Heat-Related Deaths A Public Health Issue For Arizona

By Steve Goldstein
Published: Wednesday, June 19, 2019 - 11:09am
Updated: Thursday, June 20, 2019 - 10:17am
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STEVE GOLDSTEIN: Tomorrow the Arizona Corporation Commission will discuss when utilities like APS can shut off a customer's power for failure to pay. The meeting comes after AP has temporarily halted its policy of turning off someone's electricity for failure to pay electric bills during the summer. That move coincided with news that an APS customer died after her power was turned off on a 107-degree day in 2018. The Sun City West woman owed APS $51. Her death was ruled heat-related. So how should utilities government and our communities potentially rethink how they look at the dangers of extreme heat? With me to talk about that is Liza Kurtz, an ASU sociologist who studies the health and social effects of extreme heat and heat-related deaths. Liza how different is the perception of extreme heat versus extreme cold? There's LIEHEAP; or the Low Income Home Energy Assistance Program, that is seemed to focus on freezing in the East rather than heat waves in places like Phoenix.

LIZA KURTZ: So you're right, in the sense that LIEHEAP and utility assistance programs tended to be developed for very cold areas. Particularly in the Northeast because there was an immediate understanding and perception that extreme cold is very dangerous and in some circumstances it can even be qualified as a disaster; like when we get Superstorm Sandy or some of the bombs cyclones that hit Colorado earlier this year. But there isn't that same perception for extreme heat or at least there hasn't been historically; there's starting to be now. So much of the federal and state funding is structured in such a way that it is arranged around the historical perception of cold as the hazard rather than heat as the hazard. Even though when you look at human physiology and what is dangerous; extreme heat can be just as dangerous as extremely cold temperatures. 

GOLDSTEIN: So the perception of that, then it's changing to some extent. Are we actually seeing that in terms of government acting on this in a different way?

KURTZ: Yeah I think very much so. So I think it differs based on state to state. Arizona is particularly at the forefront of this. We've always been a hot place and we're getting warmer. And also, we have a real opportunity to be climate leaders in this sphere because the sort of running joke is, if people can live happily and comfortably in Phoenix they can live happily and comfortably just about anywhere. So Phoenix, as a city, has really been on the forefront of this. With things like the city's HeatReady program and efforts between ASU and local non-governmental organizations to sort of streamline and solidify things like utility assistance programs for people who need them; to provide various types of assistance for folks who may not have shelter in the summer. So there's a growing perception that this is a problem and we need to do something about it.

GOLDSTEIN: When it comes to assistance programs, should we be doing more? We have a major senior population here. We have; obviously as you said,... it's getting hotter and hotter. And the idea of surviving without an air conditioner or maybe even a swamp cooler seems impossible.

KURTZ: I think regardless of what form the solution takes it's very apparent that there needs to be a solution. 182 people is the preliminary count of heat-deaths in 2018 in Maricopa County alone. And I like to think of heat-deaths as really a primary public health issue; these are preventable deaths. It's not like we don't know how to keep people from dying of heat. We know what the solutions are and now it's about implementing those solutions. So certainly utility assistance can be one way forward for that and... it's a very useful way forward for many of the most vulnerable populations; like people with medical conditions, the elderly populations, people on fixed income.

GOLDSTEIN: Other things that come to mind for you then?

KURTZ: Oh certainly, from the perspective of the public health statistics we know that a tremendous number of heat deaths also take place outside. And many of those deaths are people who are experiencing homelessness and did not have shelter. So certainly sheltering programs, affordable housing programs, job programs, veterans programs, cooling centers; all of this sort of layers together and heat deaths really become a story about where are people falling through the cracks in our society as a whole and not just about extreme temperatures.

GOLDSTEIN: Should we expect more responsibility to be taken by utilities whether it's utility assistance or something else? Is there something there or does that sort of get into the range of overregulation or not letting the market decide?

KURTZ: Well I certainly think, on a personal level I think that there are limits to what the market should be able to decide when it comes to human health. And I think most people agree with that and it's just everyone has slightly different opinions about where those limits are. But I would certainly hold up some of the regulation and not even necessarily state regulation;,also industry-based regulation that happens in the Northeast around what utilities must do before they disconnect power in the winter. Because there's, again, there's that perception and there's that acknowledgment that this is a life threatening hazard. And so I don't think it's out of the realm of possibility to start to look into regulatory or industry solutions that mirror what happens in places where we know if we shut off someone's power and they have nowhere else to go they could die from cold. It's equally true here. So what does that type of structure look like here, where it's so hot, if you shut off someone's power; they could also die.

GOLDSTEIN: Often many of us don't know our neighbors these days. But should more neighbors just be thinking about; OK I have this elderly neighbor, I have a neighbor who is in poor health and maybe I could check on them or we could try something. Because it does seem like in order to prevent death, it almost seems like, we all have to come together?

KURTZ: Yeah I think that's a really really good point. And it can certainly be awkward meeting one's neighbors especially meeting one's neighbors and either asking for help or talking about giving help. That's a very awkward sort of transaction to have, socially. Although, I do think we have a leg up in the sense that, what a better way to meet a neighbor than to start by talking about the weather. And if it's very hot there's your natural in for, hey you know if your AC ever breaks just let me know you can come over to my place. Because it's not always about something as drastic as utilities shutoff. Sometimes it is just, oh the AC is out for an evening or an afternoon. And even if it's not a threat to your health there's no reason you should suffer and be uncomfortable alone in your house.

GOLDSTEIN: Are heat-related deaths more attributable to; climate change, to cost of living going up, to a lack of affordable housing, you mention affordable housing. Is it all these factors equally? Is there one that sort of stands out to you more than the others?

KURTZ: It's really hard unfortunately to disentangle all of those in a clean way. So they really play off each other. Certainly, climate change at the local and regional level. Things like the urban heat island, where all the concrete we build and the roads we build holds in heat overnight and it doesn't cool off at night, that has massive health implications but also things like unaffordable housing. We've seen a large rise in the number of unsheltered homeless-seniors for instance. The Arizona Republic in 2017 did a wonderful series called, The Human Cost of Heat; that was really unpacking some of the stories from family members around people who died from heat and like what were the chains of circumstance that led to this tragic outcome. Things from I can't get a job because I have an incarceration history, I have mental health issues and I can't find support for them, I have addiction issues and I'm not able to be treated. Like every major problem that we have in our society ends up contributing to these heat-deaths.

GOLDSTEIN: Liza Kurtz is a sociologist at ASU who studies the health and social effects of extreme heat and heat-related deaths.

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