The US has seen an increase in extreme heat waves over the last few years, pushing temperatures to unprecedented levels. From scorching urban centers to rural communities, these prolonged periods of intense heat have brought on severe public health hazards.

Extreme heat results in more deaths annually than all other weather-related hazards.  Understanding its wide-ranging impact on the US is crucial for informed decision-making and effective resilience strategies, particularly in areas with less resilient infrastructure.  Urban city centers tend to see higher temperatures due to the asphalt absorbing heat, more buildings, less vegetation, and higher population density. In rural areas, and other laborers who work outside are directly exposed to the blistering heat and have an increased risk of heat stroke or heat exhaustion.

Increases in temperature have impacted poultry workers combating the H5N1 situation. Due to temperatures exceeding 104°F in poultry barns, industrial fans have been set up which could spread the virus in ways that reduce the effectiveness of the personal protective equipment (PPE) the workers are wearing. The excessive heat can make working conditions extremely difficult when the poultry workers are having to wear extensive amounts of PPE such as Tyvek suits, respirators, goggles, boots, and gloves. City centers and rural communities both have heat-vulnerable populations – according to the US Census Bureau, about 25% of the US population is socially vulnerable to extreme heat exposure. While some cities and municipalities are equipped to combat heat waves by offering public cooling centers, not all are resourced with the funding or infrastructure to do so.

It is important for individuals to have a preparedness plan and know what actions can be taken to mitigate the risk of extreme heat. More information on what those actions can be found in our .

As with many types of disasters, medically fragile communities, including dialysis patients and persons living with disabilities, face heightened challenges during periods of extreme heat. For those without air conditioning, the inability to stay cool can exacerbate health risks and complicate their access to necessary care. Extreme heat can particularly impact individuals who rely on medical equipment that requires electricity, such as those who require refrigeration for medications, and people who rely on CPAP machines to help them breathe during their sleep. Additionally, these individuals might find it more difficult to travel to cooling centers due to mobility issues or other health constraints. Ensuring reliable access to power and electricity becomes crucial not only for maintaining the functionality of life-sustaining medical equipment but also for safeguarding the overall well-being of these vulnerable populations during heat waves.

The risk of extreme heat waves becomes even greater in states that historically experience cooler temperatures, mainly in the northwest, because they do not have the existing infrastructure in place to withstand the rising heat temperatures. In 2022, roughly 100 people in Oregon succumbed to heat-related injuries with instances where apartments did not have air conditioning unites installed. The state legislature had to act by signing a bill that would give tenants the right to have AC units in their apartment.

With that being one example of how existing infrastructure in unaccustomed areas may not be able to withstand the ever-changing climate reality. There are numerous efforts underway between public and private sector stakeholders to combat climate change, with the most recent action being a petition to urge FEMA to declare extreme heat as a “major disaster.” This would allow the federal government to assist states and communities with assets and funding that could help prepare for heat waves as already happens with other types of extreme weather events, such as hurricanes, or wildfires.

In addition to infrastructure challenges, the risks of extreme heat waves fall disproportionately on historically underserved populations. From a 2021 EPA report, it noted that Black and African American individuals are 40% more likely to currently live in areas with the highest projected increases in extreme temperature related deaths with 3.6°F of global warming. The report also noted that Hispanic and Latino individuals are 43% more likely, than non-Hispanic and non-Latino individuals, to currently live in areas with the highest projected labor hour losses in weather-exposed industries (construction and agriculture) due to climate-driven increases in high-temperature days.  

While climate change is affecting the entire US, risks and impacts are disproportionately exacerbated in communities that are least able to prepare for, respond to, and recover from extreme heat waves. Along with public health concerns, extreme heat can lead to infrastructure failures, such as power outages from increased air conditioning use, which can further exacerbate the dangers of heat waves. Roads and bridges can also suffer damage from prolonged elevated temperatures, causing transportation issues and increasing the risk of accidents. The economic impacts of extreme heat are also significant, with increased healthcare costs, lost labor productivity, and damage to crops and livestock in agricultural regions. Proactive tactics need to be implemented to ensure all communities can be resilient to extreme heat moving forward.