Greg Hess, the medical examiner for Pima County in southern Arizona, is leading efforts to more accurately track and categorize deaths caused by extreme heat. His office processes approximately 3,000 deaths annually, with a significant portion occurring during the April-through-October period when temperatures regularly reach dangerous levels. Although Pima County is not the hottest or largest county in the nation, Hess and his team have developed some of the most advanced strategies in the country for identifying and documenting heat-related mortality.
Experts in public health and climate science have identified a critical gap in how the United States measures the human cost of climate-related disasters. According to researchers including epidemiologist Kristie Ebi at the University of Washington, thousands of Americans die each year from climate-fueled events such as intense heat waves and severe hurricanes, yet no official government agencies or state officials maintain comprehensive records of these deaths. This undercounting has significant consequences beyond affecting grieving families—it directly impairs the ability of policymakers and city planners to understand the full scope of climate impacts and to develop effective prevention strategies, such as determining where and when to establish cooling centers during heat emergencies.
Hess came to his position at Pima County in 2011, initially confronting a humanitarian crisis along the U.S.-Mexico border where migrants attempting to cross the desert died from heat and exposure at alarming rates—sometimes dozens per summer. These challenging circumstances compelled his team to create detailed investigative protocols for thoroughly examining each death, identifying victims, and locating family members. The experience reinforced Hess’s conviction that comprehensive, well-documented data holds substantial value for understanding mortality patterns and informing public health decisions.
A growing coalition of medical examiners, coroners, epidemiologists and public health professionals across the country is working to improve how climate-related deaths are counted and tracked. Their shared objective is to provide policymakers, city leaders and advocates with accurate data necessary to implement life-saving measures and better prepare communities for climate-related threats. As climate change continues to intensify extreme weather events, more accurate mortality tracking has become increasingly urgent.
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