The central argument of the paper is provocative precisely because it challenges a widespread assumption: that access to air conditioning guarantees protection from dangerous heat. According to the authors, air conditioning only protects people if they can afford to run it, maintain it, and use it safely. Rising utility costs, the expense of repairing or replacing aging cooling systems, mobility limitations that make installing window units difficult, and an aging housing stock that was never designed to withstand prolonged extreme heat all combine to leave many older Americans exposed even when they technically have cooling equipment in their homes. Cognitive decline adds another layer of risk, because some individuals may fail to recognize when indoor temperatures have reached dangerous levels or may be unable to take appropriate action on their own behalf.

The physiological reasons behind this vulnerability are well established. Aging reduces the body’s ability to regulate temperature, making older adults less efficient at dissipating heat through sweating and cardiovascular adjustments. Common chronic conditions, including diabetes and neurodegenerative diseases, further heighten heat-related risks, as do many medications frequently prescribed to older adults, which can interfere with thermoregulation or hydration. The health consequences of extreme heat exposure are not limited to heat stroke. The analysis links exposure to cardiovascular and respiratory problems, sleep disruption, cognitive impairment, reduced attention, and mental health concerns, painting a picture of heat as a systemic threat to the health of aging populations rather than a short-lived inconvenience.

Heat is, as co-author Amir Baniassadi, PhD, Assistant Scientist II at the Marcus Institute, notes, one of the deadliest weather-related hazards in the United States, and older adults are among those at greatest risk. But the analysis emphasizes that the nature of that risk varies dramatically from region to region, which means a one-size-fits-all national policy is unlikely to succeed. In the Desert Southwest, where air conditioning is often essential for survival, questions of affordability and performance standards have become critical public health concerns. Some Arizona cities have responded with rental housing laws that require air-conditioning systems to be operational, repaired promptly, and capable of cooling a residence to as much as 20 degrees Fahrenheit below outdoor temperatures. These are among the strongest such protections in the country, yet the analysis shows they may still fall short in a rapidly warming climate.

The numbers from Phoenix illustrate the problem starkly. In 2024, the city experienced 70 days on which temperatures reached 110 degrees Fahrenheit or higher. Under the local rules, a legally compliant cooling system could still leave indoor temperatures above 90 degrees Fahrenheit on such days. Lead author Peter Crank, PhD, Assistant Professor in the Department of Geography and Environmental Management at the University of Waterloo, states that indoor temperatures above 90 degrees are not safe for many older adults, and that clear, objective standards for cooling performance are critical to protecting health and ensuring safe living conditions. In other words, even the regulatory gold standard in the hottest part of the country leaves a gap between legal compliance and genuine physiological safety, a gap that widens with every additional extreme heat day.

The analysis also scrutinizes cooling centers, which are frequently promoted by municipalities as a frontline public response to extreme heat. While these facilities can provide meaningful relief, the authors document a series of barriers that limit their usefulness for the very population they are meant to serve. Transportation challenges can make reaching a cooling center difficult or impossible for people with mobility limitations. Limited operating hours, particularly the lack of overnight and weekend availability, mean that the most dangerous hours of a heatwave often occur when centers are closed. Safety concerns and simple lack of awareness of available services further reduce utilization. A resource that exists on paper but cannot be reached, or is closed during the hottest hours, offers little protection to a frail older adult in an overheated apartment.

The challenges look strikingly different in historically colder climates, and the analysis devotes particular attention to the Northeast. In cities such as Boston, many older adults live in older buildings designed to retain heat during harsh winters, a feature that becomes a liability during prolonged hot weather. Much of this housing stock lacks central air conditioning and can trap heat indoors, exposing residents to dangerous temperatures even during periods when outdoor conditions might seem manageable. Yet the regulatory and social safety net in the region has not adapted. Regulations governing indoor cooling, renter protections, and utility assistance have not kept pace with increasingly frequent heatwaves, leaving a mismatch between the climate older Americans actually face and the policies built for the climate of the past.

The financial asymmetry the authors identify is particularly striking. Substantial public resources exist to help households cover heating costs during the winter months, reflecting decades of policy attention to cold-related mortality. Comparable protections for cooling remain limited across much of the Northeast. Maximum indoor temperature standards are largely absent from housing codes, and most energy-assistance programs continue to focus primarily on winter heating needs despite rising summertime heat risks. For an older adult on a fixed income, this means the choice between an unbearable utility bill and an unsafe indoor environment is one that policy has largely left unaddressed, even as summer temperatures in northern cities increasingly rival those of southern ones.

In response, the authors call for policies that recognize regional differences in climate, housing, and infrastructure while directly confronting affordability and accessibility challenges. Their recommended approaches include stronger renter protections, the adoption of indoor temperature standards, expanded utility assistance programs that cover cooling as well as heating, support for the maintenance and replacement of cooling systems, and improvements to the availability and accessibility of cooling centers, including extended hours. As Crank observes, the barriers facing an older adult in Phoenix are not necessarily the same as those facing someone in Boston, and effective heat policy must account for differences in climate, housing, infrastructure, and resources while ensuring that all older adults have access to safe indoor temperatures.

The broader significance of this analysis lies in its reframing of extreme heat as a policy failure rather than merely a meteorological hazard. The tools needed to protect older adults largely already exist: cooling technology, utility assistance frameworks, housing regulation, and public health infrastructure. What is missing, the authors argue, is the political and regulatory adaptation to a climate in which heat has become a chronic, deadly, and regionally diverse threat. As heatwaves intensify in both the Desert Southwest and the historically temperate Northeast, the gap between what buildings, budgets, and laws were designed for and what older Americans now experience will continue to widen. Closing that gap, the analysis suggests, is not simply a matter of installing more air conditioners, but of rethinking how housing, energy, and health policy intersect for a population whose lives increasingly depend on it.

Subject of Research: Health and policy risks of extreme heat exposure among older adults in the United States

Article Title: New analysis underscores the rising threat of extreme heat on older adults

Article References: New analysis underscores the rising threat of extreme heat on older adults. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: extreme heat, older adults, aging, air conditioning, public health, heat policy, cooling centers, housing, utility assistance, Phoenix, Boston, climate change

The survey, the 30th wave of a nationally representative panel study, was conducted Aug. 4-17, 2026, among 1,904 empaneled U.S. adults by SSRS, an independent research company, using both web and telephone interviews. The margin of sampling error for the full sample is plus or minus 3.2 percentage points at the 95 percent confidence level, and the data were weighted to reflect the U.S. adult population. Sixty-five percent of respondents said climate change is increasing the risk of heat-related illnesses, respiratory diseases, and insect-borne diseases. That figure is unchanged from August 2025, when it also stood at 65 percent, and from July 2024, when it reached 67 percent, but it is significantly higher than the 58 percent recorded in November 2023. The trajectory suggests a durable shift in public perception rather than a temporary spike tied to any single weather event.

Americans also broadly recognize that heat waves themselves are intensifying. Sixty-two percent say U.S. heat waves are becoming more frequent and more intense than in the past, statistically unchanged from 61 percent in August 2025, 65 percent in July 2024, and 58 percent in November 2023. The survey measured four categories of extreme weather and their effects on daily routines. Extreme outdoor heat topped the list, with 76 percent of respondents reporting that it affected their daily activities at least sometimes over the past year. Poor air quality resulting from wildfire smoke came next at 38 percent, while flooding (20 percent) and tornadoes or hurricanes (11 percent) were cited far less often, consistent with their lower frequency. Notably, the more frequently respondents reported that extreme heat, poor air quality, or flooding had disrupted their daily activities, the more likely they were to believe that climate change is raising the risk of heat-related, respiratory, and insect-borne illnesses.

The financial toll of extreme weather is also registering in household budgets. Nearly half of Americans, 46 percent, say that during the past year they faced unexpected utility expenses caused by storms, flooding, heat, or wildfires, statistically unchanged from 45 percent in August 2025. Thirteen percent reported unexpected homeowner’s insurance premium expenses from these causes, a significant decline from 18 percent a year earlier, while 8 percent reported unexpected health care expenses, unchanged from August 2025. Ken Winneg, APPC’s managing director of survey research, said the pattern reflects a broader transformation in how extreme heat fits into everyday life. “Extreme heat is no longer just an occasional inconvenience,” Winneg said. “It is affecting Americans’ household budgets and daily routines, from electricity bills to simply going outside.”

When asked specifically about the impact of extreme heat on their activities and lifestyle over the past year, majorities reported at least a minor effect across several domains. Eighty-two percent said extreme heat had a major or minor impact on their electricity bills, 75 percent on outdoor activities, 56 percent on exercise routines, and 56 percent on sleep. Several of these measures have climbed since August 2025: the share reporting a major or minor impact on exercise and sleep rose to 56 percent from 50 percent, and the proportion reporting effects on pets increased to 45 percent from 37 percent, all statistically significant increases. The data paint a picture of heat as a persistent, ambient stressor that shapes decisions about when to exercise, how well people sleep, and even how families care for their animals, rather than a rare emergency confined to the hottest afternoons of the season.

Despite this widespread exposure, public awareness of protective resources remains strikingly low. Sixty-five percent of Americans say they do not know the location of a cooling center they could go to in the event of extreme heat, while just 35 percent say they know where one is located. That knowledge level has shown little recent movement: 35 percent knew a cooling center location in August 2025 and 33 percent in July 2024, although the current figure is significantly higher than the 30 percent recorded in November 2023. Laura A. Gibson, an APPC research analyst, argued that the gap represents a communication failure that communities can address. “As we continue to experience extreme heat,” Gibson said, “communities need to do more to make the public, particularly vulnerable populations, aware of these cooling facilities.”

Unhealthy air quality, which is closely related to extreme heat through wildfire activity, has also become a more visible problem. During the summer of 2026, much of the nation experienced smoky and hazy conditions from wildfires. Six in 10 Americans, 60 percent, say the area where they live experienced days in the past three months when local health authorities reported that the air quality was unhealthy, up significantly from 48 percent in August 2025. Another 24 percent said their area did not experience such days, and 16 percent were unsure. The American Lung Association’s “State of the Air” 2026 report found that 44 percent of Americans live in areas earning failing grades for unhealthy levels of ozone or particle pollution, providing an independent corroboration of the public’s reported experience.

People who reported unhealthy air in their area took a variety of protective measures, several of which have become more common over time. Eighty-two percent said they responded to local authorities’ air-quality warnings by staying indoors more than they typically would, up from 76 percent in August 2025 and 74 percent in August 2023. Fifty-one percent closed their windows, compared with 45 percent in August 2025 and 48 percent in August 2023. Forty-eight percent turned on the air conditioning, statistically unchanged from 47 percent in August 2025 but significantly higher than 37 percent in August 2023. Twenty-two percent used a room-air purifier, compared with 19 percent in August 2025 and 17 percent in August 2023, and 12 percent wore a KN95 or N95 mask outdoors, up significantly from 7 percent in August 2025 and statistically similar to 9 percent in August 2023.

Looking ahead, a majority of Americans expect the dangers of extreme heat to intensify. Nearly six in 10, 59 percent, say people in their community will be more likely to experience heat stroke caused by extreme heat waves in the next 10 years. Twenty-nine percent said people will be about as likely to experience it, 4 percent said less likely, and 8 percent were unsure. That expectation is essentially unchanged from August 2025, when 59 percent anticipated greater risk, and July 2024, when 58 percent did, but it remains significantly higher than the 52 percent recorded in November 2023. The consistency of this outlook across three annual survey waves indicates that anticipation of worsening heat risk has become a settled feature of public opinion rather than a reaction to any single summer.

Knowledge of the specific symptoms of heat-related illness, however, remains uneven, and the survey identified notable gaps in health literacy. In August 2026, 88 percent of Americans correctly identified dizziness as a sign of heat-related illness, 83 percent identified nausea, and 72 percent identified hot, red, dry, or damp skin. But only 47 percent identified cold, pale, and clammy skin as a symptom, even though that presentation is a recognized warning sign. Just 5 percent incorrectly identified hunger as a symptom. “Most Americans recognize that climate change is increasing the risk of heat-related and other illnesses, but our findings show that recognizing the risk doesn’t always translate into knowing the signs of heat-related illness,” Winneg said. “That knowledge can be especially important as extreme heat becomes an increasingly common part of Americans’ lives.”

Two further knowledge gaps stand out in the data. Only 32 percent of Americans know that pregnant people exposed to extreme heat are more likely to deliver their babies early than pregnant people who are not exposed. Nearly half, 49 percent, said they were not sure, 17 percent incorrectly said exposed pregnant people are just as likely to deliver early, and 3 percent said they are less likely to do so. That level of knowledge has not changed significantly from August 2025, when 33 percent knew the fact, or July 2024, when 30 percent did, although it is significantly higher than the 24 percent recorded in November 2023. Meanwhile, most Americans do correctly identify who is most vulnerable to fatal heat: 69 percent said heat-related deaths are most common among adults ages 65 and older, while 8 percent said children, 2 percent said adults ages 21 to 40, and 4 percent said adults ages 41 to 64, with 16 percent unsure. That figure is unchanged from August 2025 but significantly higher than the 62 percent recorded in August 2022.

Taken together, the survey results suggest a public that has absorbed the reality of a hotter, smokier, more disruptive climate into its everyday routines and expectations, even as critical gaps persist in knowledge about protective resources and medical warning signs. The APPC’s Annenberg Science and Public Health survey panel has been tracking American public knowledge, beliefs, and behaviors regarding vaccination, Covid-19, flu, RSV, climate, and other consequential health issues, providing one of the longest-running longitudinal windows into how health perceptions evolve alongside environmental change. In addition to Gibson and Winneg, the ASAPH survey team includes Patrick E. Jamieson, director of the Annenberg Health and Risk Communication Institute, which oversees the survey; research analyst Shawn Patterson Jr.; and Kathleen Hall Jamieson, APPC’s director emerita. As records continue to fall and heat becomes a structural feature of American life, the survey’s authors suggest, closing the gap between risk awareness and practical preparedness will be one of the most consequential public health communication challenges of the coming decade.

Subject of Research: Public perceptions of climate change's health effects during the hottest U.S. summer on record

Article Title: In hottest summer on record, 2 in 3 Americans say climate change is increasing heat-related illnesses

Article References: In hottest summer on record, 2 in 3 Americans say climate change is increasing heat-related illnesses. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: extreme heat, climate change, heat-related illness, Annenberg Public Policy Center, ASAPH survey, air quality, wildfire smoke, cooling centers, heat stroke, public health, NOAA, household costs