May 15, 2026 - 20:02
San Antonio has started officially tracking deaths linked to extreme heat, a move that public health experts say is long overdue in a city where summer temperatures regularly top 100 degrees. The new system, run by the Metropolitan Health District, aims to count fatalities where heat is a primary or contributing cause. But even with this effort, officials acknowledge the numbers will almost certainly be an undercount.
The challenge is that heat deaths are notoriously hard to pin down. A person found dead in a home without air conditioning might have had a heart attack or stroke, with the heat playing a silent role. Medical examiners often list the immediate cause, not the environmental trigger. San Antonio's new tracking method relies on death certificates, emergency room reports, and medical examiner data, but it still misses cases where heat is never mentioned in official records.
In 2023, the city recorded 18 heat-related deaths. But experts say the real toll could be two or three times higher. Vulnerable groups include the elderly, people with chronic illnesses, and those without access to cooling. The city has opened cooling centers and expanded outreach, but advocates argue that without accurate data, resources will never match the need.
The tracking effort is part of a broader push by cities like Phoenix and Miami to understand how rising temperatures kill. San Antonio's numbers, while imperfect, at least provide a starting point. As one health official put it, "You cannot fix what you do not count." Still, the gaps in the data mean the true cost of extreme heat remains hidden.
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