Here's why an Arizona medical examiner is working to track heat-related deaths
Greg Hess deals with death day in, day out.
Hess is the medical examiner for Pima County, Ariz., a region along the United States-Mexico border.
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Hess → work → border
His office handles some 3,000 deaths each year — quiet deaths, overdoses, gruesome deaths, tragic ones.
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office → handle → deaths
From April through October every year, Hess is confronted with an increasingly obvious and dramatic problem: His morgue drawers fill with people who died sooner than they should have because of Arizona's suffocating heat.
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they → confront → heat
But Hess and his team are at the country's forefront in one key way: They have developed some of the most innovative strategies to accurately count the number of people dying from heat-related problems.
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They → develop → problems
Those efforts could redefine how the United States understands the growing cost of climate change, because right now, the human toll of climate-worsened disasters is dramatically undercounted.
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toll → redefine → disasters
A small group of health experts across the country has concluded over time that thousands of Americans die every year because of climate-fueled disasters, like stronger, more dangerous hurricanes or heat waves so intense they obliterate historical records.
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they → conclude → records
And no one is keeping official track of the scope of the problem — not government agencies, researchers or state officials.
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one → keep → problem
Those omissions aren't just painful for the loved ones of the dead, says Kristie Ebi, a public health and climate epidemiologist at the University of Washington.
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Ebi → love → Washington
They have concrete consequences: Without an accurate count of the human toll of weather disasters, it is hard — or sometimes impossible — to understand their full impact on families and communities.
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it → have → families
By extension, Ebi says, an incomplete count impairs the ability to plan for and prevent such losses in the future, like knowing when and where to locate cooling centers during a heat wave.
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count → say → wave
"If you don't know how many people suffer and die in disasters, then you can't set priorities appropriately," she says.
But now a small contingent is trying to count better — a critical goal as climate change pushes heat to nearly unlivable temperatures, makes hurricanes deadlier and chokes communities with wildfire smoke.
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hurricanes → know → smoke
And their goal is to provide insights based on their data so that policymakers, city leaders and advocates have the information needed to save lives.
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policymakers → provide → lives
A heat-curious medical examiner
Hale, ruddy-cheeked Hess grew up in Wisconsin, but he has thrived in the desert.
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he → grow → desert
He rides his bike to and from work, even through the blazing Arizona summer heat, and he is the undisputed champion of the office's ongoing pickleball competition (evidence: a small silvery cup on his office shelf, a pickleball jammed inside and a stamped label reading "CHAMPION").
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he → rid → CHAMPION
When he was in medical school, he rotated through a forensic pathology stint, which other students avoided.
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students → rotate → which
After all, wasn't being a doctor about saving people, they asked?
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they → save → people
What was the point of working on someone who was already dead?
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who → work → someone
There was a mystery in these people on the autopsy table, entire lives encapsulated in the bodies that remained.
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that → be → bodies
Plus, upon first meeting, his new department head asked Hess about his beer preferences.
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head → ask → preferences
This was the place for him, he thought: on a team of people who were, despite their deeply serious work, playful, thoughtful and creative.
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who → think → people
Hess did a residency in Wisconsin and a stint as an Air Force doctor in California.
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Hess → do → California
But when he took the lead medical examiner position in Pima County, Ariz., in 2011, he ran headlong into a crisis — one that would inform his work for years to come.
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that → take → years
Pima County is tucked up against the U.S.-Mexico border in southern Arizona.
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County → tuck → Arizona
It's a small county — about a million people, most of whom live in Tucson.
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most → live → Tucson
The rest is rural, swaths of desert crisscrossed by roads stripped pale by the incessant sun.
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rest → crisscross → sun
When Hess arrived, the county was a hot spot for people attempting to cross the border on foot from Mexico into the U.S.
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county → arrive → U.S.
But the desert was punishing.
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desert → punish → ?
Every few weeks during summer after summer, Hess got a call asking his death investigators to go to a scene where two, or six, or eight people had been killed by heat and exposure.
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people → get → heat
The annual counts ran into the hundreds.
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counts → run → hundreds
The nonstop stream of complicated deaths pushed Hess' team to develop innovative protocols.
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stream → push → protocols
They learned how to thoroughly investigate each death, identify those lost, and track down family members left behind, to give them some sense of closure.
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They → learn → closure
Hess developed a deep appreciation for the data his team produced and what it could do.
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it → develop → what
A few years later, the opioid epidemic slammed into Pima and filled the office's autopsy tables.
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epidemic → slam → tables
Once again, Hess and his team leaned into their experience collecting thorough, complete data describing and humanizing the deaths.
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Hess → lean → deaths
as always, Hess collated all the data into neat annual reports.
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Hess → collate → reports
But he suspected they sat on someone's desktop, unread.
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they → suspect → desktop
The reports were packed with valuable insight, but their utility was limited because they were "not very timely," he said.
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he → pack → insight
But around this time, during the height of the opioid epidemic, other officials — from county public health, the mayor's office, the police force, the federal government — realized that death data could help prevent more deaths by identifying patterns quickly and figuring out how to intervene.
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data → realize → patterns
But that would require a faster exchange of data.
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that → require → data
So in 2022 Hess got the go-ahead to hire an epidemiologist, Tasha Tully, to mine the rich seam of information the team collected.
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team → get → information
…and 131 more, not listed.
The Aporia
