In 2015, when Diana and Charles Cox were considering where to retire, they drove their RV across the Southwest to visit several possibilities: Santa Fe, Sedona, Phoenix, Las Vegas.
They lived in San Jose, Calif., for nearly 20 years, but Ms. Cox is shedding his practice as a biotech patent attorney, and his income is declining as taxes, housing and other living expenses rise.
Her husband, 71, a contractor, retired years ago. “I’m having more and more trouble paying the mortgage,” said Ms. Cox, who is 69.
Phoenix won because of its lower costs, international airport and multiple health care providers, important for two people with chronic medical conditions. The couple bought a home in a 55-plus community in suburban Goodyear, Ariz., in 2016. Knowing the summer heat would be intense there, they planned to spend the season back in the Bay Area in their RV
But the pandemic has made travel unsafe for years. Mr. Cox underwent treatment for prostate cancer. The father of Ms. Cox has moved and needs care. So they almost summered in Goodyear.
The number of elderly Americans like the Coxes exposed to extreme heat is rising, the result of an aging population, continued migration to heat-prone areas and climate change. Researchers say the trend will only get worse.
“The places that are hot right now are definitely the places that are getting older,” said Deborah Carr, a sociologist at Boston University and lead author of a recent study of population aging and heat exposure.
Phoenix, a longtime retirement destination, has averaged 108 days a year of 100-plus degree temperatures since 1970. But this year has been brutal: As of July 31, Phoenix has hit 68 days this year with temperatures over 100 degrees. Temperatures hit at least 110 degrees Fahrenheit for 31 straight days, from the last day of June to the end of July, setting a record.
And the dangerous heat returned to the city this weekend.
Summer in the Phoenix suburbs is “miserable,” Ms. Cox, at midnight when the temperature in Goodyear reached 106. “You really can’t go out and do things. We haven’t been as friendly as I would have liked.”
This year was particularly miserable because a delayed home renovation project forced the couple to move into their RV for three months, starting in June. The car’s two air conditioning units are struggling. So does the refrigerator, which causes salads to wilt and milk to spoil.
“A few days ago it was up to 92 here,” said Ms. Cox. “The cats are crouching under the ceiling fan.” He called the heat inside “uncomfortable, but not deadly.”
The heat can be deadly, though, especially for the elderly. Last year, Maricopa County, which includes Phoenix, recorded 425 heat-related deaths, a 25 percent increase from 2021. Two-thirds occurred in people over 50.
The over 65 population increased 52 percent in Arizona between 2009 and 2019; it grew 57 percent in Nevada and 47 percent in Texas. This reflects the aging of current residents, but also the continued migration to those states.
The Census Bureau reported last year that more than 600,000 adults moved to new states annually from 2015 to 2019, with the largest net migration in Florida, Arizona, North Carolina, South Carolina and Texas.
At the same time, climate change is increasing temperatures in normally temperate locations. “Areas that are older — the Midwest, the Northeast, New England — are experiencing increased heat exposure at the fastest clip,” said Dr. Carr. “And we’re not quite ready for it.”
The elderly, especially those with chronic diseases such as heart disease or diabetes, are vulnerable to extreme heat because there are more of them problems with thermoregulation, the body’s ability to maintain its temperature.
“Older bodies are less efficient at pumping blood to the skin and less efficient at sweating,” which reduces their ability to cool themselves, Dr. Neelu Tummala, a surgeon and co-director of the Climate Health Institute at George Washington University.
“That makes it harder for the heart to pump,” he says, adding to cardiovascular stress and pain. Commonly used medicines such as diuretics and beta blockers may increase the risk of undiagnosed dehydration.
The risk of kidney disease or failure increases. Struggles with mobility or cognition can prevent seniors from seeking treatment.
“Extreme heat is the deadliest form of weather in the United States, more than hurricanes or tornadoes or wildfires,” said Brian Stone, Jr., who teaches environmental planning at Georgia Tech.
He is the lead author of a groundbreaking recent study estimating the effect of a major blackout during a strong heat wave in three cities: Detroit, Atlanta and Phoenix – although the possibility of such blackouts is increasing everywhere, said Dr. Stone. Electrical grid failures affecting more than 50,000 residents more than doubled in the most recent six years for which data is available.
The researchers’ models assume five days of temperatures as high as 95 degrees (in Detroit), 97 degrees (Atlanta) and 113 degrees (Phoenix), accompanied by blackouts of all residences within 48 hours , followed by 72 hours of electricity that was gradually restored to the people.
Heat-related deaths exceeded 220 in Detroit, which has fewer air-conditioned homes than many Southern cities, the study found. In Atlanta, the death toll will be six.
In Phoenix, the extreme heat may have killed more than 13,000 people – not a typo – and most were older, as in almost all natural disasters.
However, Dr. doubts. Carr said that even this summer’s extreme heat will prevent migration to popular retirement areas. Besides the mild winters, “elderly people want to move where the cost of living and housing costs are lower,” says Dr. Carr.
They may see the summer heat as transient or aberrational, he says, or “they may prioritize family over the possibility of heat waves.”
That’s exactly why Jean Swain Horton moved from Sacramento (a hot spot) to Frisco, Texas, two years ago. Her son and daughter-in-law are moving in with a new baby, Theo, and they want her to come along; he moved into the same apartment complex.
Ms. Horton, 67, doesn’t want to stay put for about five months of the year, or live in a dark apartment with shades pulled to block the sun. But she wants to be close to Theo and help take care of him. “I’ll go anywhere to be near my grandson,” he said.
John Berger, 68 and newly retired, just sold his house near Long Beach, Calif., where he and his wife have never installed or needed air conditioning. They are going to Albuquerque, where they plan to buy a house that their grown daughter and her roommate can share.
In Long Beach, he figured the multigenerational residence would cost at least $900,000, an unaffordable price for him as a retiree. In Albuquerque, he thinks he can spend half that.
True, Albuquerque can be hot, but it only averages four days a year of 100-plus temperatures (although this year the city has tallied 15 such days through July).
“It was probably denial,” Mr. Berger said of the family’s decision to live in the heat. “Maybe it’s, ‘I’ll figure out how to make this work for me.’ People learn to adapt.”
The Coxes adapted. They installed solar panels on their house and plan to buy a backup battery. In case of blackout, there is a backup generator for RV Ms. Cox always carries water with him when he leaves home.
In his overheated RV, however, he sometimes longs for the windy Bay Area. How many days did San Jose top 100 degrees this year? Zero.
“If we can do it, I’ll be back on the California coast,” said Ms. Cox. “I’d rather have the windows open.”