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Mishmash of how US heat deaths are counted complicates efforts to keep people safe as Earth warms

phoenix – Postman Eugene Gates Jr. was delivering mail in the stifling heat of Dallas this summer when he collapsed in a homeowner’s yard and was taken to a hospital where he died.

Kara Gates, who is still awaiting the autopsy report, said she believes the heat played a role in her 66-year-old husband’s death. At the time of Eugene Gates’ death on June 20, the temperature was 98 degrees Fahrenheit (36.6 degrees Celsius), with a heat index of over 110 degrees Fahrenheit (43.3 degrees Celsius) when humidity is factored in.

“Until the day I die, I will believe this is due to fever,” said Kara Gates.

Even when extreme heat is clearly the cause, death certificates do not always reflect the role that extreme heat played. Experts say they don’t really know how many people die each year in the United States from the heat in a warming world because more than 3,000 counties calculate heat stroke deaths inconsistently. It states that it means no.

Its inaccuracy is better protect people The heat wave is to blame because officials who formulate policies and fund programs do not get the financial or other support they need to change the situation.

“Basically, all heat-related deaths are preventable. Christy L. Ebi says:

Once we have more accurate numbers, we can set out to develop a much better heat wave early warning system, targeting people at higher risk and ensuring they are aware of these risks. You can,” she said.

The only consistency in the number of heat stroke deaths in the United States today is that officials and climate experts admit that the death toll is grossly underestimated.

Dr. Greg Hess, medical examiner in Pima County, Arizona’s second most populous county, home to Tucson, said, “Death investigations are done in very different ways depending on where the person died. It’s no surprise that they don’t,” he said. National data on heat-related deaths are plentiful. ”

Many experts say the decades-old standard method known as counting excess deaths gives a better indication of how extreme heat can harm people.

“We want to look at the number of people who would not have died during that time period to really understand the magnitude of the impact,” says Ebi. Heat.

Excess mortality calculations are often used to estimate the number of deaths in natural disasters, with researchers tallying more deaths than occurred during the same period of the previous year when conditions were average.

Excess death counts were used to calculate the human impact of a heat wave that killed over 700 people in Chicago in July 1995. Many of them were black seniors living alone. The researchers also counted excess deaths during the COVID-19 pandemic to provide more complete information on deaths directly and indirectly related to coronavirus.

But as it stands, the Centers for Disease Control and Prevention reports only 600 to 700 heat stroke deaths in the United States each year.a study A paper published last month in the journal Nature Medicine estimated that more than 61,000 people died from heat stroke across Europe last summer, roughly twice the number of people in the United States, but heat stroke more than 100 times the number of deaths from

Dr. Samed Katana, a cardiologist at the Philadelphia Veterans Affairs Medical Center and an assistant professor at the University of Pennsylvania’s Perelman School of Medicine, said heat deaths contribute significantly to deaths from causes such as heart failure. should also consider.

Katana also participated the study Aggregate of excess deaths for all counties in the United States, released last year. The findings suggest that between 2008 and 2017, between 3,000 and 20,000 adult deaths from all causes listed on death certificates were associated with extreme heat. Heart disease is cited as the cause of about half of the deaths.

Canadian provinces after 2021 summer Pacific Northwest heatwave british columbia Reported over 600 deaths from heat exposure Oregon and Washington Each initially reported a similar death toll of just over 100.

“It’s frustrating that for 90 years, public health officials in the United States haven’t had a good grasp of heat stroke mortality,” said Dr. David Jones, M.D., Ph.D., professor of medicine at Harvard Medical School. Division of Epidemiology, TH Chang School of Public Health, Harvard University.

There is no uniformity across US jurisdictions as to who does the counting. In some locations, death investigations may be conducted by a coroner, usually a doctor trained in forensic pathology. In other areas, such as Orange County, California, the coroner may also be an elected sheriff. In some small Texas counties, a magistrate may decide the cause of death.

Utah and Massachusetts are among the states that do not track heat-related deaths in which heat exposure is a secondary factor.

CDC derives information about heat deaths from death certificate information contained in local, state, tribal, and territory databases, which are often years behind in reporting.

In a CDC statement, the coroner and other officials said: fill out a death certificate Although “reporting all causes of death is encouraged,” they do not necessarily tie them to death from extreme heat exposure and include a diagnostic code for heat stroke.

Arizona coroner Hess said determining environmental heat as a contributing factor to a person’s death is difficult and investigations, including toxicology tests, can take weeks or even months. .

“If someone is shot in the head, it’s pretty clear what happened there. But if a body is found in a hot apartment 48 hours after death, it leaves a lot of ambiguity,” Hess said. Ta.

Hess noted that Pima County began including heat-related deaths in counting environmental heat deaths this year. Maricopa County, home to Phoenix, the hottest metropolis in the United States, has a long history of heat stroke deaths. Clark County, Nevada, where Las Vegas is located, is now also considering heat-related deaths.

Maricopa’s Public Health Department counted 425 “heat-related” deaths last year, including deaths secondary to heat, such as heart attacks caused by high temperatures.

By 5 August this year, 59 heat-related deaths had been confirmed, with an additional 345 under investigation. The latest stats make it Phoenix’s hottest month on record, following a record 31st consecutive day of temperatures above 110 degrees Fahrenheit (43.3 degrees Celsius).

Dallas, which regularly sees summer highs above 100 degrees Fahrenheit (37.7 degrees Celsius), has been plagued with sweltering heat and muggy humidity this month amid an excessive heat warning. Masu.

Carla Gates, the widow of a postman, said cities around the world must learn how to deal with extreme weather. She said her spouse, who has been with her for 36 years, tried to protect herself by carrying boxes of ice and several bottles of cold water.

“Our climate has changed,” she said. “And I don’t think we’re going back to where we were 20 years ago. So we’ll have to get used to it and we’ll have to make some adjustments.”

Now she wants to pay tribute to her husband and push for legislation to ensure that people working outdoors are protected from the heat. Gates said her husband was in an old mail truck with no air conditioning the day he died.

“I’m working in the heat doing what I love and I don’t want anyone to get a phone call saying their loved one has died,” she said.


Mr. Lafleur reported from Dallas. Associated Press reporters from across the United States also contributed.

Copyright 2023 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission.

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