Thursday, June 01, 2000
Officials aim to beat heat deaths
Agencies rolling out new system to protect people who are at risk
By Tim Bonfield
The Cincinnati Enquirer
Last summer, Cincinnati made national news when a July heat wave killed 18 people.
This summer, public health officials vow things will be different.
By mid-June, the Cincinnati Health Department and several cooperating agencies plan to roll out a revamped system for warning people about heat waves and what to do about them.
Out will be the city cool shelters that few people used. In will be an expanded buddy system of church groups, block watches and senior citizen agencies to check on neighbors at risk.
Out will be city-only heat “alerts” and “emergencies” declared after the heat wave hits. In will be regional heat alerts to be based more on weather predictions.
Largely unaddressed, however, will be a recommendation from a federal study to require air conditioning at more than 120 area group homes, many of which house people with mental illnesses or other disabilities that make them more likely to suffer from sweltering heat.
“This year will be a transitional year for us in many respects. We plan to do several things differently,” said Cincinnati health commissioner Malcolm Adcock.
Last year, Cincinnati was among the earliest and hardest-hit cities during a multistate heat wave that claimed more than 197 lives in late July.
The last Cincinnati summer that was so deadly was 1988, when officials reported 16 heat-related deaths over a two-month period.
The new summer heat program stems from an ana lysis of the city's response to last year's heat wave issued in April by the Centers for Disease Control and Prevention (CDC).
That report found little value in the city cool center program and noted difficulty getting a patchwork of political jurisdictions between here and Dayton to work from the same public health message.
As a result, Cincinnati health officials have been
working for months with Montgomery County health officials, who had already hired a consultant to redesign its heat alert system.
Now, instead of waiting for at least two days of high heat to declare an emergency, the Cincinnati and Dayton health departments plan to coordinate warning announcements to be based more on weather predictions.
“We'll be able to issue an alert for the following day,” Dr. Adcock said.
A regional approach to heat warnings makes sense, said Hamilton County Coroner Carl Parrott. Moving toward a system based more on weather predictions also seems more helpful, he said.
Last year, part of the reason Cincinnati attracted national media attention about heat-related deaths was because the coroner's office was aggressive about investigating suspected heat-related deaths and making the findings public.
“It doesn't do any good to sit back and count the bodies,” Dr. Parrott said. “When we saw the first two deaths, I called (Dr. Adcock) on a Saturday and said, "Hey, we've got a problem.'”
A disturbing aspect of the 1999 deaths was that they occurred despite extensive public warnings about the heat.
Days before anybody died, the city had declared a “heat emergency” on July 21, which remained in effect through Aug. 1. During that time, health officials, newspapers and TV stations blitzed the public with tips about how to stay cool.
Utilities complied with requests not to cut off services to nonpaying customers. Social service agencies distributed several thousand electric fans and hundreds of air conditioners to needy people.
City officials monitored heat-related ambulance runs and tracked indoor temperatures at several low-rent apartment buildings. They designated 29 recreation centers and senior centers as “cool centers” that offered extended hours plus free transportation.
While praising the health department's efforts to get the word out about the heat wave, the CDC report found the city's cool center concept to be nearly useless.
On average, 30 people per day used the cool centers. The city got a total of 14 requests for free transportation.
Instead, residents at risk seemed to fear leaving their homes. Those who did leave preferred visiting with relatives or friends with air conditioning rather than spending time at local recreation centers.
“The images on TV of many children playing in the cool center may have prevented some elderly people from using the facilities,” the CDC report stated. “In general, many elderly people believe they may be a burden; they want to remain independent and fear that expressing a need for help may hasten their being placed in a nursing home.”
To reduce heat-related deaths among shut-ins, the health department wants community groups to join a buddy system of agencies reaching out to people at high risk from the heat.
The city plans to print brochures about coping with the heat, distribute them to groups, then put those groups on a fax list to notify them directly that heat alerts and emergencies have been declared.
Agencies to be recruited include senior citizen groups, neighborhood block watch groups and African-American churches.
For example, some people may feel more comfortable leaving their hot apartments to spend time socializing in a cool church basement instead of a city-run cool center, Dr. Adcock said.
When the next heat wave hits, that kind of activity could help save lives.
For groups interested in participating in the summer heat program, call the Cincinnati Health Department at 357-7200.
For this year at least the city has decided against changing the terms it uses for heat emergencies. A proposal to switch from alerts and emergencies to watches and warnings was rejected because the National Weather Service uses the same words but does not use the same standards.
In Cincinnati, an emergency kicks in when the heat index (a measure of temperature and humidity) tops 95 degrees for four days; or just two days if the overnight low temperature also stays above 70 degrees.
The National Weather Service “warning” begins when the heat index tops 105 degrees for two straight days. An “advisory” gets issued when the heat index tops 105 for two days and the overnight low heat index tops 80 degrees.
Under the city standards, every death from last year's heat wave occurred on a day when the heat emergency was in place.
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