Aug 7, 2023 - Climate

Bexar County heat-related death tally unknown

Illustration of white lilies wilting in the heat.

Illustration: Maura Losch/Axios

Amid dangerously high temperatures forecast to continue for much of August, Bexar County officials can't easily tell the public how many people are dying of heat-related causes.

Why it matters: "We can't begin to deal with the public health risks of extreme heat unless we know the scale of the consequences of it," Jeff Goodell, Austin-based climate change reporter and author of the new book "The Heat Will Kill You First," tells Axios.

Details: The Bexar County Medical Examiner's Office has a high bar to list hyperthermia as a cause of death, county spokesperson Tom Peine tells Axios. To do so, the medical examiner would have to determine there is no other reason the person died.

  • The office lists heat as a contributing factor in someone's death if there is enough information to do so, but gathering that information is a challenge.
  • Because of how the information is kept, the Medical Examiner's Office can't easily pull data to tell the public how many deaths involve heat, Peine says.

Reality check: High heat exposure can lead to a heart attack or stroke, which may be listed as someone's primary cause of death. But with enough information, officials can determine whether heat was a contributing factor.

  • "A gun leaves a wound and it's easy to say that person was killed by a gunshot," Goodell says. "Heat doesn't leave a mark; it doesn't leave a sign."

Between the lines: The Bexar County Medical Examiner's Office is understaffed, a situation that has worsened since last year. That affects how much the office can investigate, Peine says.

  • "Many heat deaths are detective stories," Goodell says. "And many officials who are charged with determining the cause of death don't have time for detective stories."
Data: Texas Department of State Health Services; Note: 2021 and 2022 values are not final; Chart: Axios Visuals

Zoom out: Some medical examiner's offices share the number of heat-related deaths in their communities.

  • Harris County has recorded at least three heat-related deaths this year and expects more.
  • Maricopa County, Arizona, home to Phoenix, has reported at least 18 heat-related deaths this year.

The big picture: Heat-related deaths have risen across Texas, per provisional state data shared with Axios. Last year, there were 306 heat-related deaths recorded, the highest number in a decade.

  • There were at least 203 heat-related deaths in 2021; 109 in 2020; and 66 in 2017.
  • The data for 2021 and 2022 are not final. The state gets its information from death certificates, and there's a lag in officials' ability to report it.

Plus, those numbers are likely an undercount. Cities, counties and physicians can take different approaches to recording heat-related deaths or whether they do so at all.

By the numbers: Across Texas, at least 36 people have died of heat-related causes this year through the end of June, the most recent tally, Texas Department of State Health Services spokesperson Lara Anton tells Axios.

  • That number will be updated as the state receives more death certificates, Anton says.

Context: Studies have tied the severity of the Southwestern heat wave to human-caused climate change.

The bottom line: "Heat death numbers are vastly undercounted," Goodell says.

  • "There's a lot of things that can be done to keep people from dying during heat waves, but if we're not aware of the risks, we're not gonna do them," Goodell says.
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