Some victims were found at home. An 84-year-old woman who’d spent over half her life in the same Sacramento, Calif., apartment died near her front door, gripping her keys. A World War II veteran succumbed in his bedroom. Many died outside, including a hiker who perished on the Pacific Crest Trail, his water bottles empty.
The killer? Heat. Hundreds of others lost their lives when a stifling air mass settled on California in July 2006. And this repeat offender’s rap sheet stretches on. In Chicago, a multiday scorcher in July 1995 killed nearly 700. Elderly, black residents and people in homes without air conditioning were hardest hit. Europe’s 2003 heat wave left more than 70,000 dead, almost 20,000 of them in France. Many elderly Parisians baked to death in upper-floor apartments while younger residents who might have checked in on their neighbors were on August vacation. In 2010, Russia lost at least 10,000 residents to heat. India, in 2015, reported more than 2,500 heat-related deaths.
Year in and year out, heat claims lives. Since 1986, the first year the National Weather Service reported data on heat-related deaths, more people in the United States have died from heat (3,979) than from any other weather-related disaster — more than floods (2,599), tornadoes (2,116) or hurricanes (1,391). Heat’s victim counts would be even higher, but unless the deceased are found with a fatal body temperature or in a hot room, the fact that heat might have been the cause is often left off of the death certificate, says Jonathan Patz, director of the Global Health Institute at the University of Wisconsin–Madison.
As greenhouse gases accumulate in the atmosphere, heat’s toll is expected to rise. Temperatures will probably keep smashing records as carbon dioxide, methane and other gases continue warming the planet. Heat waves (unusually hot weather lasting two or more days) will probably be longer, hotter and more frequent in the future.
Beyond deaths, researchers are beginning to document other losses: Heat appears to rob us of sleep, of smarts and of healthy births. “Heat has the ability to affect so many people,” says Rupa Basu, an epidemiologist with the California Environmental Protection Agency’s Office of Environmental Health Hazard Assessment in Oakland. “Everybody’s vulnerable.”
Many people see heat as more of an annoyance than a threat, but climate change, extreme heat and human health are entwined. “There might not be a huge burden of disease from heat-related illness right now in your community,” says Jeremy Hess, an emergency medicine physician and public health researcher at the University of Washington in Seattle. “But give it another 20 years, and it might be a more significant issue.”
The number of days each year above 95° Fahrenheit (35° Celsius) is expected to rise across the United States, and average summer temperatures will reach new heights if greenhouse gas emissions remain high. The maps below compare late 20th century temperatures to projections for the mid–21st century.
Adaptation has limits
The human body can’t tolerate excessive heat. The biological and chemical processes that keep us alive are best carried out at a core temperature of 36° to 37° Celsius (96.8° to 98.6° Fahrenheit), with slight variation from person to person. Beyond that, “the body’s primary response to heat is to try and get rid of it,” says Jonathan Samet, dean of the Colorado School of Public Health in Aurora. Blood vessels in the skin dilate and heart rate goes up to push blood flow to the skin, where the blood can release heat to cool down. Meanwhile, sweating kicks in to cool the skin.
With repeated exposure to high temperatures, the body can become more efficient at shedding excess heat. That’s why a person can move from cold Minneapolis to steamy Miami and get used to the higher heat and humidity. But there is a limit to how much a person can adjust, which depends on the person’s underlying health and the ambient temperature and humidity. If the outside is hotter than the body, blood at the skin surface won’t release heat. If humidity is high, sweating won’t cool the skin. Two scientists proposed in 2008 that humans cannot effectively dissipate heat with extended exposure to a wet-bulb temperature, which combines heat and humidity, that is greater than 35° C.
Forced to regulate heat without a break, the body gets worn out. Heat exhaustion leads to weakness, dizziness and nausea. If a person doesn’t cool off, heat stroke is likely — and likely fatal. The ability to regulate heat breaks down and core body temperature reaches or exceeds 40° C. A person suffering heat stroke may have seizures, convulsions or go into a coma.
No one is immune to heat, but it hits some groups harder than others. The elderly, considered the most vulnerable, have fewer sweat glands and their bodies respond more slowly to rising temperatures. Children haven’t fully developed the ability to regulate heat, and pregnant women can struggle due to the demands of the fetus. People with chronic diseases like diabetes, cardiovascular disease and obesity can have trouble dissipating heat. And, of course, people living in poverty often lack air conditioning and other resources to withstand sweltering conditions.
Although tornadoes, floods and hurricanes tend to get more attention, U.S. heat fatalities top the list of weather-related deaths in the 30 years since heat-related data were first reported.
Researchers are discovering more ways that heat can hurt. Take sleep: The onset and duration of sleep is sensitive to temperature. The body cools down as it prepares to sleep; this decrease in core temperature is…
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