Global Courant 2023-05-01 21:53:49
Heat waves due to climate change are longer lasting and more intense in the US. People over the age of 60, especially people of color, are more susceptible to heat-related health problems. Heat-related deaths are challenging U.S. cities like Phoenix, Arizona, to better protect the elderly as summer approaches.
Paramedics called to a retirement home in Arizona last summer found an 80-year-old woman slumped in her mobile home, enveloped in the stifling 99-degree heat that plagued her for days after her air conditioner broke down. Attempts to revive her failed, and her death was ruled by exposure to ambient heat, compounded by heart disease and diabetes.
In America’s hottest major metro, the elderly, like the Sun Lakes mobile home resident, were responsible for most of the 77 people who died last summer in the sweltering heat in their homes, almost all without air conditioning. Now the heat hazards long known in Greater Phoenix are becoming known nationwide as global warming brings new challenges to protecting the elderly.
From the Pacific Northwest to Chicago to North Carolina, health clinics, utilities and local governments are being tested to keep older people safe as temperatures rise. They adopt rules for shutting off electricity, prescribe when communal air conditioning should be turned on and improve communication with high-risk groups living alone.
Phoenix and its suburbs, located in the Sonoran Desert, are ground zero for heat-related deaths in the US. Such fatalities are so common that Arizona’s largest county maintains a weekly online census during its six-month hot season from May to October. Temperatures this year already reached the high 90 degrees in the first week of April.
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A warming world
“Phoenix is really the model for what we’ll see in other places,” said study researcher Jennifer Ailshire, a desert city resident who is now at the University of Southern California’s Leonard Davis School of Gerontology, where she studies how environmental factors affect the affect health and aging. “The world is changing rapidly and I fear we are not acting fast enough to teach people how damaging rising temperatures can be.”
A 2021 study estimated that more than a third of heat-related deaths in the US each year can be attributed to human-induced global warming. It found more than 1,100 deaths a year from climate change-induced heat in some 200 U.S. cities, many in the East and Midwest, where people often don’t have air conditioning or aren’t used to hot weather. Another study showed that in the coming decades, dangerous heat will hit much of the world at least three times as hard as climate change worsens.
Isolated and vulnerable, heat victims last year during Maricopa County’s deadliest summer on record included a couple in their 80s with no known relatives, an 83-year-old woman with dementia who lived alone after her husband was placed in hospice and a 62-year-old Rwandan refugee whose air conditioner broke down.
While most of the county’s confirmed 378 heat-related deaths occurred outdoors, those who died indoors were particularly vulnerable due to insulation, mobility issues or medical issues, as summer temperatures outside reached 115 degrees.
Older people of color, with a higher propensity for chronic conditions such as diabetes, obesity and high blood pressure, are particularly at risk.
In Chicago, three African-American women in their 60s and 70s died in the spring of 2022 when the centrally controlled heating in their housing complex remained on and the air conditioning was off despite unusual 90-degree weather in mid-May.
An undetermined number of elderly people died in the summer of 2021 when an unexpected heat wave swept across the US Pacific Northwest. Canada reported coroners confirmed more than 600 people died from the heat in neighboring British Columbia.
Nurse Anthony Carano speaks with a patient at Mountain Park Health Center in Phoenix on March 30, 2023. People over the age of 60 are at increasing risk of dying from heat-related health problems. (AP Photo/Matt York)
Checking on older people
Many US cities, including Phoenix, have plans to protect people during heat waves, open refrigeration centers and distribute 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 Harvard TH Chan School of Public Health.
“If you’re elderly and sick, you’re unlikely to get on an Uber or bus to go to a cold storage facility,” said Bernstein, who vividly recalls a 1995 heat wave that killed 739 mostly elderly people in Chicago, his hometown. . “So many were socially isolated and at tremendous risk.”
Sociologist Eric M. Klinenberg, who wrote about the catastrophe in his book “Heat Wave: A Social Autopsy of Disaster in Chicago,” has noted that socializing can protect the elderly during disasters.
“Older people are more likely to live alone,” he said, “and they are most likely to die.”
This applies to all extreme weather conditions.
When Hurricane Katrina devastated Louisiana in 2005, about half of the 1,000 people who died were 75 or older. Most of them drowned when their homes were flooded.
Chicago encourages residents to check on elderly relatives and neighbors on hot days, and city workers visit people’s homes. But last year’s deaths in a Chicago apartment building show that more is needed.
Community Health Clinics can help
The Bernstein center has partnered with aid organization Americares to help local health clinics prepare vulnerable patients for heat waves and other extreme weather.
A “climate resilience toolkit” includes tips such as making sure patients have wall thermometers and knowing how to check weather forecasts on a smartphone. Patients learn simple ways to beat the heat, such as taking a shower or sponge bath to cool off and drinking plenty of water.
Alexis Hodges, a family physician at Dare’s Community Care Clinic in coastal North Carolina, said rising temperatures can trigger kidney failure in patients with kidney problems and exacerbate dehydration from medications such as diuretics.
Hodges contributed to the climate kit from a region that experiences all kinds of weather: extreme heat, hurricanes, floods and wildfires.
At the nonprofit Mountain Park Health centers that serve 100,000 patients annually in Greater Phoenix, nurse Anthony Carano has written numerous letters to utilities for low-income patients with chronic conditions, asking them not to turn off power despite missed calls. payments.
“This is such an at-risk population,” Carano said of the predominantly Latino patient population suffering from diabetes and other conditions exacerbated by hot weather. About one-tenth of the patients are 60 years and older.
Francisca Canes, a 77-year-old patient who visits for back pain, says she is lucky to live with two daughters who take care of her during warm spells. In the summer, she keeps in shape by going for a four-mile walk with several friends at four in the morning.
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Replacement and repair of air conditioning
Maricopa County used federal funds in April to allocate an additional $10 million to its air conditioning replacement and repair program for eligible people, bringing total funding to $13.65 million. In Phoenix and several rural Arizona counties, older people on low incomes can apply for free air conditioner repair or replacement through a separate non-profit program.
The Healthy Homes Air Conditioning Program of the nonprofit Foundation for Senior Living last summer got about 30 people new air conditioners or repairs and helped others with home improvements.
Priority goes to the elderly, people with disabilities and families with very small children, who are also vulnerable to the heat. A person living alone should make $27,180 or less, said Laura Simone, program coordinator for FSL Home Improvements.
The program recently installed energy-efficient windows in the 1930s home of 81-year-old widow Socorro Silvas.
“I’m so thankful they take care of low-income people like me,” says Silvas, who got her air conditioner in the middle of a sweltering summer several years ago through a program from Tolleson, a suburb west of Phoenix.
Utilities can also help protect vulnerable people by halting power outages during hot spells.
“In Arizona, air conditioning is a matter of life and death, especially when you’re older,” said Dana Kennedy, AARP’s state director, who has campaigned for stricter regulations to prevent summer power outages.
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Stricter regulations
New Arizona utility rules were passed after 72-year-old Stephanie Pullman died in August 2018 at her home in the Phoenix area when outside temperatures reached 107 degrees.
The medical examiner’s office said Pullman died of “exposure to ambient heat” combined with cardiovascular disease after her power was cut at a cost of $176.84. debt.
The Arizona agency that regulates utilities now prohibits power cuts for nonpayment during the hottest months.
After the three Chicago women died last year, residential buildings for older people in the city are now required to have air-conditioned common areas and administrators are no longer required to keep centrally controlled heating on during unseasonably hot weather. The Illinois State Senate recently passed legislation requiring all affordable homes to have air conditioning that operates when the temperature is 80 degrees or higher and that residents can control.
Kennedy said mobile homes are especially dangerous because high temperatures turn them into hot metal containers.
“Many are not insulated,” says Kennedy, who advised a group at Arizona State University to make mobile homes safer with more surrounding shade and on-site cooling centers. “These heat deaths are really heartbreaking, but in many cases we can help prevent them.”