Oct. 24, 2024, 5:17 p.m.
A summer of extreme heat brought another wave of deaths to Maricopa County, Arizona.
The number of heat-related fatalities in the region, which includes Phoenix, is poised to pass the 645 recorded in 2023. There are currently 429 confirmed heat-related deaths so far in 2024, the majority of which occurred outdoors, with an additional 241 under investigation.
The county health department has not released its full analysis yet for 2024, but its report for 2023 showed the largest proportion of heat-related deaths was among people experiencing homelessness.
While extreme weather patterns are often connected to concerns about the broader climate, health officials in Arizona and elsewhere are dealing with the immediate health implications of the changing weather, especially for vulnerable populations.
Nick Staab, assistant medical director for the Maricopa County Public Health Department, said challenges with the heat are not new, although the last two summers of record-breaking heat waves have brought more attention to the issue.
This past summer, Phoenix saw a record 70 days above 110 degrees, smashing the record from 2023 that saw 55 days at these temperatures, according to the National Weather Service. The city also saw 39 days during which minimum temperatures did not dip below 90 degrees, breaking another record set in 2023 at 35 days.
Overall, there were 990 deaths in the state related to heat in 2023, 65 percent of which were in Maricopa County. The overall state number is a significant jump over the 671 recorded heat-related deaths in the state in 2022.
“Heat exacerbates any underlying public health issue,” Staab said. “Whether it’s being unsheltered, whether it’s substance use, whether it’s chronic disease, whether it’s the health of our older population, all of those things are kind of underlying the heat issue.”
Will Humble, executive director of the Arizona Public Health Association, said the lack of both affordable housing and eviction protections is the main problem when trying to mitigate the health impacts of extreme heat.
“Yes, it’s incredibly hot. Yes, things have changed because of climate change and the urban heat island, but you combine that with the lack of affordable housing and the ease at which people can be evicted, and that’s the combination that leads to the lethal environment and why we keep making headlines,” Humble said.
He said one policy that would help reduce deaths is having the state preempt local zoning decisions to incentivize building multi-family housing. “Zoning has a huge impact on homelessness deaths, way more than cutting back on how much carbon we use here in Arizona,” Humble said.
Most of the challenges local health departments encounter when it comes to climate change and extreme weather events are the “really practical impacts,” said Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials.
Pointing to the recent hurricane that pummeled western North Carolina, Freeman said there are departments dealing with new weather challenges.
“We’re also seeing just day-to-day things, like extreme weather days, extreme heat causing local health departments often to be given the task of opening cooling centers, for example, across the city to try to protect people,” she said.
Freeman said counties are looking at innovative ways to track health impacts from the environment, but not always “under the guise of climate change, either, because a real part of this story is the politics of the words. But the fact is that these are events that are occurring—whatever you call them—and the community has to be prepared for them and actually be able to respond to them now.”
The politicization of climate change is on full display in Arizona. Last session, Republicans in the Grand Canyon State voted out of the state Senate a bill that would block public funding to various “climate change” initiatives, including reducing greenhouse gas emissions, limiting the increase of the global temperature, and adopting a climate action plan.
But the state is also in the process of implementing a new Medicaid demonstration program. It will provide up to six months of rent or temporary housing for Medicaid beneficiaries who are transitioning out of institutional care or correctional facilities, who are homeless or at risk of homelessness, or who are transitioning out of the child welfare system including foster care. Costs covered can also include utilities.
Medicaid programs across the U.S. are being used to pay for various tools, such as air conditioners, said Jill Krueger, director of climate and health at the Network for Public Health Law.
“We’re starting to see some states using those essentially to pay for, to provide essentially prescriptions for, things like air conditioners or maybe split level heat pumps basically to assist both with protection from heat and wildfire smoke,” she said.
But, Krueger said, “there are certainly gaps in terms of protections for the homeless populations.”
Staab said the Maricopa County Public Health Department is working with community-based organizations, municipalities, cities, and towns to make sure unsheltered individuals can “get access to cool spaces.”
He pointed to the Maricopa Association of Governments’ Heat Relief Network. As of Monday, multiple locations were serving as cooling centers, respite centers, and places to receive bottles of water, including several libraries.
Staab emphasized the effects of heat waves are community-wide. “We do a lot of messaging during the summer about the importance of welfare checks, of just checking on your friends and neighbors and family members who may be [at] high risk, because of how important it is to make sure that their air conditioning is working,” he said.
Among the 156 Maricopa deaths that occurred indoors in 2023, in 88 percent of cases air conditioners were present. But 85 percent of those units were not functioning, 12 percent weren’t being used, and 2 percent didn’t have electricity. So far in 2024, 101 heat-related deaths occurred indoors, and in 63 percent of those cases there were non-functioning air-conditioning units, in more than 15 percent of cases the residents weren’t using the units, and in nearly 9 percent of cases residents didn’t have electricity.
Arizona Gov. Katie Hobbs’s Extreme Heat Preparedness Plan, issued earlier this year, includes a push to access more assistance from the federal Low-Income Home Energy Assistance Program. LIHEAP helps defray energy costs for low-income Americans and pay for weatherization and minor energy-related projects. Hobbs's administration says the state receives a smaller allocation of LIHEAP dollars due to a historical formula that favors cold-weather states.
On a national level, advocates and officials have argued that the funding for LIHEAP does not go far enough to help states deal with growing energy needs due to heat. Assistance for the program was reduced after Congress didn’t re-up supplemental dollars for the program in fiscal 2024, reducing the pot from over $6 billion to slightly more than $4 billion.
As of the end of August, the National Energy Assistance Directors Association estimated utility debt had increased by 8.4 percent since December 2023, a signal that more Americans might struggle to pay their energy bills. Adding to the challenge, the group recently projected the price of home heating in the cold months will increase this year by 10.5 percent.
For Arizonans in particular, residents were hit with an 8 percent rate increase earlier this year after the Arizona Corporation Commission approved the increase from the Arizona Public Service Company. The commission, which oversees public-service utilities, consists of five commissioners. Three of those five seats are at play in the 2024 election.
“We know that it's only going to continue to get hotter and hotter,” Democratic candidate for commissioner Ylenia Aguilar told clean-energy and politics podcast Volts earlier this month. “And the reality is most people don't really understand this notion of climate change, especially in the state.”
Even though the commission implemented a moratorium against utility shutoffs during heat waves, Aguilar noted that people will still be stuck with a high bill at the end and called for more financial support.
Humble, through his blog, encourages residents to consider their votes for the Arizona Corporation Commission, saying that increasing electrical bills can impact a family’s ability to pay for air conditioning and other vital household bills.
“In recent years, the ACC has been quick to approve almost every rate increase requested by utilities, despite concerns that this puts undue financial stress on families,” Humble wrote in a September post.
He told National Journal utility costs can contribute to an individual being evicted because “you got this utility bill and then you got your rent, and you can’t do both but you can’t live without your air conditioning.”
