This week’s heat could be deadly for some North Carolinians

This week's heat could be deadly for some North Carolinians

This week is shaping up to be a scorcher as a record–breaking “heat dome” settles over the East Coast and midwestern United States. 

The National Weather Service office in Raleigh has issued a hazardous weather outlook starting Tuesday and extending through the weekend, warning “High temperatures will be in the low to mid 90s Friday and around 95 to near 100 degrees Saturday and Sunday. Heat index values will peak in the upper 90s to around 105 degrees Saturday and Sunday.”

“Heat kills more people than any other weather-related event,” explained Ashley Ward, director of the Heat Policy Innovation Hub at the Duke Nicholas Institute for Environmental Policy Solutions. Part of the reason heat is so deadly, she said, is because you can’t see it. “When I look out my window today, and it’s going to be 100 degrees outside, it looks exactly the same as when I look out my window and it’s 85 degrees outside.”

Heat’s invisibility means people often have a different risk assessment about it than they do other visible extreme weather events, such as hurricanes or tornadoes, explained Chip Konrad, a climatologist and geography professor at UNC Chapel Hill. People know these are deadly and take their threats seriously. 

“But heat?” he said, “When we get heat waves they typically impact multiple states — sometimes the entire eastern U.S. — and any given heat wave is going to impact a lot more people than other weather hazards.” 

That wide expanse increases heat’s deadly potential. 

“It’s kind of like you’re boiling the frog in the water,” Ward said.

Threat of overheating

Many think the main danger heat waves pose to human health is the risk of dehydration. That’s partially correct, but researchers say that a deadlier risk — an underestimated one — is the way extreme heat prevents the body from being able to cool off.  

“One of the symptoms most people cite is a lack of ability to sweat,” Ward said. “What happens is the body’s unable to cool itself through evaporative cooling, which is when sweat on your skin is evaporated into the atmosphere, and then that cools your body temperature down.”

People ultimately die of heat exposure when the body can no longer do this to regulate its temperature. It leads people’s organs — including their hearts — to fail. And while many public information campaigns teach people the ways they can protect themselves from overheating during afternoon highs, researchers say that actually what might be the most dangerous part of the day is overnight. 

This coming weekend, overnight lows are predicted to be as high as 75 degrees across the state and even Asheville, which usually has lower overnight lows, is predicted to be as hot as 68 degrees overnight on Friday and Saturday. 

“The time in which we are most vulnerable to heat illness is when temperatures overnight do not drop below, say, 75 degrees,” Ward said. “Our bodies need time to recover from heat exposure during the day. And when temperatures outside don’t drop below 75, and we return to our homes in which we can’t afford to run air conditioning, or they’re not energy efficient, our body is never able to fully recover. And then the next day we return to that same job, and are exposed again.”

The same is true for days that aren’t exactly part of a heat wave but are still hot. 

“When there’s a heat wave or heat advisory or heat warning, workers are really good at reducing their exposure,” said Maggie Sugg, a geography professor at Appalachian State University in Boone. “But they experience the most heat strain and dangerous heat outside of it — in climatologically normal conditions, kind of what we saw at the end of [last] summer.

“We’re really good at behavioral modifications and adaptation when it’s really hot, but just normal North Carolina weather is really warm, right?” she said. “So that seems to be the most dangerous, when people are not quite on guard.”

High temperature? Here are some resources:

The North Carolina Department of Housing and Human Service (NCDHHS) recommends doing the following to avoid heat-related illness:

  • Increase Fluid intake
  • Take frequent breaks in cool and shady or air-conditioned places if spending extended time outside.
  • Reduce normal activity levels.  
  • Speak with your physician about how to stay safe if you take medicines that make you more vulnerable to heat, such as tranquilizers or drugs for high blood pressure, migraines, allergies, muscle spasms and mental illness.  
  • Check on neighbors, and if working outdoors, check on your co-workers.  
  • Never leave children or pets unattended in vehicles, especially during warm or hot weather, as temperature levels inside a car can reach a deadly level in a matter of minutes

If you or someone you know experiences heat-related illness, move to a cool place, drink water, place cold clothes on the body and seek medical attention. Additionally, there may be cooling assistance available for those who are eligible: 

  • The Crisis Intervention Program is a federally funded program that assists individuals and families who are experiencing a heating or cooling related crisis. Check eligibility and apply by contacting your local Department of Social Services.
    • Applications run July 1 through June 30 each year and funds are available until they run out. So, if there’s no funding remaining for this fiscal year, if you apply in early July, you’re more likely to be approved.
    • Eligible families are those earning less than 150 percent of the federal poverty level
  • Operation Fan Heat Relief is a summer program intended to provide a more comfortable living environment and reduce heat related illnesses for older adults and adults with disabilities by providing fans and sometimes air conditioners to affected people. The program runs annually from May through October.

For more information on how to prevent heat-related health issues, additional data or to sign up to receive the weekly North Carolina Heat Report via email, go to

Exacerbates existing health disparities

All extreme weather events can be thought of as “threat multipliers.” 

Researchers across the country have found that heatwaves are more dangerous for people with chronic illnesses, and for elderly people who are socially isolated  — meaning they live alone and don’t have friends or family regularly checking on them. Others have documented increases in suicides and pre-term births during high temperatures.

Sugg’s doctoral dissertation examined who in North Carolina was most at risk of ending up in the emergency department for a heat-related illness. She found that people who lived in the southern coastal plains region were the most likely to be admitted to the ER for heat-related illnesses when the temperature spiked — a finding that ran counter to earlier research. 

The coastal plains region is rural. Usually, because urban areas are full of concrete and other surfaces which absorb and hold heat, the residents of these regions bear a disproportionate burden of heat illness. 

In North Carolina though, the coastal plains regularly see some of the hottest temperatures in the state, many residents work outside in agriculture (compared to urban areas where many work indoors with air conditioning), and it has a high concentration of poor counties — meaning that even if residents have air conditioning, many cannot afford to use it. 

In urban areas, community spaces such as libraries or schools can be used as centralized cooling spaces. But in rural areas, people often live farther away from each other and from town centers, making it more difficult for people to actually get to the cooling center, and to communicate to residents that this is an option. 

“Heat is like a silent killer,” Sugg said. “It really amplifies existing disparities.”

The role of climate change

While climate change will increase the frequency, duration and strength of heat waves, it will also lead to more hurricanes. This could be yet another ‘threat multiplier’ because often heat waves can follow hurricanes, especially later in the season. This happened in Louisiana after Hurricane Ida hit in 2021. 

“The two can combine in ways that make it a lot worse,” said Konrad, from UNC. After Hurricane Ida, “there were so many people suffering from heat illness because they didn’t have any air conditioning. The temperature was well in the 90s. The humidity was ridiculous.”

Though we’ve seen more heat waves and intense hurricanes in recent years, data from the Centers for Disease Control and Prevention shows that people may be realizing the extent of the threat and taking steps to lessen the impacts.

“Some heat-related illness and deaths have actually decreased in recent decades, or not increased as much as we thought they would,” said Virginia Guidry, who leads the Occupational and Environmental Epidemiology office at the state health department. The decrease could be due to better predictions, educational campaigns or more accessible programs that offer cooling centers or energy payment assistance. 

“It’s not as straightforward as we would have thought that when it gets hotter, you start seeing more people in the emergency room,” she said. “Even though that relationship is there, it’s also sometimes attenuated by these actions.”

While heat waves and climate change are systemic issues that require big solutions, there are things individuals can and should do to protect themselves from overheating: stay out of the sun if you can, wipe down your whole body with a cold towel, take a cool shower, sit in front of a fan, and drink plenty of fluids that won’t dehydrate you — that may even mean avoiding a cold beer on a 100-degree day.

Hot Weather Tips for Seniors

Talk with your doctor and be aware of the medications you or a senior loved one takes and know for example that painkillers can reduce awareness of the heat. Diuretics, which promote fluid loss, can lead to dehydration more often during hot weather. 

In addition to using electric fans, the following tips should be observed to reduce heat-related problems:

  • Cool off by taking baths or showers, or placing ice bags or wet towels on the body
  • Stay out of direct sunlight, put shades over the windows, and use cross-ventilation and fans to cool rooms
  • Wear lightweight, light-colored, loose-fitting clothing that permits sweat to evaporate
  • Drink plenty of liquids such as water, fruit, or vegetable juices and iced tea to replace the fluids lost by sweating. As a person ages, thirst declines. Limit intake of alcoholic beverages or fluids that have too much salt, since it can complicate existing medical problems, such as high blood pressure. Caffeinated drinks also cause you to lose water, so those should be avoided in extreme heat too.
  • Eat small meals, and eat more often and avoid foods that are high in protein, which increases metabolic (body) heat
  • Keep your medicines in a cool, dry place
  • Check up on friends or neighbors who live alone
  • This can also be a good time to join your local senior center or take advantage of buildings made accessible to seniors during excessive heat. Your community’s public information office can be contacted for additional information

Take the heat seriously and do not ignore danger signs like nausea, dizziness or lightheadedness, fatigue, confusion, labored breathing, chest discomfort and rapid or erratic pulse. They can all be signs of trouble. Get to a cool place, drink cool water slowly and seek medical help if conditions don’t improve.

Information courtesy: NC DHHS

This story is a republication of a story from 2022, updated to reflect new information for 2024.

Republish our articles for free, online or in print, under a Creative Commons license.

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