‘It could be a matter of life and death,’ hotter NJ nights threaten vulnerable

By Joe Martucci (The Press of Atlantic City) and Patricia Martinez Sastre (Climate Central)

This story was produced through a collaboration between The Press of Atlantic City and Climate Central.

PLEASANTVILLE — With air as muggy as the tropics and the low tide along Lakes Bay smelling like sulfur, Danielle Kilburn, 32, was swelling up again.

“I went to the doctor. The question they always ask to see if it’s normal swelling or trending toward preeclampsia is ‘Do you wake up fine?’” Kilburn said. “And I wake up as swollen as a balloon.”

Preeclampsia can pose many dangers for an unborn baby, according to the Mayo Clinic.

Kilburn, who moved from Colorado last September, lives without air conditioning in her rented Pleasantville home, shared with her fiancé, young child and soon-to-be baby. She works as a math and physics tutor and is worried about the impact extreme heat could have on her newborn.

“My fear is that I have about a month to have a baby and to find a way to get this house cooled down, because it could be a matter of life and death,” Kilburn said.

Being exposed to extreme heat during pregnancy stresses the fetus and can lead to complications both for the mother — hypertension, gestational diabetes — and the baby, like lower birth weight, medical research shows. Also, being too warm while sleeping can increase the risk of sudden infant death syndrome.

Climate change affects almost every facet of life, from our bodies to the economy, the culture and the physical landscape. Humid summers in South Jersey were always tough, but with the warming climate they’re getting tougher, with nights that are warming up and exposing the most vulnerable — like pregnant moms — to heat stress that doesn’t let up.

Even in a summer that hasn’t seen much extreme heat, the hotter nights and overall warming trend have many impacts on health. To better understand how hotter summers are changing life in our communities, The Press of Atlantic City and Climate Central — a non-advocacy climate change science and news organization — teamed up for this special report.

“The big problem with warmer nights is that they don’t allow people to recover,” said Tony Wolf, who researched climate change and human physiology as a postdoctoral scholar in kinesiology at Penn State University.

“Heat stress places a higher demand on the normal physiological processes of the body — our heart has to pump more blood per minute in order to deliver more blood to the skin, which increases strain on the cardiovascular system,” Wolf said. “We also see increased ventilation rates during heat stress, potentially contributing to respiratory distress in some people.”

If the number of extremely hot nights keeps growing, as studies predict, that increased physiological strain could add to the likelihood of health issues from heat exposure. Humidity worsens that scenario by preventing the evaporation of sweat, which normally cools the body. The combination of heat and moisture is what experts call “heat index” value.

While air conditioning has made these more frequent sultry nights more tolerable, those without it face rising risk of harm during the summer. Those most at risk are the elderly with comorbidities such as hypertension or diabetes, outdoor workers, children and pregnant women.

Historically, the Atlantic City area has had on average three days per year with a heat index above 100, according to a 2019 study by the Union of Concerned Scientists. By midcentury, that number could increase to 22 days per year if our heat-trapping emissions aren’t reduced, and up to 47 days per year by the late century.

“We’re looking at roughly a month and a half with a heat index above 100 when you might be really hot or experiencing those hot nights. That’s a long time,” said Kristina Dahl, a principal climate scientist at the Union of Concerned Scientists. “On the other hand, if we take really bold action and we swiftly and dramatically reduce our emissions globally, we could limit that frequency of extreme heat to 14 days per year.”

The trend Dahl’s group projected is already here, and it’s not just for afternoon temperatures.

A long-running weather station at the Sen. Frank S. Farley State Marina in Atlantic City showed an average of only one night a year that failed to fall below 75 degrees between 1881 and 1910. Today, the average is 12 nights a year, according to data from the National Oceanic and Atmospheric Administration. Other stations show the same fast-rising trend in the past 30 years.

Life without AC

Despite the growing exposure, not everyone can access air conditioning. For many residents in South Jersey — where data show large at-risk populations with a high rate of low-income families and ailments like diabetes — not everyone can afford it.

At least 12% of home energy expenditures are spent on air conditioning in the “mixed-humid” climate region, which includes South Jersey, according to data from the U.S. Energy Information Administration. That amounts to between $200 and $300 a year in higher utility bills.

For residents with lower incomes, that extra cost is hard to cover.

“I hate being sticky all damn day. I hate humidity,” said Shondalei Rodriguez, of Northfield. “However, I suffer because of the electricity bill. Like, who can even afford the bill anymore?”

Rodriguez only turns on her window units during the hottest days.

Kilburn has the same worries about turning on the air conditioning.

“The summers are financially a really hard time for us, so I appreciate saving money. But I’d rather save in other ways,” she said. “I’d gladly spend the money on air conditioning and save it somewhere else.”

And then there is the rare couple living in an oceanfront apartment in Atlantic City who choose not to have air conditioning.

Zach Katzen, 44, agreed to the no-AC lifestyle at the urging of his girlfriend, Valerie Feo, 35, who sleeps under blankets even on the hottest nights. Now he spends many evenings with his face in front of a floor fan while watching television, and he takes as many as five showers a night to cool off.

“Sometimes at night I will regret that choice (not to get air conditioning),” Katzen said.

Health and heat

Heat can kill.

Other weather disasters may be more spectacular, like wildfires or catastrophic storms such as Sandy and Ida, but heat is the number one killer among extreme weather events. At least 181 people died in New Jersey from heat stroke between 2000 and 2020, according to state Department of Health statistics. The worst years were 2002 and 2011, with 21 deaths each summer.

Nationwide, The Centers for Disease Control and Prevention estimates 600 to 700 preventable deaths per year are caused by extreme heat. But that’s only a fraction of a much more worrisome reality, because most heat-related deaths are attributed to other causes heat contributes to, such as heart attacks.

“When we do more complex analyses and we try to understand how many people actually would not have died in absence of extreme heat — because of this sneaky and indirect mechanism that will exacerbate existing comorbidities — the number of deaths attributable to heat can go up between 12,000 to 20,000,” said Dr. Tarik Benharhnia, an associate professor of climate change epidemiology at the Scripps Institution of Oceanography at the University of California at San Diego.

Heat also puts South Jersey residents in the hospital each summer. Among the six counties in New Jersey with the highest rates of hospitalizations for heat-related illnesses, Atlantic ranked second, Cape May third and Cumberland tied for fifth, according to data for 2016 to 2020 from the New Jersey Department of Health.

There is no single temperature or heat index threshold where everyone starts to feel the effects of extreme heat. And while it affects each of us differently, generally, at a heat index of 90 degrees, vulnerable groups like outdoor workers, seniors and children start to become affected, according to climate scientists.

At a heat index around 105 degrees, nearly everyone is at risk.

“Yes, we can adapt physiologically to the heat,” said Wolf. “But the extent to which we can adapt, as the environment around the world continues to warm, is kind of anybody’s guess at this point.”

Why nights are hotter

Since records began in 1943, the mean nighttime minimum temperature between June and August has risen almost two degrees at Atlantic City International Airport, according to NOAA. The overall increase in Atlantic City has been more than five degrees since records were first taken in 1874.

Across most of the U.S., since records began in 1895, nights have warmed at a rate of 1.58 degrees per century, nearly twice as fast as the warming rate observed for maximum daytime temperatures.

Several factors explain why nights are hotter and, over the past several decades, tend to be warming faster than days across the U.S..

One cause relates to the varying thickness of the layer of air affected by carbon dioxide, which blankets the earth more warmly at night. Burning fossil fuels adds carbon dioxide to the atmosphere.

Another cause relates to the way a warming climate creates more clouds over land, which tend to absorb in the nighttime the heat coming back out from the surface toward the atmosphere.

Our urban environment also plays a part. Especially within large metropolises, city landscapes hold in the heat, a phenomenon called the urban heat island effect, said Jennifer Vanos, an associate professor in the Global Futures Laboratory in the School of Sustainability at Arizona State University.

“It’s at nighttime when all of the buildings and the concrete that have been absorbing that heat all day long start to emit it into the atmosphere,” she said. “And so then we see that the cities are not cooling off as fast as the rural areas.”

Even the use of air conditioners plays a role in the problem. When in operation during nighttime hours, they continuously emit heat into their surroundings. Studies in several cities around the world have shown this can increase the mean outside air temperature about 3.5 degrees and exacerbate the urban heat island effect.

“It’s like a pump that takes hot air from inside to outside,” said Benharhnia. “So of course if a lot of households do that, it will automatically increase the temperature.”

Adapting to hotter summers

Less affluent residents endure the worst health impacts of extreme summer heat. In addition to struggling with the cost of air conditioning, low-income residents tend to live in denser, hotter neighborhoods, where long-term underinvestment has provided too little shade, green space or facilities to escape the heat.

In South Jersey and on the Jersey Shore, Rutgers University’s heat vulnerability index’s most severe ratings include most of Atlantic City, a section of Pleasantville — east of Main Street and between Stillwater County Park and Route 30 — much of Wildwood and the entirety of West Wildwood.

Even the use of air conditioners plays a role in the problem. When in operation during nighttime hours, they continuously emit heat into their surroundings. Studies in several cities around the world have shown this can increase the mean outside air temperature about 3.5 degrees and exacerbate the urban heat island effect.

“It’s like a pump that takes hot air from inside to outside,” said Benharhnia. “So of course if a lot of households do that, it will automatically increase the temperature.”

Adapting to hotter summers

Less affluent residents endure the worst health impacts of extreme summer heat. In addition to struggling with the cost of air conditioning, low-income residents tend to live in denser, hotter neighborhoods, where long-term underinvestment has provided too little shade, green space or facilities to escape the heat.

In South Jersey and on the Jersey Shore, Rutgers University’s heat vulnerability index’s most severe ratings include most of Atlantic City, a section of Pleasantville — east of Main Street and between Stillwater County Park and Route 30 — much of Wildwood and the entirety of West Wildwood.

“We build differently for hurricanes, so how can we build differently for heat?” said Vanos. “Treating heat as a disaster, the way other disasters are treated, I think is a really important factor in driving funding towards communities who really need it to save lives.”

For Kilburn, such help cannot come too soon.

When her family moved to Pleasantville, she did not know her home would not have air conditioning. Newly purchased fans and one evaporative cooler did not work as expected.

“It literally did not cool anything,” she said. “We’re slowly trying to cobble together air conditioning units and cool down one room at a time, but it is not going well. This is a two-story, three bedroom house, and it’s definitely old.”

Kilburn wishes she could at least have the choice, and the money, to provide air conditioning for her loved ones. That will have to wait, despite her numerous fears.

“I’m scheduled for a C-section. We are going to move (the delivery) back a week or so to give my body a break,” said Kilburn, whose newborn is expected in August.