ARI SHAPIRO, HOST:
Climate change is intensifying disasters like heat waves and hurricanes, and the U.S. does not accurately track the number of deaths that natural disasters cause. That's led to a massive undercount of climate-related deaths. But there are people trying to change that. Alejandra Borunda from NPR's climate desk is here to explain, Hey there.
ALEJANDRA BORUNDA, BYLINE: Hey - nice to be here.
SHAPIRO: Why would it be that the U.S. doesn't have a good count of disaster victims? I feel like every time there's a hurricane, we say this many people died. Explain this.
BORUNDA: Yeah, it's a really good point. It turns out it's actually really hard to count well. Right now official counts rely on the cause of death field in death certificates, and that's determined by a doctor or forensic pathologist or maybe a coroner. Let's take heat-related deaths, for example. They make up a big chunk of weather-related deaths. And heat is the obvious cause, in some cases, like a person who died while hiking in the Arizona Desert in July. But often it's a less straightforward process. Greg Hess is the medical examiner for Pima County in Southwest Arizona. He's based in Tucson.
GREG HESS: Let's say it's an elderly person in an enclosed environment like a home, and maybe it's hot in there. And they will often likely have other medical problems.
BORUNDA: So if that person dies of a heart attack, was the cause of death their longstanding heart issue, or was it heat, or was it both? In most places, it would probably just be marked down as a heart attack.
SHAPIRO: And if that happens again and again, that obviously means we'd miss a lot of heat-related deaths - so any sense of how big the undercount is?
BORUNDA: Yeah. The numbers are really sobering. The Centers for Disease Control and Prevention says that about 1,200 people die each year in the U.S. from heat. But statistical estimates from epidemiologists put that number at potentially more than 10,000. That's a huge difference. Kristie Ebi is a climate and health scientist at the University of Washington.
KRISTIE EBI: If you don't know how many people suffer and die in disasters, then you can't set priorities appropriately because you don't understand the scale of the problem.
BORUNDA: And that's just heat. Hurricanes and wildfires are a whole other ball game. But honestly, overall, it's safe to say that there is a massive undercount.
SHAPIRO: So what's the solution? Is there a way to get a fuller picture here?
BORUNDA: Yeah. It's going to be pretty hard. Hess explains the main problem.
HESS: The death investigation in the United States is just so fragmented.
BORUNDA: There are about 2,000 different jurisdictions certifying deaths in the U.S., and there's honestly no national system for making calls about whether heat or a storm played a role. So a forensic pathologist in New York might have a totally different system for accounting than someone in Texas or even from someone in their own office sometimes. But there are some people, like Hess in Pima County or Jeff Johnston in Maricopa County, which is the Phoenix area, who are trying to standardize within their own jurisdictions at least.
SHAPIRO: What are they doing?
BORUNDA: Yeah. You know, they realized that they needed evidence that heat influenced someone's death. So they went out and looked for those clues. Their death investigators carry thermometers in their bags now. They find out if someone's AC was out. It's really simple stuff, but it works to get a better picture here. Last year, for example, there ended up being 645 heat-related deaths in Maricopa. That's several times the number that they used to report a couple years ago, and it's a really shocking number, but it's also much more realistic.
SHAPIRO: So is the idea that if you get better numbers, you can do a better job of protecting people from dying of heat and other natural disasters?
BORUNDA: Definitely that's what everyone hopes could happen. For example, Maricopa County's Health Department looked at data from their medical examiner, and they figured out that people were dying because they couldn't afford to run their ACs in the summer. So the county instituted rules saying utilities couldn't shut off power during heat season. And it's also making a case for getting more federal dollars because it can really start to show the human costs of heat. And I also just think this really matters to people, you know? Knowing what killed someone you love is really important emotionally.
SHAPIRO: NPR's Alejandra Borunda. Thank you.
BORUNDA: Thanks so much.
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