A report released by Multnomah County on the one-year anniversary of last June's record-shattering heat wave shows the event likely contributed to a spike in all deaths.
Deaths in Multnomah County were double what would be typical during the last week of June 2021, according to mortality data collected by the county.
The findings were detailed in a final report on deaths and other health impacts from extreme heat events last year, which county officials released Sunday, June 26.
Last June, the Pacific Northwest experienced record-high temperatures caused by a "heat dome" that trapped hot air over the region for two weeks. Portland broke its previous record-high temperature on three consecutive days, with the hottest day coming on June 28, 2021, when temperatures reached 116 degrees.
Seventy-two people in Multnomah County died of excessive heat, or "hyperthermia," in 2021, with 69 heat deaths during the heat dome event, the report states. The other three deaths are attributed to a later heat wave last August.
But overall mortality data in the report suggests the heat dome contributed to excess deaths caused by issues other than excessive heat, something local public officials previously assumed. An analysis of mortality data from the U.S. Centers for Disease Control and Prevention by The New York Times last year asserted that conclusion as well.
The release of the report was timely as temperatures at Portland International Airport reached 99 degrees on Sunday, June 26, during the first heat wave of the summer of 2022.
It was the first day of the first annual Heat Week — a series of events hosted by local public officials and organizations aimed at drawing attention to climate change and building resiliency for an increasing frequency of extreme heat events.
Events began Sunday with a memorial at the Leach Botanical Garden in Southeast Portland for those who died during last year's extreme heat.
As the hottest hours of the day approached, public officials, researchers and climate advocates remembered 2021's deadly heat events and called for further action to mitigate climate change and prevent future heat deaths. Names of the victims of last year's heat events were displayed nearby with candles lit for each of them.
"In a typical Portland summer, as you all know, heat deaths, until last year, were literally unheard of; they were literally zero," said Dr. Jennifer Vines, Multnomah County health officer.
Vines said she gasped when she received reports during the heat dome from county medical examiners showing that heat deaths were in the double digits. "To the family and friends of those who died, I offer my deepest condolences."
There were 257 emergency department and urgent care visits for heat illness in 2021, according to the report — three times higher than the previous five-year average.
Brendon Haggerty, an author of the county's new report, said heat deaths don't account for all of the excess deaths that occurred during the heat dome.
There were 92 more deaths the week the hottest temperatures of the heat dome hit than the average for that week from 2017 to 2019, according to Oregon Health Authority vital records used to produce the report.
Additionally, all-cause mortality in June 2021 was 37% higher than the average for that month from 2019 and 2020, the report says.
The impact extreme heat can have on mortality broadly is well-supported in research, Haggerty said in an interview.
Heat can exacerbate underlying health problems such as diabetes as well as cardiovascular and respiratory conditions, potentially contributing to death, he said, noting that COVID-19 infections may have been a compounding factor. People also seek out rivers to escape extreme heat, which can lead to drownings, particularly early in the summer when rivers are still running cold. Additionally, extreme heat can aggravate people and contribute to domestic violence, Haggerty said.
Speaking at the memorial, Haggerty pointed out that certain demographic groups and people with certain living conditions were disproportionately represented in last year's hyperthermia deaths.
Seventy-eight percent of those who died were 60 or older, 66% lived alone, 58% lived in multifamily dwellings and 33% lived above the second floor of a building, the data show.
Four people who were homeless died. Six people died in apartment buildings owned and managed by the affordable housing provider Home Forward, the report states, adding that one person died in an apartment owned and managed by Central City Concern.
A lack of air conditioning was a key factor in the deaths, Haggerty said. Only 10 people had any mention of air conditioning in death investigators' notes, with seven indicating that air conditioning units were unplugged or not properly working.
Furthermore, 58% of the deaths occurred in census tracts identified by the county as urban heat islands — areas of cities that become substantially hotter than other areas due to a lack of tree canopy and heat-trapping infrastructure.
Vivek Shandas is a Heat Week organizer and Portland State University professor who studies urban heat. He said cities situated about 45 degrees above the Earth's equator like Portland are among the most unprepared for climate change.
"We saw that really bear down on us last year," Shandas said. "So the whole question is: 'What are each of us doing to be able to move this adaptation agenda?'"
Multnomah County Commissioner Lori Stegmann pointed to her work to create "resilience hubs" in areas most vulnerable to extreme weather, including in East Multnomah County, which Stegmann represents. Hub sites would provide a safe emergency location for people to receive resources, Stegmann said, adding that they also would have an online presence.
"The fact is we weren't ready," Stegmann said. "My hope is that eventually there will be hundreds of resilience hub locations throughout our community."
Funding to plan for such hubs was included in Multnomah County's recently adopted budget.
The budget for the 2023 fiscal year also included funding for a climate resilience coordinator and a pilot program in East County to provide portable air conditioners to 1,000 households that lack access to them. Portland launched a similar program this year that was expected to provide 15,000 air conditioning units.
"Last summer taught us all an important lesson," Portland Mayor Ted Wheeler said. "It taught us the importance of communication and it taught us the importance of outreach."
Wheeler noted the city's efforts to expand cooling centers, strengthen partnerships with community groups that conduct outreach ahead of extreme heat and bolster its Neighborhood Emergency Teams, which contact heat-vulnerable residents in specific multifamily buildings.
This year, cooling centers did not open in the area, even as a heat advisory was in effect from Saturday, June 25, through Monday, June 27. City and county leaders said thresholds to open them weren't met with overnight temperatures in the 60s.
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