1993 — June-Aug (esp.), Heat, especially July 6-16 Philadelphia Heatwave (118 deaths)–311
— 311 Blanchard tally based on State breakouts below.
— 299 CDC WONDER. ICD-9/E900, exposure to excessive natural heat search, 9-2-2016.[1]
–>113 June-Aug. National Climatic Data Center., NOAA. Storm Data, Vol. 35, No. 6-8, 1993.
— 0 June. National Climatic Data Center. Storm Data, Vol. 35, No. 6, June 1993.
–>109 July. National Climatic Data Center. Storm Data, Vol. 35, No. 7, July 1993.
— 4 Aug. National Climatic Data Center. Storm Data, Vol. 35, No. 8, August 1993.
— 0 NCDC. Storm Events Database. Excessive Heat and Heat Searches all U.S. States 1993.
Summary of Heat Fatalities by State
Arizona 19
Arkansas 10
District of Columbia 2
Florida 4
Georgia 1
Illinois 14
Louisiana 14
Minnesota 1
Missouri ~7
Nevada 1
New Hampshire 1
New Jersey 16
New York 14
North Carolina 11
Ohio 1
Oklahoma 16
Pennsylvania 120
South Carolina 11
Tennessee 18
Texas 26
Wisconsin 3
Breakout of 1993 Heat Fatalities by States and Localities (where noted)
Arizona (19) May-August
— 16 CDC WONDER. ICD-9/E900, exposure to excessive natural heat search, 9-2-2016.
— 19 AZ DHS. Deaths from Exposure to Excessive Natural Heat…1992-2009. 2014, p. 17.[2]
Breakout by State or country of residence From Table 1, “Characteristics of deaths…”, p. 15.
–15 Arizona
— 3 Other U.S. State or Canada
— 1 Mexico/Other Central or South American country
Geographic region of occurrence From Table 1, “Characteristics of deaths…”, p. 15.
— 6 Border counties
–12 Central Arizona counties
— 1 Northern Arizona counties
Gender From Table 1, “Characteristics of deaths…”, p. 15.
–15 Male
— 4 Female
Race/Ethnicity From Table 1, “Characteristics of deaths…”, p. 15.
— 9 White non-Hispanic
— 6 Hispanic or Latino
— 1 Black or African American
— 2 American Indian or Alaska Native
— 1 Unknown
Age group From Table 1, “Characteristics of deaths…”, p. 15.
— 1 0-4
— 0 5-9
— 1 10-14[3]
— 0 15-19
— 1 20-24
— 1 25-29
— 0 30-34
— 1 35-39
— 1 40-44
— 2 45-49
— 4 50-54
— 1 55-59
— 1 60-64
— 0 65-69
— 2 70-74
— 1 75-79
— 0 80-84
— 1 85+
— 1 Unknown
County of occurrence From Table 1, “Characteristics of deaths…”, p. 16.
— 9 Maricopa
— 1 Mohave
— 5 Pima
— 2 Pinal
— 1 Yuma
Month of death From Table 1, “Characteristics of deaths…”, p. 16.
— 1 May
— 6 June
— 5 July
— 7 August
Arkansas (10)
–10 CDC WONDER. ICD-9/E900, exposure to excessive natural heat search, 9-2-2016.
— 1 Helena, July 26. Heat stress; male cotton seed oil worker. OSHA Inspection 107706210.
California (20)
–20 CDC WONDER. ICD-9/E900, exposure to excessive natural heat search, 9-2-2016.
District of Columbia ( 2)
— 2 July 10, one in northwest and one in southeast part of DC. NCDC. Storm Data, 35/7, p. 135.
Florida ( 4)
— 4 Lushine. “Underreporting…” Fig. 3, “Annual Temperature Deaths, Florida, 1979-1999.”[4]
Georgia ( 1)
— 1 Norcross, Sep 8. Heat stress; garbage truck worker; body temp. of 108° at hospital. OSHA.
Illinois (14)
–14 CDC WONDER. ICD-9/E900, exposure to excessive natural heat search, 9-2-2016.
— 1 Wauconda, Aug 11. Newly hired (unacclimated), male, 21, carpenter’s apprentice. OSHA.[5]
Louisiana (14)
–14 CDC WONDER. ICD-9/E900, exposure to excessive natural heat search, 9-2-2016.
Minnesota ( 1)
— 1 Bloomington, Aug 11. Heatstroke; male curb and sidewalk masonry worker. OSHA.
Missouri (~7)
— ~7 MO DHSS. Data & Statistical Reports. Chart: “Hyperthermia Mortality, Missouri 1980-2013.”[6]
Nevada ( 1)
— 1 Las Vegas, Clark County, Aug 3. Male, 56, “while working in 113 degree heat.” NCDC.[7]
New Hampshire ( 1)
— 1 Keene. The News, Frederick, MD. “Break in Heat Wave on the Way.” July 12, 1993.
New Jersey (16)
–16 State. CDC WONDER. ICD-9/E900, exposure to excessive natural heat search, 9-2-2016.
— 3 State. Blanchard tally based on locality breakouts below.
— 1 Northern NJ. National Climatic Data Center. Storm Data, Vol. 35, No. 7, July 1993, p. 196.
Breakout of New Jersey Heat Fatalities by Location (where noted):
— 1 Brooklawn. The News, Frederick, MD. “Break in Heat Wave on the Way.” July 12, 1993.
— 1 Camden. The News, Frederick, MD. “Break in Heat Wave on the Way.” July 12, 1993.
— 1 Colonia, July 12. Heatstroke; Colonia Country Club outdoor worker, extended shift, 105°.[8]
New York (14)
–14 CDC WONDER. ICD-9/E900, exposure to excessive natural heat search, 9-2-2016.
— 1 Coastal (southeast NY), July 4-31. NCDC, Storm Data, Vol. 35, No. 7, July 1993, p. 201.
— 1 New York City. The News, Frederick, MD. “Break in Heat Wave on the Way.” 7-12-1993.
— 3 New York City. USA Today. “Heat fatalities down in Philadelphia.” 8-19-2002.
North Carolina (11)
–11 CDC WONDER. ICD-9/E900, exposure to excessive natural heat search, 9-2-2016.
–11 Mirabelli and Richardson. “Heat-Related Fatalities in North Carolina.” AJPH, 95/4, 2005.[9]
— 1 Charlotte, May 28. Heat exhaustion; male roofing worker; core body temp. 107° F. OSHA.
Ohio ( 1)
— 1 Fort Loramie. The News, Frederick, MD. “Break in Heat Wave on the Way.” July 12, 1993.
Oklahoma (16)
–16 Garwe (OK Dept Health). “Heat-Related Deaths, Oklahoma, 1990-2001,” 5-31-2002, p.1.[10]
–13 CDC WONDER. ICD-9/E900, exposure to excessive natural heat search, 9-2-2016.
Pennsylvania (120)
— 120 Blanchard tally based on 118 for Philly and one each for Allentown and Downingtown.
— 31 CDC WONDER. ICD-9/E900, exposure to excessive natural heat search, 9-2-2016.
— 2 State (not Philly) AP. “Heat Wave…Toll Doubles in Philly…Senior Citizens.” 8-12-1993.
Breakout of Pennsylvania Heat Fatalities by Location (where noted):
— 1 Allentown. The News, Frederick, MD. “Break in Heat Wave on the Way.” 7-12-1993.
— 1 Downington. AP. “Heat Wave Death Toll Doubles in Philly…Senior Citizens.” 8-12-1993.
— 118 Philadelphia, July 6-16. CDC. “Heat-Related Deaths After an Extreme Heat Event…”[11]
— 118 Philadelphia. Philadelphia Inquirer (Marder / Wood). “CDC Confirms…” 11-20-2015.
— 118 Philadelphia. Philadelphia Inquirer (A. R. Wood). “Phila….heat-death toll.” 6-20-2004.
— 118 Philadelphia. USA Today. “Heat fatalities down in Philadelphia.” 8-19-2002.
— 118 Philadelphia. Wilhelmi, Purvis and Harriss. Natural Hazards Review, Aug 2004, p.148.
— 111 Philadelphia. Indiana Gazette, PA (AP). “Heat-Emergency Plan Considered.” 7-28-1993
–>100 “ NCDC. Storm Data, Vol. 35, No. 7, July 1993, p. 239.
–>100 “ Kaufman. “Old and Vulnerable in Phila.’s Heat Wave Deaths…” 7-18-1993
— 84 “ CDC, Morbidity and Mortality Weekly Report, Vol. 42, No. 28, 7-23-1993.
— 41 “ The News, Frederick, MD. “Break in Heat Wave on the Way.” 7-12-1993.
— 24 “ Jul 11 AP. “Heat Wave Death Toll Doubles in Philly…Senior Citizens.” 8-12-1993
— 23 Philadelphia County. CDC WONDER. ICD-9/E900, exposure to excessive natural heat.
South Carolina (11)
–11 CDC WONDER. ICD-9/E900, exposure to excessive natural heat search, 9-2-2016.
— 8 National Climatic Data Center. Storm Data, Vol. 35, No’s. 7-8, July-Aug 1993.
Breakout of South Carolina Heat Fatalities by Locality where noted:
— 1 Aiken County, July 4. Severe heat; female, 57. NCDC. Storm Data, 35/7, July 1993, p. 248.
— 1 Bamburg County, July 3. Heatstroke; male, 64. NCDC. Storm Data, 35/7, July 1993, p. 248.
— 1 Cherokee Co., July 8. Heat exhaustion; male, 48. NCDC Storm Data, 35/7, July 1993, p.250
— 1 Darlington County, July 16. Heatstroke; male, 64. NCDC Storm Data, 35/7, July 1993, 251.
— 1 Florence County, Aug 31. Heatstroke; male, 46. NCDC Storm Data, 35/8, Aug 1993, p. 117
— 1 Hampton County, July 9. Heatstroke; female, 65. NCDC Storm Data, 35/7, July 1993, p.250
— 1 Pickens Co., July 10. Heat exhaustion; female, 82. NCDC Storm Data, 35/7, July 1993, 251.
— 1 Richland County, July 13. Heatstroke, male, 59. NCDC Storm Data, 35/7, July 1993, p.251.
Tennessee (18)
–18 CDC WONDER. ICD-9/E900, exposure to excessive natural heat search, 9-2-2016.
Texas (26)
–26 CDC WONDER. ICD-9/E900, exposure to excessive natural heat search, 9-2-2016.
— 1 Corpus Christi, June 28. Heat stress; first day on job male ditch digger; heat index 95-102°.[12]
Wisconsin ( 3)
— 1 Appleton, Outagamie County, Aug 25. Excessive heat; male constructing chain link fence.[13]
— 1 Menomonee Falls, May 10. Heat stroke; male roofer, core body temp. 108° at hospital.[14]
— 1 Wausau, Marathon County, Aug 25. Excessive heat; male training for marathon run.[15]
Narrative Information
Philadelphia
CDC: “From July 1 through July 13, 1993, the heat wave in the eastern United States has been implicated as the direct cause of or a contributing factor to 84 deaths among persons residing in the Philadelphia area.” (CDC, MMWR, Vol. 42, No. 28, July 23, 1993)
July 4-14, NCDC Storm Data: “A persistent ridge of high pressure centered over the southeast and extending northward well into the Middle Atlantic region began a heat wave that lasted eleven days. The searing daytime heat, followed by humid nights offering no relief, resulted in numerous deaths – especially in Philadelphia. This heat wave claimed over one hundred lives in Philadelphia, most of which apparently occurred over the weekend of the 9th and 10th. The number of deaths related to this heat wave was the most ever in Philadelphia, however, this number was highly controversial and partially a result of a campaign to educate the public about preventable deaths among the frail elderly. The overwhelming majority of the deaths were among people 60 years and older. In too many cases, the victims had been shuttered away in the upstairs of intercity apartments with no fan or air conditioner. In Philadelphia, there were nine days of 95 or above temperatures during the heat wave. July 2nd to July 4th marked three consecutive days with a temperature of 100 degrees or more. Aside from the fatalities related to the excessive heat, several concrete roads buckled and/or exploded, crops were scorched, and livestock were less productive….” (NCDC. Storm Data, Vol. 35, No. 7, July 1993, p. 239.)
Newspapers Chronological
July 12, AP: “Philadelphia’s death toll doubled as the heat wave entered its eighth day and officials warned that the number could rise even higher before the relief promised by the National Weather Service arrives by Tuesday. Twenty-four people were declared dead of heat-related causes in Philadelphia Sunday, raising the city’s heat wave death toll to 41, according to City Health Commissioner Dr. Robert K. Ross.
“At least two other deaths elsewhere in the state last week were attributed to the heat.
“Most of the victims were senior citizens who lived in apartments without air conditioning, and many had underlying conditions such as heart disease or diabetes, leaving them vulnerable to the heat, Ross said. “My concern is that we’re not out of the woods yet,” Ross said. “We have a minimum of two more days of high heat and humidity.”
“In 1991, 25 people died during a heat wave in the city. That dropped to just four heat-related deaths last year. Health Department spokesman Jeff Moran said the 1993 count was the most in memory.
“A 4-year-old boy playing in a station wagon died Saturday when he was overcome by the heat. The unidentified child, from the Philadelphia suburb of Downington, was visiting relatives in West Nantmeal Township when he climbed into his aunt’s parked station wagon and fell victim to the heat, state police said.
“The state’s other heat-related death was an Allentown woman who was found dead on Thursday.
“The heat drove someone to steal six air conditioning units from an apartment complex by pretending to be a repairman, York police said. The suspect first shut off circuit breakers to cut power to the unit, then knocked on residents’ doors and told them the air conditioners were broken and needed repairing, police said. Police have not arrested a suspect. The tenants, all elderly residents, received replacement air conditioners from the apartment building, officials said.
“The American Red Cross in Philadelphia was accepting donations of fans and air conditioners to pass on to city residents, said Steve Michaelson, case work services manager. The Red Cross opened up a shelter for people who were too hot to remain in their homes, and have 10 volunteers working a 24-hour heat hotline, Michaelson said. “We’ve been averaging about 40 to
50 calls an hour at our peak area,” Michaelson said, adding the hotline has been receiving 20 to 30 calls an hour since Friday. Most people were asking for fans or air conditioners while others sought advice on how to beat the heat, he said….
“Sunday seemed more bearable after three days of high temperatures of 100 degrees or more. The 4 p.m. reading was 96 in Philadelphia, and humidity was down, so the heat index — measuring the what the temperature feels like — was only 97 degrees, weather officials said. The weather service kept a heat advisory in effect today for extreme southeast Pennsylvania and for southern New Jersey except for the coast. A cold front over the upper Great Lakes will reach eastern Pennsylvania and southern New Jersey tonight, and could bring cooler temperatures by Tuesday, the weather service said”.” (AP. “Heat Wave Death Toll Doubles in Philly; Mostly Senior Citizens.” Indiana Gazette, Indiana, PA, 7-12-1993, p. 1.)
July 12, The News, Frederick, MD: “After almost two weeks of miserable heat and humidity, cooler weather is on the way. In the meantime, though, temperatures are expected to be in the low to mid-90s today with a 40 percent chance of thunderstorms this afternoon.
“Not only Frederick County, but the rest of the East Coast has been baking under what has been triple-digit heat in some places.
“In Philadelphia, 24 people were declared dead of heat-related causes, raising the city’s death toll to 41, according to Dr. Robert K. Ross, the city’s health commissioner. Many of the dead were senior citizens who lived in apartments without air conditioning, and many had underlying conditions such as heart disease or diabetes, leaving them vulnerable to the heat, Dr. Ross said.
Other cities reporting one death each during the heat wave were:
New York City;
Allentown, Pa.;
Brooklawn and
Camden, N.J.;
Fort Loramie, Ohio; and
Keene, N.H.
“Meanwhile, beaches and pools were packed again Sunday from New England to Miami….Air conditioners and fans were in demand all over the region. A shipment of 150 air conditioners at a Silo appliance store in Whitehall Township, Pa., sold Saturday in less than two hours…And the York Ice Co. in Pennsylvania has been selling between 150 and 175 tons of ice a day…” (The News, Frederick, MD. “Break in Heat Wave on the Way.” July 12, 1993.)
July 12, Kaufman: “Some were afraid to open the window because of crime; others were afraid to turn on the air conditioner because of the electric bills. Most were over 65. Some had diabetes and heart problems. More than a few suffered from some level of apparent dementia. They often lived alone, though most had neighbors and relatives who tried to help but were often rebuffed. Most were poor. And all, it is now clear, were in some way dangerously frail.
“These are the more than 100 people who the Philadelphia medical examiner said died of heat-related causes during the heat wave of 1993. Like trees toppled in a storm or withered from the scorching sun, they were the ones too diseased or too injured to withstand the harsh conditions.
“The number of heat-related deaths in Philadelphia has shocked many people, especially because it is so much higher than in other big cities caught in the same heat wave. Most other cities record heat deaths only when a medical determination has been made that the victim succumbed to hyperthermia. The Philadelphia Medical Examiner’s Office records heat deaths in cases in which the heat contributed to the death, even though the victim had underlying health problems.
“However they are counted, the 100-plus deaths offer a window into a world that most Philadelphians seldom see – the city’s increasingly large population of frail and vulnerable elderly. At 15 percent, Philadelphia has the largest proportion of elderly people among the 20 largest cities in America, according to the 1990 census. Philadelphia has more than 240,000 people over 65, and almost 23,000 over age 85.
“Recent studies have found a high proportion of the city’s elderly to be ill (37 percent reported themselves to be in “fair or poor health”), isolated (44 percent live alone) and poor (34 percent reported incomes below the poverty line). All these numbers, gathered in 1990 by the Philadelphia Health Management Corporation, exceed national norms. Given these conditions, say those who work with the elderly, it should hardly be surprising that a heat wave would take such a toll. “I think what we are seeing here is a symptom of a much bigger problem with our elderly, rather than a specific disease,” Health Commissioner Robert K. Ross said. “What we have in Philadelphia is thousands of elderly people who are literally living on the edge,” he said. “Eight days of hot weather and – here in 1993 when air conditioning is not exactly a new thing – 100 elderly people die because of the heat. This shows that in terms of long-term care for our elderly, we are in some serious trouble.”
“Rodney Williams, executive director of the Philadelphia Corporation for Aging (PCA), which oversees most programs for the elderly in the city, believes that what is unique about the recent heat wave is that the elderly deaths have been widely reported. “There have been these kind of unfortunate things for years,” he said. ”But they have been unrecorded, unannounced and unresponded to. What’s different now is that people are talking about it.”
“The absence of comprehensive long-term care is not a problem unique to Philadelphia. But the city does have some unique characteristics. For example, officials say that:
- Elderly Philadelphians are far more likely to own their own homes than elderly in other cities. This means that many poor elderly, who elsewhere might rely on landlords for services, are themselves responsible for keeping up their homes. And on a small, fixed income, an air conditioner and the electricity to power it quickly become a luxury.
- Because Philadelphia has so many elderly people living alone – the PHMC study estimates 110,000 live on their own – some inevitably fall through social and family safety nets. Almost 30,000 elderly Philadelphians “report not having anyone to help them if their health deteriorated,” according to the study.
- Philadelphia has 7,000 fewer nursing home beds than it needs, according to the state Department of Health. For poor elderly who rely on Medicaid to pay their nursing home bills, it can take years to find a home that will accept them. At least three of those who died last week had at one point applied for the Medicaid certification needed to get on a nursing home waiting list, according to PCA.
“People have always wondered what happens to frail people who can’t get into a nursing home or get other care they might need,” said Bernice Soffer, executive director of the Coalition of Advocates of the Infirm Elderly. “I think we are now seeing what happens – some just die earlier than they might have. “This heat wave and the deaths should be a wake-up call for the city.”
“For each of the deaths ruled heat-related by the Medical Examiner’s Office, there is a report with medical history, police observations and comments from neighbors and family. From these reports, this pattern emerged:
“The overwhelming number of victims were old, twice as likely to be female, and about evenly divided between black and white. Given that there are almost three times as many white elderly in the city as black elderly, this means that blacks were disproportionately hard-hit. It also means that minority and poor neighborhoods such as Kensington and North and West Philadelphia had far more victims than their elderly population would warrant.
“The medical examiner’s reports also show that many of the victims lived alone, although few seemed to be without social contacts. Grace Harkins, who lives in Virginia, told authorities this about her aunt, 87-year-old Lee Odgers: “She had refused any and all offers of help.” Harkins called Odgers one day before the elderly woman died. “I offered to get her an air conditioner, but she refused,” Harkins said. “She was a very independent-type person.” The police noted that all the windows were closed in Odger’s second-floor Northeast Philadelphia apartment, and that candles on the wall had melted from the heat.
“Henry Ewell of North Philadelphia lived on his own, but relatives and others frequently came in and out of his home. Yet when authorities removed his body last week, the thermostat on the dining room wall registered over 90 degrees. Every window in the 74-year-old, World War II veteran’s house was closed, except for one in the room where his great-nephew, in town for the summer, sometimes stayed. Ewell’s body was found by a neighbor, Courtland Miller Jr. He said, “It was so hot that as soon as the police officer came in there, he just started busting out in a sweat.” When relatives arrived from out of state to make funeral arrangements, they borrowed three fans from neighbors to cool down the house a bit. And they finally opened the large window in the living room. “He never pulled that window up,” said Esther Robinson, Ewell’s niece, who was fanning herself inside the still-steaming house in the 1700 block of North Taney Street on Wednesday. “I don’t know why he never did; maybe it’s the crime in the city,” she said. Ewell, retired from the Edison Shoe Co., was not well. He had been in the hospital in February for prostate cancer, but relatives say that his condition was under control and that Ewell remained an involved person. Earlier in the year, neighbors said, he had opened his home to a homeless woman who had been living outside….
“Almost every day for the last few years, Carmen Lerro would check in on his great-aunt, 84-year-old Katherine Lerro, at her Italian Market apartment. It wasn’t hard because Carmen worked on the first floor, and his great-aunt lived on the third. She had lived there for decades with her sister, but the sister died several years ago and left Katherine living alone. Carmen said that his great-aunt always complained of feeling cold. He said she turned off the third-floor central air conditioning he had installed, and generally kept all the windows closed. He also said she wore at least one sweater and a wool hat when inside. She was wearing them when Carmen found her dead in her apartment last Sunday. “I had been up there earlier telling her to open the windows and take off her sweater, but she just didn’t want to,” he said. “It had to be over 100 in that room.” Carmen Lerro said his great-aunt had had long-term psychological problems, but feared nursing homes and other institutions. “She just wanted to stay in that apartment and look out the window,” he said.
“According to Health Commissioner Ross, many of those who died seemed to have been mentally confused. “There is a component of senility involved,” he said. “Many are discovered inappropriately dressed for the weather, with two and three layers of clothing. “Maybe they lived through some very tough times and they think they can tough this out, too.”
“Alice Irving was never bothered much by the heat. “She always wore long sleeves. She’d get cool quick,” her daughter, Mary Porter, said during an interview at Irving’s South Philadelphia home. And because of her arthritis, she didn’t like air conditioning. But that does not explain why, even as temperatures reached the 100-degree mark last weekend, the 73-year-old woman kept closed the windows of her rowhouse on the 1300 block of South Chadwick Street. Her daughter said that was to keep out the dust. “My mother didn’t like her curtains dirty,” Porter said. “She didn’t open the windows.” Irving was found last Sunday by her granddaughter, Vanessa Porter. Irving had collapsed on a small chair near the front door. Vanessa Porter, who lived with Irving, said her grandmother had a different reason for locking all the windows. “She had to lock the door because of the security,” she said. “People tried to rob us before, and it was unsafe to even open the windows because we live in a drug-infested area.”
“According to Lynne Kotranski, who helped write the 1990 PHMC report on the elderly in Philadelphia, one of their principal findings was that many seniors were vulnerable socially as much as medically. As many as 21,000 elderly in Philadelphia not only live alone but report having very few social supports, Kotranski said. “We talking here about a pretty dramatic situation, with so many people isolated and with few helpers,” she said. It is easy to see how winter blizzards imperil already precarious lives, she said, but heat waves don’t have the same kind of drama.
“For instance, the state Department of Public Welfare makes grants to low- income residents to pay for heating bills. That program, which uses federal money, could also issue summertime grants for air-conditioning, but a department spokesman said the state decided some time ago not to make those grants. “They looked at the greatest need, which was the wintertime in Pennsylvania,” Mark McGaffin said, referring to officials who wrote the rules for the state heating assistance program.
“Quite of few of those whose deaths were deemed heat-related had a relationship with a senior center or with PCA itself. Karen Mudd, a spokeswoman for PCA, said that in 23 of the first 70 heat-related elderly deaths, the victim had received some kind of services from PCA in recent years. Three had begun the process of qualifying for a Medicaid-sponsored nursing home placement, and seven were receiving in-home services such as meals-on-wheels and homemaker services.
“One of those needing help was 86-year-old Jennie Scott of North Philadelphia. According to Veronica Jackson, captain of her North Lambert Street block, Scott lived alone and depended on neighbors and friends to bring groceries. “I went to see her every day. I would go get her water, make sure she was doing OK. She had two fans, but she hadn’t turned on the fan on the second- floor bedroom,” Jackson said. “Her health was pretty good.” She said that Scott had a daughter in Florida and a cousin in the area, but no other family she was aware of. Scott also had a social worker from the North City Congress, a senior center in North Philadelphia. The social worker helped Jackson to get storm doors, new windows and fans, and to pay her bills.
“Scott was not the only North City Congress client to succumb during the heat wave. According to Mary Sweeney, assistant executive director of the center, seven others died during the extreme heat. Sweeney sighed when asked about the number of deaths in poorer areas such as North Philadelphia. “That’s where the greatest need is,” Sweeney said. “That’s why we’re here.”
“For 19 years, Rita Schiavone has looked after shut-ins. What began as a personal mission has become a major endeavor, with hundreds of volunteer visitors looking in on as many as 1,500 frail elderly in Philadelphia and surrounding counties. “This is the worst summer we have ever had, by far,” Schiavone said from her Aid for Friends office on Holme Avenue in the Northeast. Officials from two other volunteer groups that visit shut-ins – Little Brothers, Friends of the Elderly and the Senior Companion Program – reached similar conclusions. “We go out and visit people and many can barely breathe, it’s so hot,” she said. “And this heat wave hit when many of our volunteers are on vacation.” Schiavone said that Aid for Friends now has a waiting list of 40 shut-ins who need visitors and more. AFF also takes food to many shut-ins and tries to buy small appliances – including toasters, fans and small air conditioners – for those without. During the heat wave, Schiavone said that volunteers frequently found shut- ins with air conditioners installed but unplugged. “Older folks often don’t like change, and they will resist something like an air conditioner,” she said. “We told them we would even pay the electric bills if they turned them on, but some just said no. “You can’t force people to do what they don’t want to do”.” (Kaufman. “Old and Vulnerable in Phila.’s Heat Wave Deaths…” Inquirer (Philly). 7-18-1993)
July 28, AP/Indiana Gazette: “Harrisburg — An elderly person living alone with no air conditioning is a typical example of a heat-related death, a Philadelphia health official told a statewide task force on heat emergencies. In many such cases, temperatures in the home exceed 130 degrees and residents are reluctant to open their windows because they fear for their safety, said Lawrence Robinson, the city’s deputy health commissioner.
“Philadelphia reported 111 heat-related deaths, most of them among elderly people, during the July 4-14 heat wave that saw temperatures rise above 90 degrees throughout the state. A handful of deaths were reported elsewhere in Pennsylvania.
“The task force convened Tuesday to develop a statewide plan to limit heat-related deaths and distress in the future. “Heat-related deaths are preventable. They are not inevitable,” said Acting Gov. Mark Singel, chairman of the statewide task force. “We need to protect people from life-threatening risks in hot weather.” Singel said the state had good response plans for winter emergencies but needed to establish “a statewide mechanism” to deal with the heat — the nation’s second biggest weather-related killer, after the cold. The panel was charged with developing ways to better coordinate social support and emergency services provided by the various state, local and private agencies represented on the task force.
“Following opening remarks, task force participants broke into three “brainstorming work groups” and planned at least one more meeting before issuing recommendations. A preliminary strategy is expected in three weeks and a more formal one in two months.” (AP/Indiana Gazette, Indiana, PA. “Heat-Emergency Plan Considered.” 7-28-1993, p. 9.)
Sources
Arizona Department of Health Services (Christopher K. Mrela and Clare Torres). Deaths from Exposure to Excessive Natural Heat Occurring in Arizona 1992-2009. AZ DHS, March 2010, 5-12-2014 modification. Accessed 9-1-2015: http://www.azdhs.gov/plan/report/im/heat/heat09.pdf
Associated Press (Nick Jesdanun). “Heat Emergency Plan Considered,” Indiana Gazette, Indiana, PA 7-28-1993, p. 9. Accessed 3-19-2016 at:
http://newspaperarchive.com/fullpagepdfviewer?img=112037899&sterm
Associated Press. “Heat Wave Death Toll Doubles in Philly; Mostly Senior Citizens,” Indiana Gazette, Indiana, PA, 8-12-1993, 1. Accessed 3-19-2016 at:
http://newspaperarchive.com/fullpagepdfviewer?img=112037654&sterm
Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1979-1998 (ICD-9/E900, exposure to excessive natural heat search). CDC WONDER On-line Database, compiled from Compressed Mortality File CMF 1968-1988, Series 20, No. 2A, 2000 and CMF 1989-1998, Series 20, No. 2E, 2003. Accessed at http://wonder.cdc.gov/cmf-icd9.html on Sep 2, 2016 1:57:07 PM
Centers for Disease Control and Prevention. “Heat-Related Deaths – United States, 1993.” MMWR (Morbidity and Mortality Weekly), Vol. 42, No. 28, 7-23-1993. Accessed 3-19-2016 at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00021217.htm
Centers for Disease Control and Prevention. “Heat-Related Deaths After an Extreme Heat Event – Four States, 2012, and United States, 1999-2009.” MMWR (Morbidity and Mortality Weekly Report), Vol. 62, No. 22, June 7, 2013, pp. 433-436. Accessed 7-6-2015 at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6222a1.htm
Garwe, Tabitha, M.P.H., Epidemiologist, Injury Prevention Service, OK DPH. ). “Heat-Related Deaths, Oklahoma, 1990-2001.” Oklahoma City, OK: Oklahoma State Department of Health, 5-31-2002. Accessed 11-8-2015 at: http://www.ok.gov/health2/documents/Heat_Deaths_1990-2001.pdf
Kaufman, Marc et al. “Old and Vulnerable in Phila.’s Heat Wave Deaths Underline Isolation of City Elderly.” Philadelphia Inquirer. 7-18-1993. Accessed at:
http://articles.philly.com/1993-07-18/news/25977552_1_heat-related-heat-wave-heat-deaths
Lushine, James B. “Underreporting of Heat and Cold Related Deaths in Florida.” Miami, FL: National Weather Service Weather Forecast Office, NOAA. 1-6-2009 modification. Accessed 11-1-2015 at: http://www.srh.noaa.gov/mfl/?n=fla_weather_casualties
Mirabelli, Maria C. and David B. Richardson. “Heat-Related Fatalities in North Carolina.” American Journal of Public Health, Vol. 95, No. 4, April 2005, pp. 635-637. Accessed 9-2-2015 at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449233/
Missouri Department of Health & Senior Services. Data & Statistical Reports. Chart: “Hyperthermia Mortality, Missouri 1980-2013.” DHSS. Accessed 11-19-2015 at: http://health.mo.gov/living/healthcondiseases/hyperthermia/data.php
National Climatic Data Center. Storm Data, Vol. 35, No. 6, June 1993. Asheville, NC: NCDC, NOAA. Accessed 3-19-2016 at: http://www1.ncdc.noaa.gov/pub/orders/IPS/IPS-B15E2429-F84D-42B9-97B2-E7DC7DC470AB.pdf
National Climatic Data Center. Storm Data, Vol. 35, No. 7, July 1993. Asheville, NC: NCDC, NOAA. Accessed 3-19-2016 at: http://www1.ncdc.noaa.gov/pub/orders/IPS/IPS-B348DA50-30E3-491D-833D-57DCA1E6D00E.pdf
National Climatic Data Center. Storm Data, Vol. 35, No. 8, August 1993. Asheville, NC: NCDC, NOAA. Accessed 3-19-2016 at: http://www1.ncdc.noaa.gov/pub/orders/IPS/IPS-12AB9B06-B77F-4DE7-AC5F-CE27B4C2683E.pdf
National Climatic Data Center. Storm Events Database. Excessive Heat Search Results for all U.S. States and Areas, 1993. Accessed 3-19- 2016 at: http://www.ncdc.noaa.gov/stormevents/listevents.jsp?eventType=%28Z%29+Excessive+Heat&beginDate_mm=01&beginDate_dd=01&beginDate_yyyy=1993&endDate_mm=12&endDate_dd=31&endDate_yyyy=1993&hailfilter=0.00&tornfilter=0&windfilter=000&sort=DT&submitbutton=Search&statefips=-999%2CALL
National Climatic Data Center. Storm Events Database. Heat Search Results for all U.S. States and Areas, 1993. Accessed 3-19- 2016 at: http://www.ncdc.noaa.gov/stormevents/listevents.jsp?eventType=%28Z%29+Heat&beginDate_mm=01&beginDate_dd=01&beginDate_yyyy=1993&endDate_mm=12&endDate_dd=31&endDate_yyyy=1993&hailfilter=0.00&tornfilter=0&windfilter=000&sort=DT&submitbutton=Search&statefips=-999%2CALL
Occupational Safety & Health Administration. Fatality and Catastrophe Investigation Summaries [1993]. “Inspection: 102528577 – G. W. Thiel, Inc.” Washington, DC: U.S. Dept. of Labor, OSHA. Accessed 3-20-2016: https://www.osha.gov/pls/imis/establishment.inspection_detail?id=102528577
Occupational Safety & Health Administration. Fatality and Catastrophe Investigation Summaries [1993]. “Inspection 103469300 – Gross Roofing, Inc. [Butler, WI].” Washington, DC: U.S. Department of Labor, OSHA. Accessed 3-20-2016 at: https://www.osha.gov/pls/imis/establishment.inspection_detail?id=103469300
Occupational Safety & Health Administration. Fatality and Catastrophe Investigation Summaries [1993]. “Inspection: 107180879 – Waste Management of Atlanta.” Accessed 3-20-2016 at: https://www.osha.gov/pls/imis/establishment.inspection_detail?id=107180879
Occupational Safety & Health Administration. Fatality and Catastrophe Investigation Summaries [1993]. “Inspection: 107430316 – RNR Construction.” Washington, DC: U.S. Department of Labor, OSHA. Accessed 3-20-2016 at: https://www.osha.gov/pls/imis/establishment.inspection_detail?id=107430316
Occupational Safety & Health Administration. Fatality and Catastrophe Investigation Summaries [1993]. “Inspection: 107706210 – Helena Cotton Oil Co., Inc.” Washington: OSHA. Accessed 3-20-2016: https://www.osha.gov/pls/imis/establishment.inspection_detail?id=107706210
Occupational Safety & Health Administration. Fatality and Catastrophe Investigation Summaries [1993]. “Inspection: 109056366 – Colonia Country Club.” Washington, DC: OSHA. Accessed 3-20-2016: https://www.osha.gov/pls/imis/establishment.inspection_detail?id=109056366
Occupational Safety & Health Administration. Fatality and Catastrophe Investigation Summaries [1993]. “Inspection: 120371059 – Concrete Master.” Washington, DC: OSHA. Accessed 3-20-2016: https://www.osha.gov/pls/imis/establishment.inspection_detail?id=120371059
Occupational Safety & Health Administration. Fatality and Catastrophe Investigation Summaries [1993]. “Inspection: 18540716 – Simon Roofing and Sheet Metal Corp. [Charlotte, NC]. Washington, DC: U.S. Department of Labor, OSHA. Accessed 3-20-2016 at: https://www.osha.gov/pls/imis/establishment.inspection_detail?id=18540716
Philadelphia Inquirer (Dianna Marder and Anthony R. Wood). “CDC Confirms City’s Counting of Heat Deaths.” 6-14-1994. Accessed 11-20-2015 at: http://articles.philly.com/1994-06-14/news/25831588_1_heat-related-deaths-heat-deaths-heat-wave
Philadelphia Inquirer (Anthony R. Wood). “Phila. Chilling its heat-death toll. It has done more to save lives in heat waves than any other city, a study found. Hotlines and other low-cost measures were cited.” 6-20-2004. Accessed 11-20-2015 at: http://articles.philly.com/2004-06-20/news/25370429_1_heat-wave-heat-deaths-death-toll
Salt Lake Tribune. “Utah wilderness therapy deaths.” 10-11-2007. Accessed 11-13-2015 at: http://www.sltrib.com/news/ci_7139316
The News, Frederick, MD. “Break in Heat Wave on the Way.” 7-12-1993. Accessed at: http://www.newspaperarchive.com/FullPagePdfViewer.aspx?img=11982782
USA Today. “Heat fatalities down in Philadelphia.” 8-19-2002. Accessed 11-1-2015 at: http://usatoday30.usatoday.com/weather/news/2002/2002-08-19-phillyheatdeaths.htm
Wilhelmi, Olga V., Kathleen L. Purvis and Robert C. Harriss. “Designing a Geospatial Information Infrastructure for Mitigation of Heat Wave Hazards in Urban Areas.” Natural Hazards Review, August 2004, pp. 147-158. Accessed at: http://openclimate.org:16080/heat_waves/Doc4001_Wilhelmi_Heat_Mitigation_GIS_NatHazRev_2004.pdf — and
http://www.climateknowledge.org/heat_waves/Doc4001_Wilhelmi_Heat_Mitigation_GIS_NatHazRev_2004.pdf
[1] CDC-Wonder results relate only to cases where hyperthermia was coded ICD-9/E900 as primary (direct) cause of death by a medical examiner on a death certificate. “Heat-related” deaths are viewed as those where heat was an indirect or contributing cause of death, and are not included. Even with what we would view as a direct E900.0 heat death we know that sometimes such deaths are coded as something else – such as a dehydration in the case of a child left in a hot car, or heart-failure brought on by a heat stroke, and thus do not show up in a exposure to excessive heat query. Also, CDC WONDER suppresses (does not show) fatality numbers in a State where the loss of life is less than 10, though these deaths are apparently incorporated into the national total. Shows U.S. pop. of 260,024,637.
[2] “Data on the number and characteristics of deaths from heat due to weather conditions were obtained from the mortality database containing information from the death certificates filed with the Arizona Department of Health Services….In addition to death certificates where exposure to excessive natural heat was indicated as the underlying cause of death, heatstroke or sunstroke may be reported on death certificates as contributing factors that had a bearing on the death, but were not its underlying cause. For example, heatstroke and sunstroke were mentioned in…Arizona death certificates where atherosclerotic cardiovascular disease…, respiratory disease…, diabetes…, or drug overdose/alcohol intoxication…were reported as the underlying cause of death. Those heat-related deaths are beyond the scope of this report.” (p. 1)
[3] According to the Salt Lake Tribune (“Utah wilderness therapy deaths.” 10-11-2007), “Jamie Young, 13, of Tucson, Ariz., died June 2, 1993, in Ramsey Canyon Hospital and Treatment Center in Sierra Vista, Ariz., of heat exhaustion after hiking in Tanque Verde Falls in Arizona.”
[4] Figure 3 is a chart which shows heat deaths in one color and cold deaths in another on the same horizontal bar for each year. The fatality range shown on the left of the chart is in increments of five, going up to thirty. The bars for each year are shown diagonally and do not show any numbers. This does not make them readily readable. Thus one has to measure with a ruler the bar showing the lowest combined deaths (1979), which appears to show one cold death and one heat death. With the unit of measurement of one death then measured against the heat portion of all the other bars, one can get an approximation of the heat deaths for each year. I say “approximate” in that by this method we counted 133 heat deaths over the 21-year period included in the graph, whereas the text of the article notes that there were 125. Repetitious measurement attempts gave us the same result. The article notes that the data came from death certificates collected by the Public Health Statistics Section, Office of Vital Statistics, Florida Department of Health and Rehabilitative Services.
[5] “Inspection: 102528577 – G. W. Thiel, Inc.” OSHA “Accident Investigation Summary” notes: employee “was on his seventh day of employment…Temperatures…on the sixth and seventh days of work…ranged from 91 to 100 degrees F with approximately 60 to 70 percent humidity, 0 to 5 mph winds, and sun. Water and first aid were not provided by the employer. Employee…was found comatose with a temperature of 108 degrees F. There was a 28 minute delay before he arrived at the hospital. Employee…experienced severe fibromyolysis, kidney and liver failure, and brain damage. Employee…never regained consciousness and died 12 days later on August 23, 1993, from multiple organ failure secondary to heat stroke.”
[6] Note “about” 7 deaths in that chart plots fatalities by increments of 10 on the left axis and years along the bottom, with a line connecting dots. Takes interpretation, even with enlargement.
[7] National Climatic Data Center. Storm Data, Vol. 35, No. 8, August 1993.
[8] OSHA. “Inspection: 109056366 – Colonia Country Club.”
[9] From Figure 1, a chart with the number of heat-related deaths along the left axis, and the year along the bottom.
[10] From Figure 1. “Heat-Related Deaths by Year, Oklahoma, 1990-2001.” Deaths in Figure 1 are denoted by a horizontal bar, against backdrop of horizontal lines in increments of five. The precise number of deaths is not given, thus one has to make an educated guess in looking at the Figure and contrasting one bar against others.
[11] “During July 6-16, 1993 an EHE [Extreme Heat Event] in Philadelphia, Pennsylvania, resulted in 118 deaths (7.5 deaths per 100,000).”
[12] Occupational Safety & Health Administration. “Inspection: 107430316 – RNR Construction.”
[13] National Climatic Data Center, NOAA. Storm Data, Vol. 35, No. 8, Aug 1993, p. 142.
[14] Occupational Safety & Health Administration. “Inspection 103469300 – Gross Roofing, Inc.”
[15] National Climatic Data Center, NOAA. Storm Data, Vol. 35, No. 8, Aug 1993, p. 142.