Summary Points
- Heat-related deaths in the U.S. are vastly undercounted in official records.
- Many deaths involve preexisting conditions, with heat often as a contributing factor.
- Physicians and coroners often do not identify heat as the cause without explicit questioning.
- Climate change is increasing extreme heat days, worsening health risks for vulnerable people.
Underreporting of Heat-Related Deaths in the U.S.
An investigation by NPR and Boston University reveals that the number of heat-related deaths in the United States is significantly higher than official figures suggest. Each year, around 1,700 deaths are recorded as caused by heat. However, the real number may be closer to 9,000. This discrepancy shows that thousands of heat-related deaths go uncounted. Many cases involve individuals with preexisting health issues, where heat acts as a hidden contributor. Doctors often do not list heat as a cause of death because the evidence isn’t obvious or explicitly tested for. As a result, the true toll of the rising temperatures is underestimated, affecting how public health responds to the crisis.
Events like extreme heat waves and climate change make this problem worse. Cities such as Tucson and Phoenix experience more days of dangerous temperatures. In Tucson, the number of days over 110 degrees has grown from less than one per year in the 1950s to as many as 18 days in some recent years. In July 2024, Tucson saw 112 days over 100 degrees, a record high. This constant exposure to heat worsens health, especially for vulnerable groups like people with genetic disorders or heart problems. Despite this, some deaths caused by heat go unnoticed because healthcare professionals focus on more apparent causes, like heart attacks or organ failure.
Challenges in Tracking Heat Deaths
Many deaths that involve heat are not thoroughly investigated or recorded as heat-related. Doctors often rely on death certificates, which list the immediate cause of death, such as a heart attack or stroke. If they do not see clear evidence of heat exposure, they rarely include it as a contributing factor. This approach leads to an undercounting of how deadly heat can be, especially during extreme weather events. In some cases, even if emergency responders suspect heat played a role, official records may still not reflect this.
Efforts are underway in some areas, like Pima County, Arizona, to better identify heat-related deaths. Medical examiners are being trained to look for subtle clues, such as medication use or environmental factors. They ask whether a person was exposed to excessive heat or if their home lacked cooling. These steps improve the accuracy of death records, but many cases still slip through the cracks. When deaths are not suspicious or violent, they often are not investigated thoroughly. Without asking the right questions, the role of heat remains unseen. The challenge lies in changing traditional practices, which require extra time, resources, and awareness. Without improved data, policymakers cannot fully understand the scope of the problem or develop effective solutions.
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