In 2017, 12 nursing home residents died when Hurricane Irma knocked out the air conditioning in the Hollywood, Florida, building.
The body temperatures of the victims reached 108 degrees, and staff were criticized for not taking them to a hospital across the street that had air conditioning.
So, what happens to the people in Southwest Florida who have no air conditioning year round?
The answer is more than just discomfort. This population demographic faces a greater risk of long- and short-term health impacts from heat exposure than people who have access to air conditioning.
Counties in Southwest Florida have been subjected to heat advisories for most of the summer. During those heat advisories, authorities urge people to avoid outdoor activities and stay inside air conditioned areas.
However, several hundred homes in Collier and Lee counties are not equipped with air conditioning, giving residents no escape from the heat.
In 2023, almost 650 households in Collier County, and 960 in Lee County were estimated to live without air conditioning year round, according to a Local Air Conditioning Estimates report recently published by the U.S. Census Bureau.
And, as temperatures and heat indexes reach high levels in Southwest Florida, temperatures inside houses without cooling systems can reach dangerous levels. The elderly, children and people with underlying health conditions are the most vulnerable to heat-related illnesses brought on by extreme temperatures.
What are the health impacts of heat exposure?
Air conditioning is often thought of as a comfort item, but according to emergency room doctor Timur Kouliev, who works for Naples Comprehensive Health, air conditioning is actually a health necessity for people who are especially vulnerable to heat conditions.
The especially vulnerable are those with chronic medical conditions which are exacerbated by heat exposure and those of extreme age, like infants and the elderly.
“What we frequently see in the emergency department isn’t just heat exhaustion, and heat stroke, which of course we do see, but it’s conditions that would otherwise be preventable,” he said. “People who are vulnerable and after being exposed to prolonged heat may have worsening of their chronic medical conditions.”
People with heart disease who have decreased cardiac function may be completely fine in “optimal temperature regulation,” but when exposed to high heat, they may suffer a heart attack, Kouliev said.
People with kidney diseases are also especially vulnerable to extended heat exposure as dehydration and stress on the body can worsen renal function.
An acute kidney injury, which could become permanent and require dialysis, is a possible complication of severe heat exhaustion and associated dehydration, according to Kouliev.
“For that reason, proactive support of vulnerable individuals in the community is so important,” Kouliev said. “Prevention is so attainable.”
However, extended heat exposure does not just pose severe health risks to people with chronic conditions. Perfectly healthy people who experience heat stroke or heat exhaustion could experience long-term health impacts.
“Heat stroke itself is really a complication of heat exhaustion, severe heat exhaustion affecting the brain,” Kouliev said, which could cause the person to pass out or have seizures.
“Could some of this effect on the brain become long term?” Kouliev said. “It could definitely happen if they suffer decreased blood flow to certain parts of the brain.”
However, early recognition and treatment helps avoid these permanent impacts, which is why understanding the signs of heat illness is so important, he added.
Part of prevention also means checking on vulnerable individuals, working to get them air conditioning or taking them to places to cool down.
Kouliev said shopping malls or libraries are great places for people to escape the heat because they are air conditioned and open to the public.
“Being proactive and being focused on prevention is so important,” he said.
However, residents without access to working air conditioning are at greater risk at night as those public cooling places are generally closed in the nighttime hours, and according to Majed Ammari, a resident physician for Lee Health, the use of fans are not always enough to prevent heat-related illnesses.
“Our bodies are constantly working to keep our core temperature in a very narrow range,” he said. “Relying solely on fans if the indoor temperature is quite high, fans alone might not prevent heat-related illness.”
He encouraged people in those situations to reach out to their communities and research resources available to them as temperatures continue to rise.
Heat-related illness “is a risk everywhere you go,” he said. “But, I would say given our climate and where we are and how active our community is, we are at heightened risk for this.”
In the meantime, he said, if you notice someone or you yourself are experiencing symptoms of heat stroke, contact a doctor or emergency services, because “it can potentially get dangerous.”
Extended exposure to heat and chronic stress on the body’s cooling systems can have some long-term health implications, so it’s important to find solutions now and limit exposure to triggering factors for heat illness.
“It really has a multi-factorial effect on multiple organs in the body,” he said.
The biggest immediate risk people without access to air conditioning in the summer heat is dehydration as the body loses more fluids than it takes in, which puts the person at a higher risk of passing out.
“With that risk, you could fall, hurt yourself, especially if you’re elderly,” Ammari said. “You can have organ damage such as injury to the kidneys, which could potentially progress into a worsening kidney disease.”
Dehydration also has an impact on the heart as it has to work harder to compensate for the lower amount of fluids in the body, stressing that organ as well.
So, if you don’t have constant access to an air conditioner, the best way to prevent the worst of the effects of extended exposure is making sure to drink as much water as possible, “copious amounts of water,” according to Ammari.
But, he reiterated the best way to prevent heat related health impacts is by reaching out to the community and finding resources to help take yourself out of those hot situations.
What are some resources for people struggling with a/c?
One of those resources in Collier County is Florida Power and Light’s air conditioning rebates, which help offset some of the upfront costs of installing new and more efficient air conditioning units.
If FPL customers upgrade their air conditioning units using one of the company’s participating independent contractors, they are eligible for an instant $200 rebate, which can help offset the cost of a new system, which will not only be more efficient and cost-saving in the long-run, but will also be more reliable than older systems reducing repair costs over time.
“There’s a lot of advantages if you’re able to upgrade your system to a more efficient unit,” Shelley Ragsdale, an FPL spokesperson. “It’s going to improve your home comfort, more consistent cooling.”
However, the initial cost of installing a completely ac unit can range into several thousand dollars, so these rebates can only do so much.
There are similar programs, some government-funded, with rebates to help people upgrade or buy new air conditioning units that are more energy efficient that can offer more effective help in paying initial costs.
And, there are tax credits, some up to $2,000, for upgrading to energy efficient air conditioning units, which is another helpful resource for people looking to integrate cooling systems into their homes and reduce the chance of more issues with repairs.
Are landlords required to provide air conditioning?
In Florida, one of the warmest states in the country, landlords are required, by law, to provide tenants with heating, but not cooling.
However, if a unit has air conditioning when a tenant moves in, the landlord is required to maintain the air conditioning unit and repair it when needed, but there is no rule requiring them to provide air conditioning from the outset.
Florida is not alone in those ordinances though, with no states in the U.S. requiring landlords to provide air conditioning in all rentals. However, there are some local ordinances in other states requiring such things.
You can reach Naples Daily News reporter Alexa Ryan by emailing Alexa.Ryan@naplesnews.com. Follow her on Instagram @alexaryanreports or X @AlexaRyan_.
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This article originally appeared on Naples Daily News: Can you live in SWFL safely without air conditioning? Health impacts
Reporting by Alexa Ryan, Fort Myers News-Press & Naples Daily News / Naples Daily News
USA TODAY Network via Reuters Connect
By Alexa Ryan, Fort Myers News-Press & Naples Daily News | USA TODAY Network
