Richard Verduzco cools off at home during hot temperatures in Phoenix in 2023. APHA's Affiliates have implemented strategies to combat health harms from rising state temperatures.
Photo by Brandon Bell, courtesy Getty Images
Many of APHA's state and regional affiliated public health associations are concerned about the impact extreme heat will have on their populations. But they have doubts about their state government's ability to protect residents, a recent APHA survey finds.
Extreme heat is a major threat to the health and well-being of communities globally, causing millions of illnesses and thousands of deaths each year.
Although public health advocates have long warned of the risks, policy action has lagged. Addressing the threat will require coordination across sectors, according to Juanita Constible, MSc, senior advocate for environmental public health at the Natural Resources Defense Council.
“Extreme heat is now a pressing and deadly public health hazard that cuts across every sector of society,” she told The Nation's Health. “Practitioners are sounding the alarm, but real solutions will require an all-hands-on-deck approach.”
Last summer, APHA and NRDC surveyed Affiliates to assess state and local readiness for extreme heat. Survey results from 35 Affiliates, released in February, found nearly 90% were concerned about their state government's ability to protect people during an extreme heat event in the next four years.
Will Humble, MPH, executive director of the Arizona Public Health Association, said he is increasingly frustrated with the status of heat preparedness in his state.
In Arizona, extreme heat has driven record-high deaths in recent years. In 2023 alone, nearly 1,000 people died from heat-related causes, according to state data. People experiencing homelessness, mental illness and substance use disorders face an elevated risk and are far more likely to die from heat exposure than the general population.
Humble said housing needs to be treated as essential infrastructure.
“What's the better approach to saving lives in the summer — handing out water bottles under bridges or getting permanent supported housing for persons with a serious mental illness?” Humble told The Nation's Health.
But Arizona policymakers have been unwilling to act on supportive housing, he said.
Arizona is not alone in facing risks. Affiliates said extreme heat has affected homelessness services in their areas, with nearly half reporting a substantial impact. The associations also identified older adults, people of color, low-income residents, people with chronic conditions and unhoused populations as among the most affected by extreme heat.
Meanwhile, two key barriers continue to limit efforts to initiate or expand heat-related policy advocacy: competing public health priorities and political opposition. More than half of Affiliates cited the urgency of other issues as their primary obstacle. Up to 40% also pointed to resistance from influential constituencies to heat-related solutions.
Despite these challenges, the associations are working to advance heat preparedness and resilience through cross-sector partnerships and advocacy.
Survey respondents identified community-based organizations as their most important partners, followed by city services, state and local health departments, and environmental and climate justice groups. Health care systems, schools and faith-based organizations were also cited.
Several Affiliates are already using those partnerships to advance local action. Public health associations in North Carolina, Oregon, South Carolina, Florida, Georgia and Louisiana have worked with APHA through its partnership with the Smart Surfaces Coalition to promote cooling strategies in their communities.
Other Affiliates, including the New York State Public Health Association, have formed climate committees to guide state-level work. A NYSPHA committee has developed a youth climate resource guide, convened youth climate focus groups and supported advocacy for statewide K-12 climate change education.
APHA has also supported Affiliates and advocates through training and resources. In partnership with Climate for Health, a free online training program is available to help strengthen extreme heat preparedness and response efforts.
For more on the Affiliate Heat Survey 2025 and information on extreme heat, visit www.apha.org/extreme-heat.
- Copyright The Nation’s Health, American Public Health Association
