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Seniors at risk: Heat and climate change

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Heat is the top killer among all types of weather hazards, including hurricanes and tornadoes. But hospitals and health care providers do not always report heat-related illnesses or heat as an underlying cause of a death, making it hard to measure the actual impact of extreme heat on health.

An estimated 12,000 Americans die of heat-related causes annually, according to research by scientists at Duke University, a number roughly comparable to annual deaths from gun homicides. The April 2020 study dramatically increased the estimates of current deaths and future deaths, surpassing the 2018 National Climate Assesment's 2100 projection by a factor of 10.

More than 80 percent of those dying from heat-related illnesses are over 60, researchers have found. The baby boomer generation (born between 1946-1964) will be among those immediately hardest hit by climate change, as their vulnerability to extreme heat coincides with rising temperatures.

Older people can get into serious danger, as heat and dehydration stress bodies already challenged by age and chronic medical conditions or made more vulnerable by certain medications. Physiological studies show that even healthy seniors are less able to sense heat or to sweat, and are less apt to feel thirst and seek fluids when dehydrated, compared to younger adults. Older bodies don't regulate internal heat as well, and poor physical fitness or being overweight makes these problems worse.

Planning for excessive heat varies across the U.S., reflecting climate and community differences. Heat events can be deadliest in cities with lower average temperatures, where residents are less adapted to heat. Conditions can be especially bad in low-income areas where seniors are less able to afford air conditioning, the housing is of lower quality (absorbing and retaining more heat), and communities of color make up a disproportionate fraction of the population.

Physicians and emergency planners say seniors' best defense against heat is social connection, with family and neighbors checking on elders who are alone in sweltering weather. Experts have found common strategies that all communities can use to avert senior heat deaths. With the additional threat of COVID-19, cities are also looking at funding for air conditioners and utility bills, closing streets to allow more outdoor space, parking air-conditioned buses as dispersed cooling centers, and even renting hotel rooms for vulnerable homeless people.