Editor’s Note: This article is the second in a series that discusses Sacramento’s hotter future, and what we can do now to be ready for it.

At 6:30 a.m. on a September morning in Phoenix, when you walk outside with your morning coffee, the day is already hot. Like 90 degrees hot.

Throughout the summer and into early fall, temperatures rarely dip below 90 in the city, even at night. By summer’s end, people are throwing blocks of ice into their swimming pools so it feels less like bathwater. In this place, car windows are tinted; exercise happens inside or at night; and blinds, curtains and windows remain shut during the day to keep out the heat. And that’s for the people with homes.

“I call it Hot Land,” said Phoenix resident and community health advocate Stacey Champion. “It’s really like living in an oven for part of the year. We are in a place where air conditioning is not a luxury — it’s literally a matter of life and death.”

Phoenix hasn’t cracked the code of how to live with extreme heat. Since May, heat has contributed to the deaths of at least 55 people in Maricopa County, where Phoenix sits. Heat-related deaths across Arizona tripled between 2014 and 2017, from 76 deaths to 235. Most of those deaths were in Phoenix.

The city has become a testing ground for living with extreme heat. How Phoenix handles heat holds lessons for other warming cities like Sacramento, where both temperatures and populations are increasing.

Heat in perspective

By 2100, according to the 2018 Sacramento Valley Climate Change Assessment, the number of days that midtown Sacramento is expected to experience temperatures topping 104 degrees is expected to grow from four days per year to 40. That is similar to what Tucson experiences now and about half of what Phoenix deals with already.

As we move into fall and winters, it’s difficult to take into account the changing climate. But consider, despite the cooler days of November, they’re not all that cool for this time of year. In fact, technically, we’re still in the fire season and expected to remain so until the first rains arrive — whenever that may be.

This past summer might provide an example of how our climate is changing. About 70 days topped that 104-degree threshold in Phoenix, and nearly every day since May was above 100. If those of us in Sacramento are concerned for our hotter future, consider that Phoenix, according to Climate Central modeling, is projected to resemble the 114-degree averages found currently in Kuwait by 2100.

From her office in Sacramento, Helene Margolis, an associate adjunct professor in the UC Davis Department of Internal Medicine, wants to be clear: “We’re here now. There’s a misconception that there has to be a ‘heatwave’ and extreme temperatures for there to be adverse health effects. But you don’t need 120-degree temperatures to have a huge public health impact.”

Margolis witnessed that firsthand in 2006 when a summer heatwave swept over most of California for an unprecedented two weeks, breaking temperature records throughout the state. She was working at the state Department of Public Health. One of her job tasks was to field calls. Some were from the coroner’s office. Heat killed at least 600 people that summer and thousands of animals.

Margolis co-authored a study led by Kim Knowlton of the Natural Resources Defense Counsel and Columbia University showing that the heatwave brought on about 1,200 additional hospitalizations statewide and 16,000 extra visits to the emergency room. Even in relatively cool San Francisco, temperatures as low as the 80s were unseasonably warm enough to increase ER visits and heat-related illnesses.

Tracking heat

As California was reeling from its heatwave, Arizona was in the middle of a major spike in heat-related deaths, as well, jumping from 42 deaths in 2004 to 85 in 2006.

“We didn’t even have a program for heat surveillance at that time,” said Vjollca Berisha, an epidemiologist with the Maricopa County Department of Public Health. “We were sort of starting from scratch.”

They knew that to manage a problem, it had to be measured. The county became the first in the nation to develop a heat surveillance program. They work with medical and coroners’ offices to track and classify deaths. From May through October, the county posts weekly numbers of heat-related deaths on its website. They collect information such as whether the deceased had been using an air conditioner. This data helps determine which communities and demographics are being most affected.

Such efforts appeared to pay off, with heat-related deaths dropping to 49 people in 2008. But then the numbers shot up to 110 deaths by 2012, dipped again, and then spiked up to 182 deaths in 2018.

Cooling centers

Cooling centers are one tool cities use to help heat-vulnerable populations. These air-conditioned facilities are often places like libraries, senior centers and community centers that people can use during heat waves to cool down.

Maricopa County has dozens of cooling stations and hydration stations, which are highlighted on a Heat Relief Regional Network Map.

Sacramento opens its handful of cooling stations when the forecast calls for highs above 105 degrees for three consecutive days and lows above 75 degrees. The county said it may revisit that threshold, given the heat strain multiple days in the lower 100s can bring. But few people tend to use the centers, reducing the incentive to spend the resources to open them more often.

Researchers and public health advocates in both cities point out several shortcomings to cooling centers that, if overcome, may help them become more effective:

• The centers often carry a stigma of being only for disadvantaged populations rather than a place for all community members to cool off.

• They are rarely open past 5 p.m. — the hottest time of day for many western cities — due to staffing and funding needs. Facilities open late or overnight may become classified as homeless shelters, requiring a different level of resources to operate.

• Pets are not often welcome at cooling centers, so their owners stay home with them.

• People aren’t always aware of open cooling centers, where they operate, or how to get there. This summer, ridesharing service Lyft offered heat-vulnerable residents in Phoenix free rides to cooling centers.

Getting climate-ready

For Sacramento to adapt and thrive in a warmer future, collaboration among agencies, institutions, jurisdictions and communities is vital to ensure that solutions are interwoven through all facets of life. As unexciting as that may sound, it could save lives and create resilient communities.

Nearly every person from Sacramento interviewed for this story mentioned a key group attempting to do this: the Capital Region Climate Readiness Collaborative. More to come in this series on their work and some solutions being proposed.

But the effort points to a rising awareness and regional discussion that climate change is a public health issue and a social justice issue — one that moves beyond hydration and air conditioning to how we build, plan, travel, educate, make policy, pave roads, paint roofs, treat each other, and foster equitable, sustainable communities.

“The longer we wait, the less opportunity we’ll have to address these issues,” Cofer said. “But some positive things are happening now.”

Lessons recap

So let’s recap some of the lessons from Phoenix: They track, they use cooling centers and hydration stations, they are looking at ways to keep power on during the hottest days for people who can’t afford it. And they, like Sacramento, are reaching across sectors to integrate solutions.