possible, transforms dark surfaces, which absorb heat, into light ones that reflect it, as a way to combat urban heat islands.
Their efforts run up against the pervasive use of A/C, which pumps hot air outside. In a city where many units are running in close proximity, they’re actually worsening the urban heat island effect.
“It’s called anthropogenic waste heat,” said Emily Maxwell, who heads the Nature Conservancy’s urban heat project. “Beyond greening, if we can decrease the waste heat from those systems, we can actually improve the ambient environment and improve temperatures.”
Fighting the adoption of A/C is an uphill battle. The number of A/C units worldwide is expected to nearly quadruple by 2050. The International Energy Agency notes that while 90 per cent of Americans have A/C, only about 8 per cent of people in Latin America, Africa and the Middle East do. People in those regions are expected to adopt A/C by the billions.
Increased A/C use will cause electricity demand to soar, and if the power comes from carbon-producing coal and natural gas, human cooling will exacerbate global warming.
Greening at all costs is the only way to reduce reliance on A/C, Montreal public health’s Kaiser said.
“You need to be bold enough, so that (greening is) likely to have an impact,” he said. “If we plant three trees in the city of Montreal, we’re not going to have an impact.”
Greening cities, roofs and architecture at a massive scale will take time. While we can plant quicky, we won’t be able to measure the effects for many years, maybe even decades. And because even the most enlightened government must face reelection, it is difficult to sustain urban greening for long enough to prove it’s making a difference.
“Look at 2050, that’s where I’m interested in having an impact. And in the meantime, I know that planting more trees, putting in more white roofs and reducing the amount of asphalt on the ground is not going to harm anyone, even if I can’t measure impact in the short term,” Kaiser said.
In other words, we can’t afford to wait until we can prove that planting trees saves lives. We’ll have to green on faith.