Federal Government Mounts Response to Rising Heat Index
September 16, 2024 | Catherine Jones, Catherine Murphy
Extreme heat is the leading cause of weather-related deaths in the United States. Heat waves are increasing in frequency, duration, and intensity and are a growing threat to human health. Summer 2024 may be the hottest on record in 30 cities. Summers have warmed in 230 locations by an average of 2.5° F since 1970, with Las Vegas and Phoenix hitting 120 degrees Fahrenheit for the first time ever this past July. First responders working in these regions are equipped with giant plastic, ice-filled bags to cool patients experiencing heat-related illness. The thermometer’s rising mercury is prompting action from Congress, federal agencies, and the White House.
The Effects of Extreme Heat
As cities establish higher average temperatures—and break records—mitigating heat exposure to prevent acute, life-threatening conditions and minimize aggravating preexisting conditions is the number one line of defense. Health risks from heat include cardiovascular events, respiratory conditions (exacerbated by air pollution), kidney disease, adverse pregnancy outcomes, increased anxiety and depression, increased risk of suicide, and aggressive behavior and violence. Direct effects include heat rash, cramping, edema, fainting, heat exhaustion, and deadly heat stroke. Certain demographics and professions are at higher risk for the impacts of extreme heat, including children, older adults, pregnant people, people experiencing homelessness, people with health conditions, first responders, athletes, outdoor workers, communities of color, and low-income communities.
ASTHO recognizes the need for public health systems that ensure readiness and resilience, including in response to extreme heat events. ASTHO’s Climate and Health Policy Statement calls for sustained federal funding, support for state and territorial climate adaptation assessments, and expanding health agency monitoring and surveillance capacity. Effective, innovative, and equitable strategies, such as increased access to cooling centers, shaded spaces, and “greenscapes” that cool urban heat islands, will lead to decreased emergency room visits and admissions.
Classifying and Tracking Extreme Heat Events
CDC defines extreme heat as air temperature that is much hotter and/or humid than average for a particular time and place. FEMA defines extreme heat as a period of temperatures above 90° F and high humidity for at least two to three days. No matter the precise definition, protecting Americans from extreme heat events and mitigating the worst impacts is a priority across the federal government.
The bipartisan Extreme Heat Emergency Act of 2023 (H.R. 3965) would classify extreme heat as a major disaster, thereby ensuring local governments are eligible for major disaster assistance from FEMA. The bipartisan Weather Act Reauthorization Act (H.R. 6093), passed by the House in May, would secure ongoing support for the National Oceanic and Atmospheric Administration’s (NOAA’s) weather research, and, importantly, directs the National Weather Service and FEMA to ensure “equitable and comprehensive weather observation coverage and emergency information sharing,” to include urban heat island mapping and forecasting for under-observed and underserved areas.
The National Integrated Heat Health Information System (NIHHIS), established in 2015, is a multi-agency partnership to improve coordination and information sharing at federal, state, local, tribal, and territorial levels. In 2022, the White House’s Interagency Working Group on Extreme Heat launched Heat.gov, a central hub providing real-time data, forecasts, and resources on extreme heat. CDC’s HeatRisk provides an interactive, county-by-county map displaying projected risk of extreme heat exposure, coupled with resources on heat and health. CDC also encourages healthcare professionals to partner with their patients to stay healthy and safe during extreme heat events.
Building a Heat-Resilient Future
On August 14, 2024, the White House issued the National Heat Strategy directing agencies to implement goals and objectives that are expected to increase U.S. resiliency to extreme heat conditions. The Occupational Safety and Health Administration (OSHA) is leading the charge on protecting workers from extreme heat. OSHA’s recent proposed rule would establish the first-ever federal safety standards addressing excessive heat in the workplace, both indoors and out, by identifying heat hazards and developing heat illness and emergency response plans, training programs, and work practice standards. This rule would affect approximately 36 million workers. Additionally, FEMA announced a $1 billion program to help communities protect against disasters and natural hazards, including extreme heat.
In the Senate’s Labor, Health and Human Services, and Related Agencies Subcommittee appropriations bill, CDC’s Climate and Health Program was flat funded at $10,000,000. The same program was eliminated in the House version of the bill. The Senate bill also included report language urging CDC and the NIHHIS to develop and implement a system for tracking healthcare costs associated with the emergency medical assistance required during extreme heat events. Numerous bicameral bills have been introduced this Congress that cover a range of heat-related topics including: excessive urban heat mitigation (H.R.2945), protections against heat fatality among athletes in institutions of higher education that participate in federal student aid programs (S. 2081), universal protections against heat illness, injury and fatality (H.R. 4897), emergency equipment for extreme heat events and mitigating or aiding individuals through stockpiling and installing equipment for households, first responders, public health and health care systems, and emergency voucher programs (H.R. 9024), and providing energy assistance for cooling homes (S. 405).
Predictions indicate that the next five years will be the warmest on record, which will have cascading effects on human health and ecosystems. Public health will play an increasingly critical role in preventing and responding to extreme heat events, which ASTHO will continue to track.