Cities have long made plans for extreme heat. Are they enough in a warming world?

Natural disasters can be dramatic -- barreling hurricanes, building-toppling tornadoes -- but heat is more deadly.That July, a weeklong heat wave that hit 106 degrees Fahrenheit killed more than 700 people. Most of the deaths occurred in poor and majority Black neighborhoods, where many elderly or isolated people suffered without proper ventilation or air conditioning. Power outages from an overwhelmed grid made it all worse.

Heat preparedness has generally improved over the years as forecasting has become more accurate, and as meteorologists, journalists and government officials have focused on spreading the word of upcoming danger. Chicago, for example, has expanded its emergency text and email notification system and identified its most vulnerable residents for outreach.

In India, a powerful heat wave in 2010 with temperatures over 118 degrees Fahrenheit led to the deaths of over 1,300 people in the city of Ahmedabad. City officials now have a heat action plan to improve awareness in the local population and health care staff. Another simple initiative: Painting roofs white to reflect the blazing sun.

Inkyu Han, an environmental health scientist at Temple University in Philadelphia, noted that cities are still struggling to get aids such as cooling centers and subsidized air conditioning into poorer neighborhoods. He said more can be done, too, with simple and sustainable solutions such as improving tree canopy.

"We definitely notice that it puts a strain on the system," Moretti said. Older people, people who work outdoors, people with disabilities and people who are homeless make up a big share of those admissions, she said. "For people in apartments that are not publicly subsidized, there is no requirement for landlords to provide air conditioning," Bachin said. "That's incredibly dangerous to particularly our local low-income population, let alone people who are unhoused or are outdoor workers."

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