Deadly heat waves threaten older people as summer nears

In America's hottest big metro, older people like the Sun Lakes mobile home resident accounted for most of the 77 people who died last summer in broiling heat inside their homes, almost all without air conditioning.

Now, heat dangers are becoming familiar nationwide as global warming creates new challenges to protect the aged.

From the Pacific Northwest to Chicago to North Carolina, health clinics, utilities and local governments are being tested to keep older people safe when temperatures soar. They're adopting rules for disconnecting electricity, mandating when to switch on communal air conditioning and improving communication with at-risk people living alone.

Situated in the Sonoran Desert, Phoenix and its suburbs are ground zero for heat-associated deaths in the U.S. Such fatalities are so common, Arizona's largest county keeps a weekly online tally during the six-month hot season from May through October. Temperatures this year were already hitting the high 90s the first week of April.

"Phoenix really is the model for what we'll be seeing in other places," said researcher Jennifer Ailshire, a native of the desert city now at the University of Southern California's Leonard Davis School of Gerontology, where she studies how environmental factors affect health and aging. "The world is changing rapidly and I fear we are not acting fast enough to teach people how harmful rising temperatures can be."

A 2021 study estimated more than a third of U.S. heat deaths each year can be attributed to human-caused global warming. It found more than 1,100 deaths a year from climate change-caused heat in some 200 U.S. cities, many in the East and Midwest, where people often don't have air conditioning or are not acclimated to hot weather. Another study showed that, as climate changes worsens in coming decades, dangerous heat will hit much of the world at least three times as hard.

Isolated and vulnerable, the heat victims last year during Maricopa County's deadliest summer on record included a couple in their 80s without known relatives, an 83-year-old woman with dementia living alone after her husband entered hospice care and a 62-year-old Rwandan refugee whose air conditioner broke down.

While most of the county's confirmed 378 heat-associated deaths were outdoors, those who died indoors were especially vulnerable because of isolation, mobility issues or medical problems as outside highs hit 115 degrees.

Older people of color with a greater tendency for chronic conditions like diabetes, obesity and high blood pressure are especially at risk.

In Chicago, three African American women in their 60s and 70s died in spring 2022 when the centrally controlled heating in their housing complex remained on and the air conditioning was off despite unseasonable 90-degree weather in mid-May.

An undetermined number of older people died during the summer of 2021 when an unexpected heat wave swept across the U.S. Pacific Northwest.

Many U.S. cities, including Phoenix, have plans to protect people during heat waves, opening cooling centers and distributing bottled water.

But many older people need personalized attention, said Dr. Aaron Bernstein, who directs the Center for Climate, Health, and the Global Environment at the Harvard T.H. Chan School of Public Health.

"If you are elderly and sick, you are unlikely to get into an Uber or bus to get to a cooling center," said Bernstein, who vividly recalls a 1995 heat wave that killed 739 mostly older people in Chicago, his hometown. "So many were socially isolated and at tremendous risk."

Sociologist Eric M. Klinenberg wrote about that catastrophe in his book "Heat Wave: A Social Autopsy of Disaster in Chicago."

"Older people are more prone to live alone," he said, "and they are the most likely to die."

That's true of all extreme weather. When Hurricane Katrina devastated Louisiana in 2005, around half of the 1,000 people killed were 75 or older, most of them drowned when their homes flooded.

Chicago encourages residents to check on older relatives and neighbors on hot days and city workers visit people's homes.

Bernstein's center is working with relief organization Americares to help community health clinics prepare vulnerable patients for heat waves and other extreme weather.

A "climate resilience tool kit" includes tips like making sure patients have wall thermometers and know how to check weather forecasts on a smartphone. Patients learn simple ways to beat the heat, like taking a shower or sponge bath to cool off and drinking plenty of water.

Alexis Hodges, a family nurse practitioner at the Community Care Clinic of Dare in coastal North Carolina, said rising temperatures can cause renal failure in patients with kidney problems and exacerbate dehydration from medications like diuretics.

At the nonprofit Mountain Park Health centers that annually serve 100,000 patients in greater Phoenix, nurse practitioner Anthony Carano wrote letters to utility companies for low-income patients with chronic conditions, asking them not to turn off power despite missed payments.

Maricopa County in April used federal funds to allocate another $10 million to its air conditioner replacement and repair program for people who qualify, bringing total funding to $13.65 million. In greater Phoenix and several rural Arizona counties, older low-income people can apply for free repair or replacement of air conditioners through a separate nonprofit program.