Missoula is one of Montana’s largest cities, but is surrounded by rural mountain communities where ranching is king. Despite the latitude and altitude, this region has experienced severe summer heat waves in recent years.
It was difficult for residents to adapt to the warm climate and new seasonal swings. Many don’t have air conditioning and are unprepared for the new pattern of daytime temperatures hovering in the 90s — for days or even weeks at a time. Dehydration, heat exhaustion, heat stroke and abnormalities in heart rate and blood pressure are among the many health complications that can develop as a result of excessive exposure to high temperatures.
It can happen anywhere and to anyone, said Missoula Firefighter Andrew Drobeck. He recalls a recent 911 call. The temperature that day soared to over 90 degrees and a worker at a local dollar store fainted. “She is sensitive to the heat. Their AC wasn’t working very well,” Drobeck said. “I think they only get a 15-minute break.”
Drobeck said many of the heat calls his department receives are from seniors struggling to stay cool in their older homes. Montana’s population is among the oldest in the country. About 1 in 4 residents are over 60. Those over 65 are especially vulnerable to heat-related illnesses, according to the Centers for Disease Control and Prevention. As people age, their bodies don’t acclimate to heat as well as when they were younger, including not producing as much sweat.
In July, a heat dome settled over much of the western US baked the region, shattering two types of temperature records: daily highs and number of consecutive days over 90 degrees. Although the Northwest, including western Montana, is typically cooler, the region experienced record heat this summer.
Emergency personnel like Drobeck noticed. Drobeck says 911 calls during heat waves have increased over the past few summers. But Missoula County officials wanted to know more: They wanted better information about the residents calling and the communities hardest hit by the heat. So the county teamed up with researchers at the University of Montana to comb through the data and create a map of 911 calls during heat waves.
The team matched call data from 2020 with census data to see who lived in the areas generating high rates of emergency calls when it was hot. The analysis found that for every 1 degree Celsius (1.8 degree Fahrenheit) increase in the average daily temperature, 911 calls increased by 1 percent, according to researcher Christina Barskywho co-authored the study.
While that may sound like a small increase, Barsky explained that a 5-degree jump in the daily average temperature can cause hundreds of additional calls to 911 over the course of a month. Those call loads can tax ambulance crews and local hospitals.
The Missoula study also found that some of the highest rates of emergency calls during extreme heat events came from rural areas, outside of Missoula’s urban core. It shows that rural communities are struggling with heat, even if they get less media attention, Barsky said. “What about those people, right? What about those places that are experiencing heat at a rate we’ve never been prepared for?” she said.
Barsky’s work has shown that communities with more residents over 65 tend to generate more 911 calls during heat waves. That may be one reason so many 911 calls come from rural Missoula County residents: Barsky said people who live in rural Montana and its small towns tend to be older and more vulnerable to severe heat-related diseases.
And aging in rural communities can cause extra problems during heat waves. Even if it cools down at night, an older person living without air conditioning may not be able to handle hours of high temperatures in their home during the day. It is not uncommon for rural residents to drive an hour or more to reach a library that may have air conditioning, a community center with a cooling room, or medical care. Such isolation and scattered resources are not unique to Montana. “I grew up in the Upper Peninsula of Michigan,” Barsky said. “There are no air-conditioned spaces in at least 50 miles. The hospital is 100 miles away.”
Heat research like the Missoula study has mostly focused on big citieswhich are often warmer than remote areas, due to the “heat island” effect. This phenomenon explains why cities tend to heat up during the day and cool down less at night: This is because pavements, buildings and other structures absorb and retain heat. Urban dwellers may experience higher temperatures during the day and less relief at night.
In contrast, researchers are only now beginning to investigate and understand the impact of heat waves in rural areas. The impact of extreme heat on rural communities has been largely ignored, said Elizabeth Doranan environmental engineering professor at the University of Vermont. Doran leads a ongoing study in Vermont revealing that towns as small as 5,000 people can stay warmer than surrounding rural areas at night due to heat radiating from hot pavement. “If we as a society are only focused on large urban centers, we’re missing a large part of the population and our strategies are going to be limiting in how effective they can be,” Doran said.
Brock Slabach, with the National Rural Health Associationagree that rural residents urgently need help to adapt to extreme heat. They need support to install air conditioning or to get to air-conditioned places to cool off during the day. Many rural residents have mobility problems or do not drive much due to age or disability. And because they often have to travel further to access health care services, extra delays in care during a heat-related emergency can lead to more serious health outcomes. “It is not at all unreasonable to suggest that people will be disadvantaged if they do not have access to those kinds of services,” he said.
Helping rural populations adapt will be a challenge. People in rural areas need help where they live, inside their homes, he said Adrian Beckdirector of Missoula County’s Office of Emergency Management. Starting a cooling center in a small community can help people who live in town, but it is unrealistic to expect people to drive an hour or more to cool off. Beck said the Missoula County Disaster and Emergency Services Department plans to use data from the 911 study to better understand why people call in the first place.
In the coming years, the department plans to speak directly to people living in rural communities about what they need to adapt to rising temperatures. “It can be as simple as knocking on their door and saying, ‘Would you benefit from an air conditioner?’ How can we connect you with resources to make that happen?’” Beck said.
But that won’t be possible for every rural household because there simply isn’t enough money at the county and state level to pay for that many air conditioning units, Missoula County officials said. This is why the province wants to plan ahead for heat waves and have specific protocols to contact and assist vulnerable rural residents.
“Ideally, we’d be in a situation where we might have community paramedics that could be deployed in those areas when we know these events are going to happen so they can check it and avoid that hospital admission,” Beck explained. She added that preventing heat-related hospitalizations among rural residents could ultimately save lives.
This article is from a partnership that includes MTPR, NPRand KFF Health News, a national newsroom that delivers in-depth journalism on health issues. Log in to KFF Health News’ free Morning Briefing.
