The death of Elidio Hernandez Gomez in August 2023 shed light on a concerning trend in the way heat-related deaths are reported and tracked in the United States. Gomez, a 59-year-old farm worker, died of a heart attack due to plaque in his arteries after falling ill while picking tomatoes in scorching temperatures. Despite the sweltering heat on the day of his death, the official cause listed on his death certificate made no mention of the extreme weather conditions.
This oversight is not unique to Gomez’s case. Federal records indicate that heat played a role in at least 2,300 deaths in 2023, yet many of these fatalities go unrecognized due to the way death certificates are completed. Medical examiners and coroners often fail to consider heat as a contributing factor to deaths like Gomez’s, where underlying health conditions are exacerbated by high temperatures.
The Centers for Disease Control and Prevention (CDC) has urged for better reporting practices, emphasizing the importance of documenting heat-related factors on death certificates. Accurate counts of heat-related deaths inform public health officials about the risks posed by extreme temperatures and can ultimately save lives.
In instances where heat-related deaths are properly documented, the data can drive policy changes and resource allocation. For example, in Oregon, a failure to accurately report heat-related deaths in real-time led to a delayed emergency response during the deadly 2021 Pacific Northwest heat dome. Had officials known the true toll of the heat wave sooner, they could have issued more urgent warnings and potentially averted some of the tragic outcomes.
Similarly, in Chicago and South Florida, adjustments to heat warning thresholds were made after officials realized that existing guidelines were inadequate and potentially costing lives. By incorporating heat-related data into decision-making processes, local authorities can better protect vulnerable populations and implement targeted heat mitigation strategies.
Despite being the leading weather-related killer in the U.S., the true extent of heat-related deaths remains unknown. Experts emphasize the need for improved tracking and reporting mechanisms to accurately assess the impact of extreme heat and inform proactive measures to prevent future fatalities.
As Andrew Phelps, former director of the Oregon Department of Emergency Management, reflects on the 2021 heat wave that claimed 123 lives in his state, he underscores the importance of putting a face and a name to heat-related deaths. By recognizing the human toll of extreme heat and incorporating this information into emergency response plans, communities can better prepare for and respond to heat waves, ultimately saving lives in the process. As the world grapples with the increasing impact of climate change, one of the most pressing issues is the rising number of deaths related to extreme heat. In many cases, these deaths go unreported or misclassified, leading to a lack of awareness and action to prevent future tragedies.
One man, Phelps, reflects on the missed opportunities to save lives during a heatwave when he wishes that authorities had urged people to check in on their relatives. He believes that a simple message from the governor could have made a significant difference, alerting the public to the dangers of the heat and the need for precautionary measures.
In response to escalating heat-related deaths, state governments have issued emergency declarations during heatwaves to emphasize the seriousness of the situation. These declarations enable the distribution of resources such as water and cooling centers to help vulnerable populations cope with the extreme temperatures.
Detailed death investigations have also played a crucial role in shaping policy and raising awareness about the dangers of heatwaves. Following the 1995 Chicago heatwave, Cook County Chief Medical Examiner Edmund Donoghue’s controversial decision to include all heat-related deaths in the count led to a reevaluation of the death toll by the Centers for Disease Control and Prevention. This ultimately led to the establishment of a new heat alert system in Chicago to warn residents and officials about the risks of extreme heat.
However, the issue of underreporting and misclassification of heat-related deaths persists in many parts of the country. Jeff Johnston, chief medical examiner in Maricopa County, Arizona, advocates for a more thorough approach to investigating heat-related deaths. By examining not just the immediate cause of death but also environmental factors and the individual’s health history, medical examiners can provide a more accurate picture of the impact of heat on mortality rates.
In Maricopa County, where heat-related deaths have tripled in recent years, the local government has taken steps to address the issue by investing in cooling centers and passing laws to protect workers from heat-related illnesses. However, Johnston emphasizes that this level of awareness and action is not common across the country, as many death certificates still fail to accurately reflect the role of heat in fatalities.
Moving forward, there is a growing recognition of the need to improve reporting and certification of extreme weather-related deaths. The CDC’s National Center for Environmental Health has been training medical professionals on how to properly document heat-related deaths in order to provide a more comprehensive understanding of the impact of extreme heat on public health.
As the threat of heatwaves continues to grow, it is essential that we prioritize accurate reporting and awareness to prevent unnecessary deaths and protect vulnerable communities from the dangers of extreme heat. By learning from past mistakes and implementing effective strategies for prevention and response, we can work towards a safer and more resilient future in the face of climate change. A recent position paper from the National Association of Medical Examiners provided crucial guidance for certifiers on how to accurately document disaster-related deaths. The paper emphasized the importance of following the “but-for” principle, which asks certifiers to consider whether someone would have died “but for” the occurrence of a disaster.
For example, if someone dies in a flood, the official cause of death might be drowning. However, if the flood was caused by a hurricane, the information should be recorded on Part II of the death certificate, which allows for listing contributing health conditions and circumstances of death. The guidance stressed that disasters should be listed on death certificates even if certifiers are unable to definitively determine if a death is disaster-related but believe it is likely or probable.
One key point made in the guidance was the importance of including heat as a contributing condition on death certificates for heat-related deaths. Whether someone dies from heat stroke directly or from a condition that heat may have exacerbated, certifiers were advised to include heat on the death certificate to accurately capture the impact of extreme temperatures on mortality.
The guidance also highlighted the significance of accurately documenting heat-related deaths, as this information is crucial for organizations like the CDC’s National Center for Health Statistics, which reviews death certificates and assigns codes based on the listed causes and contributors. By including heat as a contributing condition on death certificates, certifiers can ensure that heat-related deaths are properly accounted for in mortality data.
In a case study involving the death of Elidio Hernandez Gomez in California’s Central Valley, questions arose about whether heat should have been listed as a contributing factor on the death certificate. While the pathologist initially did not consider heat as a factor in Gomez’s death, the guidance from the National Association of Medical Examiners would suggest including heat as a contributing condition given the circumstances surrounding his death.
In Miami-Dade County, where extreme heat is a common occurrence, officials recently commissioned an excess mortality study to more accurately count heat-related deaths. These studies compare the number of deaths during extreme heat events with expected mortality rates in normal weather conditions, providing a more comprehensive understanding of the impact of heat on mortality.
The study by Florida State University geographer Christopher Uejio estimated a significantly higher number of heat-related deaths in Miami-Dade County than initially reported by medical examiners. This information prompted local officials to take action, declaring an official heat season and advocating for a new heat warning system to better protect residents from the dangers of extreme temperatures.
Overall, the guidance from the National Association of Medical Examiners and the use of excess mortality studies highlight the importance of accurately documenting and counting disaster-related and heat-related deaths. By following these guidelines and conducting thorough studies, officials can better understand the impact of extreme weather events on mortality rates and take appropriate measures to protect public health. Public health agencies typically rely on death certificate counts to track mortality rates, but as climate change continues to impact human health, there is a growing need for more sophisticated statistical analyses to accurately assess the true impact of extreme weather events.
Larry Kalkstein, president of Applied Climatologists Inc., emphasizes the importance of combining climatology and statistical expertise to properly analyze the effects of climate change on society. In September 2022, a severe heat wave swept through the western U.S., resulting in record-breaking temperatures and heat-related illnesses. While death certificates attributed 20 deaths to heat-related causes during this period, a study conducted by California’s Department of Public Health revealed a 5 percent increase in statewide death rates, leading to 395 additional deaths.
Interestingly, the study found that the most significant increases in mortality occurred among Latino residents and individuals between the ages of 24 and 64, challenging the common assumption that the elderly are the most vulnerable to extreme heat. This highlights the need for targeted interventions and public health strategies to protect at-risk populations during heat waves.
Despite the potential of statistical studies to enhance mortality data, there are challenges in standardizing methodologies and obtaining comprehensive data. Variability in statistical approaches can lead to vastly different death count estimates, as seen in Miami where annual death counts ranged from 34 to 600. Efforts to streamline excess mortality studies and improve collaboration between researchers and public health authorities are ongoing, but resistance and data accessibility issues persist in some regions.
International research groups like the MCC Collaborative Research Network are developing innovative methods to estimate heat-related deaths globally, utilizing daily temperature fluctuations and death rates to predict mortality trends. By forecasting heat-related deaths before they occur, researchers hope to establish stronger partnerships with public health authorities and improve early warning systems for extreme heat events.
Applied Climatologists Inc. is also at the forefront of forecasting heat-related deaths, with a protocol that can estimate excess deaths up to five days before a heat wave strikes. This proactive approach enables local authorities to implement targeted interventions and preventive measures to mitigate the health impacts of extreme heat.
As the planet continues to warm, it is clear that official death counts often underestimate the true toll of heat-related illnesses. More research and collaboration between climate scientists, statisticians, and public health experts are essential to accurately assess the impact of climate change on human health and implement effective strategies to protect vulnerable communities. The impact of social media on mental health has been a topic of much debate in recent years. With the rise of platforms like Instagram, Facebook, and Twitter, many people are spending more time than ever before on social media, and this can have both positive and negative effects on mental health.
One of the positive aspects of social media is its ability to connect people from all over the world. Platforms like Facebook and Instagram allow users to stay in touch with friends and family members, even if they are miles apart. This can help to combat feelings of isolation and loneliness, which can be detrimental to mental health.
Additionally, social media can be a valuable tool for raising awareness about mental health issues and connecting people with resources and support. Many organizations and individuals use social media to share information about mental health and to promote self-care and wellness practices.
However, social media can also have negative effects on mental health. The constant stream of carefully curated images and updates can lead to feelings of inadequacy and comparison. People may feel pressure to present themselves in a certain way online, which can lead to feelings of anxiety and low self-esteem.
Moreover, social media can be a breeding ground for cyberbullying and harassment. People may feel emboldened to say hurtful things online that they would never say in person, leading to feelings of shame and isolation.
To combat the negative effects of social media on mental health, it is important to set boundaries and limit screen time. Taking breaks from social media and engaging in offline activities can help to reduce feelings of anxiety and comparison.
Additionally, it is important to curate your social media feed to include positive and uplifting content. Unfollowing accounts that make you feel bad about yourself and following accounts that promote self-love and acceptance can help to improve your mental health.
Overall, social media can have both positive and negative effects on mental health. By being mindful of how we use social media and taking steps to protect our mental well-being, we can enjoy the benefits of staying connected online while also prioritizing our mental health.