Section 11.01 Extreme heat - Durham County
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CHAPTER 11 CLIMATE CHANGE
Section 11.01 Extreme heat
Overview
Extreme heat is one of the deadliest climate hazards.i The term “excessive heat” is defined as two
or more days of temperatures above 90°F.ii In Durham, extreme heat is often accompanied by high
humidity. Under these conditions, the human body needs to work harder to maintain a normal body
temperature because the evaporation of sweat is slowed. This leads to heat exhaustion, heatstroke
and possibly death.iii Anyone can be affected by extreme heat, but the hazard often
disproportionately impacts low-income communities. Climate change is projected to increase the
number, severity and duration of extreme heat events.iv Future public health consequences of
extreme heat are likely to increase, but adaptation and mitigation steps can improve outcomes.
Secondary Data
The health impacts of extreme heat are already significant and only expected to become worse as
climate change drives temperatures higher. Between 2010 and 2020, there were an estimated
12,000 premature deaths in the United States due to extreme heat, more than all other extreme
weather hazards combined including tornadoes, flooding, hurricanes, wind, cold, lightning and
winter storms.v There are an estimated 3,000 heat-related illness emergency department visits
every summer in North Carolina.vi Currently, approximately 250 heat-related deaths occur
annually in North Carolina.vii Under the worst-case climate warming scenario, the number of heat-
related deaths in North Carolina is estimated to increase to 3,300 per year.viii
While extreme heat can have negative public health effects, it is one of the few climate health
hazards that can be mitigated with advance planning. Often called a silent storm, extreme heat
approaches without the dramatic warning signs of other storms such as whipping winds, heavy
rains or rushing rivers. Instead, heat waves feel like an ordinary hot day until the unusually hot
temperatures begin to affect the body. In mild cases, extreme heat causes dehydration and lack of
energy. In more severe cases it causes heat exhaustion, heatstroke, hyperthermia, and in the worst
cases, death. Extreme heat deaths occur not just on the hottest days, but at warm temperatures as
well.ix When night temperatures stay above 80°F, it is harder for the human body to cool down,
increasing the chances of adverse heat effects. Extreme heat also makes pre-existing conditions
such as mental illness, asthma, diabetes and cardiovascular disease worse.x
Heat waves have different impacts across Durham County. Temperatures are typically 22°F
warmer in urban areas than the surrounding countryside.xi Temperatures stay warmer overnight
due to the “urban heat island” effect.xii This is the result of large amounts of heat-trapping buildings
and paved surfaces as well as the lack of vegetation. Building materials like brick, concrete and
asphalt absorb heat during the day and release it slowly overnight to the surrounding air. This
means that these areas do not have a chance to cool off before the sun comes up again.
Additionally, fewer trees, meadows and vegetative ground cover in urban areas mean less natural
cooling. Plants create natural cooling systems. Water that evaporates from plant leaves during
photosynthesis harnesses heat energy that transforms liquid water into vapor, cooling the plant’s
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surroundings.xiii Additionally, plants create pockets of shade and microclimates that circulate
cooled air as a result of the evaporation process.xiv
Extreme heat will also have a disproportionate impact on residents who do not have reliable access
to air conditioning and/or who have secondary risk factors as discussed below in the Interpretations
section.xv In some areas, the legacy of structural racism compounds the triple impact of an
increased urban heat island effect, less access to reliable cooling and less access to health
insurance.xvi There are eight census tracts in Durham County where this is evident, as documented
in Figure 11.01(a) and discussed in the Interpretations section below.
Figure 11.01(a): Comparing variables associated with heat vulnerability between Durham County and
the eight historically redlined census tractsxvii
Heat Illness Risk Factors in Historically Redlined Census Tracts,
Durham County, 2018
100
90
80
70
60
50
40
30
20
10
0
% Below % Rental % No Car % No Health % Impervious % Canopy % Nonwhite
Poverty Line Insurance Cover
Census Tract 13.01 Census Tract 13.03 Census Tract 14 Census Tract 23
Census Tract 9 Census Tract 10.01 Census Tract 10.02 Census Tract 11
Heatwaves are sometimes accompanied by power blackouts due to high demand for energy or
other weather-related hazards such as hurricanes and thunderstorms.xviii In these situations, all
residents of Durham would be at high risk for heat health problems. During COVID-19 or possible
future pandemics, the use of air conditioning in shared indoor rooms or cooling stations may
present a secondary health risk of contracting a serious virus or disease.xix
Overall, Durham County is projected to experience 60 extreme heat days over 90°F a year by 2030,
increasing to 75 days by 2080.xx
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Projected Days Per Year Above 95oF, Durham County, 2006-2099
120
100
Average High Temperature (0F)
80
60
40
20
0
2006
2010
2014
2018
2022
2026
2030
2034
2038
2042
2046
2050
2054
2058
2062
2066
2070
2074
2078
2082
2086
2090
2094
2098
Year
Lower Carbon Emissions Scenario
Higher carbon Emissions Scenario
Figure 11.01(b): Projected Days in Durham County over 95 Degrees Fahrenheitxxi
Figure 11.1(b) shows the projected number of days per year that Durham County is expected to
reach 95oF or more. The green line projects average maximum daily temperatures if humans are
able to curb greenhouse gas emissions to meet internationally agreed-upon carbon reduction
targets. The blue line projects temperatures if humans continue to emit high levels of greenhouse
gases.xxii
Interpretations: Disparities, Gaps, and Emerging Issues
Extreme heat can affect anyone. However, people who are more likely to be adversely affected
generally fall into three categories in Durham County:
• People exposed to very hot temperatures or prolonged warm temperatures in their working
environment.xxiii
• People who have pre-existing health conditions such as heart disease, diabetes, mental
illness or asthma that may worsen as the body is stressed in extreme heat conditions.xxiv
• People who may have difficulty moving to a cooler environment such as people with
physical disabilities, social isolation, language isolation, or people whose bodies have a
harder time thermal regulating such as people with severe obesity and under the age of four
or over 65 years old. xxv,xxvi
When possible, people in the above categories should mitigate adverse health impacts by avoiding
exposure to extreme heat and finding a cool environment. However, this is not possible for some
residents, either because they cannot afford air conditioning and/or landlords do not provide it,
their physical condition makes it difficult to move to a cooler environment or because their work
conditions expose them to heat.
In the next decade, the ability to find a cooler environment will increasingly emerge as a
determinant of health. Residents who do not have access to cooling resources such as air-
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conditioning, a cool car or the ability to take a day off work on an extremely hot day are more
likely to experience heat sickness or heat-related death.xxvii
Eight census tracts in Durham and a large number of the residents who currently live in them are
at higher risk of extreme heat-related illness as a direct result of the legacy of structural racism.
Between 1934 and 1968, census tracts 9, 10.01, 10.02, 11, 13.01, 13.03, 14, and 23 were designated
as areas that were too risky to lend in by the United States’ Home Owners’ Loan Corporation
(HOLC).xxviii The HOLC agency was established as part of the New Deal during the Great
Depression in an effort to refinance mortgages at risk of default and encourage new home sales.
However, neighborhoods with high numbers of people of color living in them were marked red on
the HOLC lending maps and therefore denied federally-subsidized mortgage opportunities.xxix
This exclusionary lending practice is now called “redlining” and its harmful legacy still persists
both in the physical infrastructure of formerly redlined neighborhoods and in the experiences of
many community members who live there.xxx The neighborhoods which were redlined lie in the
Southeast, East, and Northeast Durham and include neighborhoods such as the Hayti, East
Durham, Albright, Wellons Village, Historic Hillside, Hillside Park, Massey-Linwood, Oak
Grove, Eastway Village, the Fayetteville Street Commercial District, North Carolina Central,
Franklin Village, Sherwood Park, Hoover Road, and Old North Durham.
Formerly redlined neighborhoods have fewer street trees and more paved surfaces, resulting in
localized temperatures on average 7° F hotter than non-redlined districts.xxxi Additionally, as a
result of policies deliberately restricting access to financing to people of color, these
neighborhoods have a higher number of non-white residents who live below the federal poverty
line, cannot afford reliable air conditioning and rely on the bus or walking for transportation, even
on extremely hot days.xxxii Many residents in Durham’s formerly redlined districts are therefore at
greater risk for heat-related illness. This heat inequity is illustrated in Figure 11.1(a).
An emerging issue for Durham residents in these eight census tracts is involuntary displacement
known as gentrification.xxxiii Housing insecurity and an involuntary move to another neighborhood
can exacerbate transportation heat exposures or the inability to afford air-conditioning. Place-
based interventions to mitigate the effects of extreme heat such as planting trees and adding cooling
stations should keep this displacement issue in mind to ensure that the people most at risk receive
continued support in their new locations.
Recommended Strategies
Mitigate Urban Heat Island Effect
• Adopt a county-wide maximum allowable indoor temperature for residential buildings
when the outdoor temperature is above 90°F, similar to the minimum allowable indoor
temperature regulation that already exists for outdoor temperatures below 68°F.xxxiv
• Increase green infrastructure such as trees, meadows, vegetated areas and green roofs,
prioritizing the historically redlined census tracts if this is also wanted by the communities
in each census tract.xxxv
• Create design standards, incentives and education to increase light-colored cooling
surfaces such as roofs, parking lots, plazas, etc.xxxvi
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• Conduct research to determine the extent of urban heat island and its impacts on specific
neighborhoods in Durham.xxxvii
Mitigate Health Impacts
• Implement a heatwave alert, education and response system through the Durham County
Emergency Management department based on EPA guidance.xxxviii This includes
partnering with formal and informal social service systems to educate the public about
extreme heat dangers and mitigation techniques.xxxix
• Set up a buddy system through formal and informal networks to check on most-impacted
community members during heat waves; incorporate through existing emergency
systems.xl
• Plan for long term heat events with established cooling stations including overnight options
and enhanced social infrastructure.xli
• Plan for additional funding for electricity assistance during heat waves.xlii
Current Initiatives & Activities
Operation Fan Heat Relief Program
The North Carolina Department of Health and Human Services provides free fans to senior
citizens and eligible adults with serious health conditions. The Center for Senior Life administers
this program in Durham County (919)-688-8247. https://www.ncdhhs.gov/divisions/aging-and-
adult-services/operation-fan-and-heat-relief
Increasing Urban Forest Cover Through Tree Planting
The City of Durham, Keep Durham Beautiful and Trees Durham collectively plant about 1,500
trees per year. The city’s Urban Forestry Management Plan aims to increase the tree canopy from
42% to 45% and plant 85% of new street trees in areas that have been underserved.
https://durhamnc.gov/DocumentCenter/View/32533/UFMP_GSD_9-18
CDC Communication toolkit on Climate Change, Extreme Heat
The Center for Disease Control provides information on heat stress illnesses and links to federal
government resources on extreme heat.
https://ephtracking.cdc.gov/showHeatStressIllnessResources
NC Department of Health and Human Services
The North Carolina Department of Health and Human Services offers climate and health
information on extreme heat. https://publichealth.nc.gov/chronicdiseaseandinjury/heat.htm
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