Extreme Heat Is Killing More Americans Than Ever

Eugene Gates Jr. was delivering mail on his route in Lakewood, Dallas, when he collapsed in a front yard on June 20, amid a stifling Texas heat wave. Temperatures on that day had reached an estimated 115 F in the Dallas area. A homeowner performed CPR, but Gates, a 66-year-old USPS carrier, died.

A day later, a 35-year-old utility lineman from West Virginia died "while working to restore power in Texas," according to More Perfect Union, a news platform covering workers' rights issues.

The two workers were among at least nine people who have died because of the extreme heat that hit Texas and several other southern states at the end of last month, which also caused a surge in emergency visits.

The tragedies have focused attention on an issue that is likely to become ever more urgent, with provisional figures obtained by Newsweek showing there were over 1,700 deaths in 2022 from heat-related causes—a new record. Even this is likely to be a huge underestimate, studies suggest.

"Heat waves are what we expect in a warming climate," Andrew Pershing, director of climate science at Climate Central, told Newsweek, referring to the weekslong June heat wave in Texas. "We expect to have more of these events occur more frequently, more intensely. And this is just following that script."

Just how bad could it get? And what, if anything, can be done about it?

Deaths and Emergencies Set to Rise

As many U.S. states, especially in the south, are getting used to record-breaking temperatures each summer, the risk of heat-related deaths is also likely to grow dramatically, according to experts. In fact, it has already gotten much worse.

"Between 1999-2022, the crude rate and count of heat-related deaths were highest for 2022 (based on provisional data) and the next highest year was 2021," Kathleen Conley, a spokesperson for the Centers for Disease Control and Prevention (CDC), told Newsweek. "So, heat-related health impacts are noticeably higher in recent years."

An average of 702 people are killed by the heat every year in the U.S., according to CDC data. That's on top of 67,512 people who visit an emergency department each year due to heat, and 9,235 who are hospitalized.

In 2000, there were 494 heat-related deaths reported, according to CDC data. By 2010, that had risen to 799, and by 2020 to 1,156. Provisional data for 2022 shows an estimated 1,708 heat-related deaths that year across the U.S.

This is a rise of about 245 percent, vastly exceeding the increase in census-recorded population from 2000 to 2020 of about 18 percent.

According to data from the Environmental Protection Agency (EPA), more than 11,000 Americans have died from heat-related causes since 1979, as shown by death certificates available.

However, the situation is likely far more severe than even these estimates.

It was 91 F in Austin, Texas, when Jeff Goodell, author of the newly released book The Heat Will Kill You First, told Newsweek that CDC mortality figures are "wildly underestimated."

"Everybody acknowledges that," he said, "because heat is not a gun, it doesn't leave a wound on your body. You can look at somebody who's been shot by a gun and see where the bullet ran through. Heat is very different," he said.

"People who die from heat, they die from a variety of things that happen. A lot of times it's heart attacks, kidney failures and things like that. So these deaths are wildly underestimated."

Two recently published studies estimated the number of heat-related deaths in the U.S. to be much higher than the official data. A study released on Jama Network Open last summer found that from 2008 to 2017 between 13,000 to 20,000 deaths could be linked to extreme heat, with approximately half of them due to heart disease.

Another recent study published on The Lancet suggested that up to 20,000 deaths a year in North America may be linked to hot temperatures. By comparison, the infamous 1936 heat wave is thought to have caused around 5,000 deaths.

Experts in Phoenix, Arizona have tracked the number of heat-related deaths in recent years, and found that there was undoubtedly a jump in cases. "And that's in a city that is used to the heat, that you think of as having some ability to deal with heat," Pershing said.

Is This Normal Or The Result Of Climate Change?

Pershing and his colleagues have developed a tool called the Climate Impact Index, which they use to calculate whether current temperatures can be attributed to the effect of global warming or not. They used the index during Texas' latest heat wave, and found that "most places, especially in southern Texas, are hitting level five on our scale, which means that the event is at least five times more likely because of climate change."

"It's really hard to imagine an event of this duration and this severity without climate change," he added.

"We know that as long as we continue to burn coal, oil and natural gas, the climate is going to continue to warm and that these events are going to continue and they're going to get increasingly more difficult.

"They're going to be bigger, they're going to be more severe. They're going to occur in seasons where we don't expect them."

The CDC expects the impact of climate change and the extreme heat to lead to a surge in related deaths in the future.

"Climate change is increasing the severity and frequency of extreme heat events," Conley said. "Under a changing climate, coupled with factors such as an aging demographic and urbanization, heat-related deaths are expected to increase in the future."

Who Is Affected?

According to the CDC, the populations most at risk include from extreme heat are:

• Adults at or above 65 years of age;
• Children and student athletes;
• People with disabilities;
• People with mental health or substance use disorders;
• Pregnant persons;
• People with limited access to cooling spaces;
• People who engage in outdoor work and activities.

"In addition, American Indian and Alaskan Native, Black, and LatinX populations are vulnerable to the effects of extreme heat," Conley said. "Urban populations—especially unhoused populations—and historically redlined communities suffer from higher exposure risk," as well as "people who have chronic medical conditions and or those taking medications for the management of certain health conditions."

According to EPA, since 1999, people aged 65 and above have been several times more likely to die from heat-related cardiovascular disease than the general population, while non-Hispanic Blacks generally have had higher-than-average rates.

Unfortunately, the CDC does not have a national database that tracks these at-risk populations. "So, it's hard to quantify how many lives are at risk," Conley said. Data around heat-related deaths is collected and processed by each individual state and territory, and this jurisdiction-specific data are then sent to the CDC's National Center for Health Statistics (NCHS).

If you're concerned about the heat, you can check the CDC's heat-health tracker, which provides county-level information on some of these risk factors along with measures of extreme heat exposure and places of interest—like schools and nursing homes—that might be susceptible to extreme heat.

Is The U.S. Prepared To Deal With Such Heat?

Pershing thinks that Americans' ability to deal with the increasingly higher temperatures "depends so much on where you live and what your circumstances are."

If you live in a new house and drive a new car, Pershing said, "you can move from air conditioner to air conditioner and you're going to be fine."

But if you have some underlying health issue, if you're financially stressed, you have challenges around your housing situation, or if you're driving a car where the air conditioner is broken, "you're going to have a much, much tougher time" dealing with heat.

These differences in people's financial and living situation, their age, and their health and their impact on people's capacity and ability to handle increasingly higher temperatures is something that comes up a lot in research about the climate, Pershing said.

But he is optimistic that people are getting to understand the urgency of the issue. "I think we're seeing a lot of engagement from the federal government around heat that wasn't there several years ago," he said. "I think we're seeing states and cities take this issue a lot more seriously."

But it's a systemic problem, Pershing said, which "intersects in these really challenging ways with the housing crisis that we have in the United States with homelessness, with drug use." All of these factors, he said, are exacerbated by the heat.

"You add heat there and you're just making what's already a stressful situation so much more stressful for people. And that's really where we get a lot of these differential impacts."

Short-term and Long-term Solutions

John M. Balbus, acting director of the new Office of Climate Change and Health Equity within the Office of the Assistant Secretary for Health (OASH)—part of the U.S. Health and Human Services—said the situation is not a bad as it could have been at this point.

"Since the Chicago heat wave of 1995, cities, states, and the federal government have all stepped up their efforts to prevent heat-related mortality," he told Newsweek. "We know that the number of heatwaves in cities and throughout the country are getting worse. But there are effective measures in place which have kept the mortality from increasing along with the heat."

The direct, short-term response to heat is usually coordinated at the local level, Balbus said, such as the opening of cooling centers or the creation of water fountains. "And that's getting folks who are at the greatest risk into those cooling centers," he said.

In the long term, city and state governments, as well as the federal government, are working on a different set of solutions, which would also address diminishing the impact of climate change.

"The Biden administration has put a really strong focus on recognizing the threats from climate change, and bringing long-term thinking to that problem through the creation of a number of resilience working groups," Balbus said.

"This year, we're working on raising awareness of the funds available through especially the Inflation Reduction Act, that's providing billions of dollars to communities to address heat."

There's billions of dollars for starting to plant trees in urban settings, Balbus said, which would alleviate urban heat in the long-term.

"The solution is going to be ensuring that the buildings where people live are as resilient to the heat as possible," Balbus said. "The short-term solution is to slap an air conditioner in every window. That's a terrible long-term solution. And most importantly, it only works so long as the powers are—and that's the most upsetting issue that we've found in Texas," he added, referring to the pressure that's been put on the state grid by increased demand in electricity.

In June, after 300,000 homes went without power, the power operator in Texas asked residents to cut back on air conditioning and appliance use.

Texas Governor Greg Abbott is in favor of a mix of energy sources to help address future shortages, although this would depend on greater storage capacity. "You can have fossil fuels while at the very same time be leaders in renewable energy," he said in March last year, according to the Houston Chronicle. "We've got to be very clear that all forms of energy are essential."

However, the most important solution to the extreme heat problem, for Goodell, is "cutting fossil fuel emissions fast."

"The reason the world is heating up faster and that we're having these extreme heat events is because we're continuing to burn fossil fuels and dump CO2 into the atmosphere," he said.

"We need to redesign our world to think about heat and incorporate it into our design of the world. But on a more day-to-day level we need to become heat smart—and learn about the risks of heat."

El Niño—a global weather phenomenon that occurs every year—is expected to bring more heat to the U.S. and the rest of the world, making the problem more acute.

"Very upsettingly, I I think we're in for seeing more heat in the short-term, and absolutely in the long-term," Balbus said.