An investigation by NPR and Boston University reveals a substantial gap between reported and actual heat-related deaths in the United States. Federal records indicate approximately 1,700 deaths annually from heat causes between 2018 and 2025, but the investigation suggests the true figure is closer to 9,000 deaths per year—roughly five times higher than official counts. Researchers note that even this estimate may not capture the full scope of heat’s deadly impact across the country.
The undercounting stems from several factors related to how deaths are documented and certified. Heat rarely serves as the sole cause of death; instead, it typically exacerbates existing health conditions, causing people to die faster than they otherwise would. Because heat exposure leaves no visible physical evidence, medical examiners and coroners often fail to note it on death certificates. When multiple contributing factors exist, physicians may simply record the cause as unknown rather than investigate potential heat exposure. In cases where a clear medical event occurs, such as a heart attack, doctors may document only that immediate cause without exploring what triggered it.
The case of Adam Willson from Tucson, Arizona, exemplifies this documentation problem. Adam, who had DiGeorge syndrome and was highly sensitive to heat, died in June 2024 after his family’s air conditioning system failed during an extended period of extreme temperatures. Medical personnel responding to his death believed heat played a role, yet his death certificate lists only unknown natural causes. Tucson itself faces escalating heat challenges due to climate change, with the number of days exceeding 110 degrees increasing from less than one annually in the 1950s-1970s to an average of nine days per year in the current decade.
Medical professionals acknowledge the difficulty of establishing heat’s role in deaths after the fact. Physicians note that without explicit questioning about heat exposure during treatment, heat-related illness often goes undiagnosed unless extremely high body temperatures are recorded. This systemic gap in medical documentation means thousands of heat deaths likely remain uncounted in national health statistics, obscuring the true public health impact of rising temperatures.
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