In Pima County, Arizona, Medical Examiner Greg Hess processes approximately 3,000 deaths annually, ranging from overdoses to tragic accidents. However, between April and October, his morgue consistently fills with individuals who died prematurely due to the region’s extreme temperatures. While Pima County is not the hottest or most populous in the nation, its medical examiner’s office has emerged as a national leader in developing innovative methods to accurately count heat-related fatalities—a critical step in understanding the human cost of climate change.
Currently, official government records dramatically undercount the toll of climate-fueled disasters. Experts like Kristie Ebi, a public health epidemiologist at the University of Washington, argue that this data gap has tangible consequences. Without precise numbers, it is difficult for policymakers to allocate resources effectively, such as determining where to place cooling centers during heat waves. “If you don’t know how many people suffer and die in disasters, then you can’t set priorities appropriately,” Ebi noted.
Hess, who took over the Pima County role in 2011, initially encountered this data crisis while dealing with migrant deaths in the desert borderlands. The recurring tragedies prompted his team to create thorough investigative protocols and annual reports. Later, during the opioid epidemic, Hess recognized that his detailed data could help prevent further losses if shared quickly. In 2022, he hired epidemiologist Tasha Tully to create a near-real-time dashboard tracking opioid deaths, which subsequently revealed the potential to apply similar methods to the rising number of heat-related fatalities.
The scale of the problem is significant. The CDC estimates that about 1,200 Americans die directly from heat each year, a figure that has risen from roughly 700 a few years prior. However, Greg Wellenius, an environmental epidemiologist at Boston University, argues this is a vast underestimate. A 2020 study from his lab suggests the true number is at least 10,000 annually. The discrepancy exists because heat is rarely listed as a cause of death on certificates, even when it plays a major role.
Kathryn Pinneri, former president of the National Association of Medical Examiners, explained that heat alone seldom kills; instead, it exacerbates underlying conditions. Hot weather increases the incidence of cardiac arrests, strokes, diabetes complications, and deaths linked to neurodegenerative diseases like Alzheimer’s. By refining how these deaths are categorized, Hess and his peers aim to provide the accurate data necessary for effective public health interventions.
So we need more paperwork to admit the government is undercounting deaths? I guess at least someone is trying to fix the system from the inside, though.
Imagine thinking 1,200 deaths is an acceptable number for a single weather condition. This data gap is literally costing lives by hiding the scale of the crisis.
Great reporting on Hess’s work. However, standardizing these certification protocols across all fifty states remains a massive bureaucratic hurdle that this article glosses over.
I always wondered why my grandmother passed during that heatwave wasn’t listed as heat-related. She had heart issues, so this ‘underlying condition’ explanation makes sense but feels inadequate.
This discrepancy is terrifying. If the real toll is nearly ten times higher than reported, where are the cooling centers? We need action, not just better statistics.