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City health director calls for national heat deaths database

This article first appeared in the St. Louis Beacon, July 24, 2012 - Facing a mounting death toll – now standing at 24 in the metro area as of Tuesday – from this summer’s heat wave, St. Louis' health director, Pam Walker, recently asked the Centers for Disease Control (CDC) to create a national heat death reporting system.

A national system would provide health officials with more data about heat-related deaths, Walker said. This would help them target and reach the people most vulnerable to extreme temperatures.

“You want to recognize the conditions in which people are dying, when they’re dying and who’s dying,” said Michael Graham, St. Louis' medical examiner.

“When you have small numbers of diseases and deaths, it’s hard to find trends,” Walker said.

Walker compared the difference between having limited regional data and having national data as “the difference between being down in the forest and being out on the balcony seeing what’s going on.”

For example, Walker looked at the deaths from this year's heat wave and noticed that many of the dead had mental health issues. 

"Knowing that that's an issue, we can change our interventions," Walker said. She plans to speak with mental health agencies and organizations to determine the best way to help mentally disabled people to get through the heat. 

Right now, there are multiple databases on the national level that Walker called “inconsistent and contradictory.” What’s worse, she said, is that they run on a time lag of anywhere from 45 days to a year and a half, making it hard to respond to the heat wave as it unfolds.

The current systems “don’t really help us make decisions,” Walker said.

Still, according to Graham and St. Louis County medical examiner Mary Case, health officials in the region have responded effectively to this summer’s heat.

Since 1980, when a heat wave less powerful than this year’s killed 153 people in the St. Louis area, “the housing hasn’t changed significantly,” Graham said, “but the number of heat deaths has dropped precipitously.”

Graham credits that reduction to changes in how the city handled periods of extreme heat. St. Louis maintains its own database similar to the one Walker is asking to have established nationally, and it now also maintains cooling centers and checks in on some residents.

For that reason, Graham thinks the database Walker is advocating would help cities unused to heat waves, like Seattle and Portland, more than it would help Midwestern cities like St. Louis.

Regardless, Walker is intent on pushing forward.

“I know we’re never going to get zero, but we normally have three cases,” she said. “In the hot summers like ’05, ’06, and last year [we had] about eight, and this year" we have had 24 so far.

Walker admits that a national database is unlikely for years because federal agencies are slow to act. In the meantime, she is focusing her attention on forming a smaller, regional database to include parts of eastern Missouri and southern Illinois.

“We’re going to move forward in the region no matter what,” Walker said.