DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA 1992-2009 Public Health Services Bureau of Public Health Statistics Health Status and Vital Statistics Section ~ Leadership for a Healthy Arizona ~ Janice K. Brewer, Governor State of Arizona Will Humble, Director Arizona Department of Health Services HEALTH STATUS AND VITAL STATISTICS SECTION BUREAU OF PUBLIC HEALTH STATISTICS ARIZONA DEPARTMENT OF HEALTH SERVICES 150 N. 18th Avenue, Suite 550 Phoenix, Arizona 85007-3248 Phone: 602/542-7333; FAX: 602/542-2940 www.hs.state.az.us/plan This publication can be made available in alternative format. Please contact the Bureau of Public Health Statistics at 602/542-7333 (voice) or call 1-800-367-8939 (TDD). The Arizona Department of Health Services is an Equal Employment Opportunity Agency. Permission to quote from or reproduce materials from this publication is granted when due acknowledgment is made. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 by Christopher K. Mrela, Ph.D., Arizona Vital Statistician Clare Torres, Senior Health Data Analyst MARCH 2010 ACKNOWLEDGMENTS Special gratitude is expressed to Wesley Kortuem, the GIS Coordinator, who developed the maps for this publication. Grateful acknowledgement is made to Richard S. Porter for reviewing the typescript. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 TABLE OF CONTENTS PURPOSE ........................................................................................................................................... 1 METHODS AND SOURCES ........................................................................................................................ 1 LIMITATIONS OF THE DATA .................................................................................................................... 1 SUMMARY OF FINDINGS ......................................................................................................................... 2 FINDINGS, FIGURES AND DATA TABLES FIGURE 1 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA BY YEAR, 1992-2009................................4 FIGURE 2 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA BY STATE OR COUNTRY OF RESIDENCE AND YEAR, 1992-2009 ........................................................................................................5 FIGURE 3 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA BY MONTH IN THE EIGHTEEN-YEAR PERIOD, 1992-2009 ................................................................................................6 FIGURE 4 PERCENT DISTRIBUTION OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA BY MONTH AND RESIDENCE STATUS IN THE EIGHTEEN-YEAR PERIOD, 1992-2009 .............................................7 FIGURE 5 PERCENT DISTRIBUTION OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA BY AGE GROUP AND RESIDENCE STATUS IN THE EIGHTEEN-YEAR PERIOD, 1992-2009 ........................................8 FIGURE 6 MEDIAN AGE AT DEATH FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY RESIDENCE STATUS, EIGHTEEN-YEAR SUMMARY FOR 1992-2009..................................................................................................9 FIGURE 7 MEDIAN AGE AT DEATH FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY GENDER AND RACE/ETHNIC GROUP, EIGHTEEN-YEAR SUMMARY FOR 1992-2009...................................................................................... 10 FIGURE 8 PERCENT DISTRIBUTION OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY RESIDENCE STATUS AND AREA OF OCCURRENCE IN ARIZONA IN THE EIGHTEEN-YEAR PERIOD, 1992-2009................................................. 11 FIGURE 9. DEATHS OF MIGRANTS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY SPECIFIC LOCATION IN ARIZONA IN 2005 .......................................................................................................................... 12 FIGURE 10 DEATHS OF ARIZONA RESIDENTS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY SPECIFIC LOCATION IN ARIZONA IN 2005 .......................................................................................................................... 13 TABLE 1 CHARACTERISTICS OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA BY YEAR, 1992-2009......................................................................................................................... 15 TABLE 2 CHARACTERISTICS OF ARIZONA DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY RESIDENCE STATUS, EIGHTEEN-YEAR SUMMARY FOR 1992-2009...................................................................................... 17 TABLE 3 CHARACTERISTICS OF ARIZONA DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY REGION, EIGHTEEN-YEAR SUMMARY FOR 1992-2009 ................................................................................................ 19 TABLE 4 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY GEOGRAPHIC REGION OF OCCURRENCE IN ARIZONA AND RESIDENCE STATUS, EIGHTEEN-YEAR SUMMARY FOR 1992-2009 .................................................... 21 TABLE 5 MEDIAN AGE AT DEATH FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY GEOGRAPHIC REGION OF OCCURRENCE IN ARIZONA AND RESIDENCE STATUS, EIGHTEEN-YEAR SUMMARY FOR 1992-2009 ................................... 21 TABLE 6 MEDIAN AGE AT DEATH FROM EXPOSURE TO EXCESSIVE NATURAL HEAT BY RACE/ETHNICITY AND GENDER, EIGHTEEN-YEAR SUMMARY FOR 1992-2009............................................................................................... 21 TABLE 7 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OF THE 116 MIGRANTS TO ARIZONA IN 2005: CASE SUMMARIES............................................................................................................................... 22 TABLE 8 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OF THE 77 ARIZONA RESIDENTS IN 2005: CASE SUMMARIES............................................................................................................................... 25 ii Purpose Our special report, Deaths from Exposure to Excessive Natural Heat Occurring in Arizona, 1992-2002 was published in March, 2004.1 It attracted a wide audience well beyond Arizona’s borders. Ever since its publication we have been receiving numerous inquiries when are we going to update it. The purpose of the original report was to provide information concerning deaths from exposure to heat due to weather conditions occurring in Arizona. Unlike our other reports, designed to monitor health status of the residents of Arizona, this publication was focused on mortality occurring in the State to both residents and non-residents. The data for 2002 (the latest year with complete information then available) were placed in a temporal context by comparison with the data for the preceding ten years. X30 in the Tenth Revision and corresponding to it code E900.0 in the Ninth Revision. In this report, the deaths from exposure to heat due to weather conditions are classified by ICD-9 for 1992-1999 and by ICD10 for 2000-2009. In addition to death certificates where exposure to excessive natural heat was indicated as the underlying cause of death, heatstroke or sunstroke may be reported on death certificates as contributing factors that had a bearing on the death, but were not its underlying cause. For example, heatstroke and sunstroke were mentioned in 2003-2009 on 103 Arizona death certificates where atherosclerotic cardiovascular disease (I25.0), respiratory disease (J449), diabetes (E149), or drug overdose/alcohol intoxication (X41– X44) were reported as the underlying cause of death. Those heatrelated deaths are beyond the scope of this report. Limitations of the Data Instead of preparing a separate publication which would provide more recent information than 2002 we have decided to update and expand the original report. Since we are interested not only in the spatial pattern but also temporal changes in mortality from exposure to excessive natural heat, expanding the number of available “data points” (1992-2009) obviously matters. Methods and Sources Data on the number and characteristics of deaths from heat due to weather conditions were obtained from the mortality database containing information from the death certificates filed with the Arizona Department of Health Services. The International Classification of Diseases (ICD) permits the classification of environmental events and circumstances as the external cause of injury death. Beginning with the 2000 data year in Arizona (1999 nationally) the Tenth Revision of the International Classification of Diseases (ICD-10) has replaced the Ninth Revision (ICD-9), which was in effect since 1979. Exposure to excessive natural heat as the underlying cause of death is identified by a three-character category __________________________________________________________ 1 This online report was followed by a brief article published in the Morbidity and Mortality Weekly Report, Heat-Related Mortality-Arizona, 1993-2002, and United States, 1979-2002. MMWR 54(25); 628-630. July 1, 2005. For a complete list of contributors see http://emergency.cdc.gov/disasters/extremeheat/pdf/070105mmwr.pdf . In this report we distinguish three groups at risk of death from exposure to excessive natural heat: Arizona residents, visitors to Arizona from other U.S. states, Canada or Europe, and illegal immigrants crossing the Arizona’s border with Mexico. These groups differ not only in size but also with regard to sociodemographic characteristics, such as age composition, gender, occupation, or race/ethnicity. One of the primary objectives in the comparative analysis of mortality is to measure the likelihood (or risk) of death in the specified population during a particular time. Mortality rates express the likelihood of death – the frequency of a vital event (such as death) in the numerator occurring to individuals in the denominator – and they are generally expressed as units of population in the denominator (per 1,000, 10,000, 100,000, and so forth). It is important to note that the risk of death expressed as mortality rate can only be computed for the residents of Arizona. Neither the number of visitors to Arizona during a calendar year, nor the number of illegal border crossers can be estimated with any precision. The value of comparing the absolute number of deaths, rather than group-specific relative frequencies, ought not to be overestimated. On the other hand, from an epidemiological or public health viewpoint, the number of deaths from a rare cause may be of great importance even if the statistically reliable mortality rate cannot be computed. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 1 Summary of Findings √ From 1992 to 2009, 1,485 deaths from exposure to heat due to weather conditions occurred in Arizona. √ The annual number of deaths due this cause increased from 10 in 1992 to 225 in 2005 and then declined sharply to 137 in 2006, 111 in 2007, and 85 in 2008. In 2009, the number of deaths from exposure to excessive natural heat increased to 110. √ The illegal immigrants crossing the Arizona’s border with Mexico accounted for the majority of these deaths (666 or 44.9 percent). The vast majority (464, or 69.7 percent) of these deaths occurred in the eight years from 2000 to 2007. √ There were 646 deaths from exposure to excessive natural heat among the residents of Arizona (43.5 percent of the total), or 36 deaths on average per year in 1992-2009. √ Visitors to Arizona from other U.S. states, Canada or Europe experienced 95 deaths from exposure to heat due to weather conditions in 19922009. √ The state or country of residence of the sixty-eight decedents in 1992-2009 remains unidentified. √ Approximately seven out of every ten deaths from exposure to excessive natural heat in 1992-2009 were males, and 54.6 percent were Hispanic or Latino. √ In 1992-2009, ninety-five percent of all deaths from exposure to heat to weather conditions occurred during the five months from May through September. √ In 1992-2009, deaths from exposure to excessive natural heat among migrants to Arizona occurred at younger ages compared to deaths from natural heat among the State’s residents. Young adults 20-44 years old accounted for 71 percent of deaths from exposure to excessive natural heat among the migrants from Mexico and other Central/South American countries. √ In contrast, older adults 65 years or older have been at the highest risk of heatstroke or sunstroke among the age groups of Arizona residents. Less than one percent of all deaths from natural heat among migrants were 65 years and older, while 37.2 percent of fatalities due to exposure to heat among Arizona residents were this old. √ In 1992-2009, the four counties along the southern border of Arizona (Cochise, Pima, Santa Cruz, and Yuma) accounted for 90.4 percent of deaths from excessive heat due to weather conditions among the illegal immigrants. √ In contrast, the centrally situated Maricopa County accounted for the majority of deaths from heat due to weather conditions among both the residents of Arizona (64.2 percent) and visitors from other States (47.4 percent). √ Unprecedented increase in the number of deaths from natural heat among migrants (from no fatalities in 1992, to 13 deaths reported in 1998 and 116 deaths in 2005) was likely to be linked to an increase in illegal immigrant traffic across Arizona’s part of the U.S. – Mexico border. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 2 √ The increase in illegal immigrant traffic across Arizona’s border is a good example of the “law of unintended effect”: the result of a rather successful crackdown on illegal immigrants in Texas, New Mexico, and California. By 1998, there was a substantial decline in the number of arrests in the traditional illegal immigration corridors of these three states, while the Tucson sector of Arizona was to become the busiest illegal-crossing corridor along the Southwest border. Prior to 1998, the average annual mortality from exposure to heat among the illegal immigrants crossing the State’s southern border did not exceed three deaths per year. √ The number of deaths from excessive natural heat among illegal immigrants declined by 57.8 percent from 116 in 2005 to 49 in 2006. It then increased to 67 in 2007 and decreased again to 30 in 2008. Tougher enforcement and a weaker U.S. economy have reduced the number of people trying to cross illegally from Mexico. In addition, Hispanics, unlike any other race/ethnic group in Arizona, faced in 2008 not only the economic recession (shared by all), but also other challenges such as the employer-sanction law (a penalty on employers hiring illegal immigrants), and a widespread practice of e-verify (checking the legal-residence status of those seeking employment). The attractiveness of Arizona as a destination for migrants was dramatically diminished resulting not only in the decrease in illegal immigrant traffic across the State’s southern border but also in outmigration of illegal residents. √ The factors behind the gradual decline in the number of deaths from exposure to excessive natural heat among Arizona residents from 77 in 2005 to 33 in 2008 are not clear. The decrease may signify improved heat response plans targeting the homeless and those with prolonged outdoor exposures, as well as reinforced heat advisories and warnings with recommendation to minimize heat exposure. As Fuyuen Yip et al. note “prior to 2005, homeless shelters were customarily open in the evenings and were closed during the day. In 2006, a rule has been enforced in the Arizona Department of Health Services Heat Emergency Response Plan to provide cooling stations such as outdoor tents for people outdoors during extremely hot days. New public health guidance in the Arizona Emergency Heat Response Plan is also provided to employers with outdoor occupational settings to ensure that their employees receive adequate opportunity to rest from the heat, shift schedules to avoid working during the warmest periods of the day and to stay well hydrated”.2 ______________________________________________________________________________________________________________________________________ Fuyuen Yip, W.D Flanders, A. Wolkin, D. Engelthaler, W. Humble, A. Neri, L. Lewis, L. Backer, C. Rubin: Impact of Excess Heat Events in Maricopa County, Arizona: 2000-2005. CDC: National Center for Environmental Health, Health Studies Branch, 2006. 2 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 3 Figure 1 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT* OCCURRING IN ARIZONA BY YEAR, 1992-2009 Number of deaths 270 225 In the eighteen-year period from 1992 to 2009, 1,485 deaths from exposure to excessive natural heat occurred in Arizona. 180 The number of deaths from exposure to excessive natural heat has shown a wide variation from year to year (low = 10 deaths in 1992, high = 225 deaths in 2005. On average, 82 people died every year from a heatstroke or sunstroke in 1992-2009 (Figure 1, Table 1). Approximately seven out of every ten deaths from exposure to excessive natural heat in 1992-2009 were males (1,090/1,485 or 73.4 percent, Table 1), and 54.6 percent (811/1,485, Table 1) were Hispanic or Latino. 119 137 129 118 111 110 85 90 74 45 10 19 50 57 54 23 56 63 O B J E C T I V E 0 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 *The underlying cause of death was classified as E900.0 by ICD-9 (1992-1999) or as X30 by ICD-10 (beginning in 2000). Included are deaths occurring in Arizona from excessive heat due to weather conditions as the cause of heatstroke or sunstroke among both residents of Arizona and non-residents. Excluded are deaths due to excessive heat of man-made origin. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 4 From 1992 to 2009, the illegal immigrants crossing the Arizona’s border with Mexico accounted for the majority of deaths (666 or 44.9 percent) from exposure to excessive natural heat. The vast majority (464, or 69.7 percent) of these deaths occurred in the eight years from 2000 to 2007. Figure 2 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT* OCCURRING IN ARIZONA BY STATE OR COUNTRY OF RESIDENCE AND YEAR, 1992-2009 240 A rizo na There were 646 deaths from exposure to excessive natural heat among the residents of Arizona (43.5 percent of the total), or 36 deaths on average per year in 1992-2009. O the r U .S . s ta te 210 M e x ic o /O the r C e ntra l o r S o uth A m e ric a n c o untry 180 Visitors to Arizona from other U.S. states, Europe or Canada experienced 95 deaths from exposure to heat due to weather conditions during the 1992-2009 period. 150 120 90 60 30 0 Mexico/Other Central or South American country Other U.S. state O B J E C T I 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 V 0 1 1 2 10 4 13 23 35 45 80 72 72 116 49 67 E 30 46 2 3 4 1 9 0 12 4 0 1 6 3 Arizona 8 15 40 47 45 19 49 30 21 17 34 50 37 77 63 34 33 37 Total 10 19 45 50 54 23 74 57 56 63 119 5 129 6 118 8 225 9 137 15 111 85 110 7 *The underlying cause of death was classified as E900.0 by ICD-9 (1992-1999) or as X30 by ICD-10 (beginning in 2000). Included are deaths occurring in Arizona from excessive heat due to weather conditions as the cause of heatstroke or sunstroke among both residents of Arizona and non-residents. Excluded are deaths due to excessive heat of man-made origin. __________________________________________________________________________ 3 4 http://en.wikipedia.org/wiki/Operation_Gatekeeper http://en.wikipedia.org/wiki/United_States_Border_Patrol#El_Paso_Sector.27s_Operation_Hold_the_Line http://www.customs.gov/linkhandler/cgov/newsroom/congressional_test/bs_future/gilbert_testimony.ctt/gilbert_testimony.pdf DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 There was no dramatic climate change, which could explain this unprecedented increase in the number of Arizona deaths from natural heat among illegal immigrants (from no fatalities in 1992, to 13 deaths reported in 1998 and 116 deaths in 2005). Rather, the increase in mortality was likely to be linked to an increase in illegal immigrant traffic across Arizona’s part of the U.S. – Mexico border. It is not unreasonable to assume, that it may have been to some extent the result of a rather successful crackdown on illegal immigrants in Texas, New Mexico and California. By 1998, the success3 of several border operations (Operation Gatekeeper in San Diego, Operation Hold the Line in El Paso, Operation Rio Grande in McAllen) effected a substantial decline in the number of arrests in the traditional illegal immigration corridors of these three states, while the Tucson sector of Arizona’s border was to become “the busiest illegal-crossing corridor along the Southwest border”4. Prior to 1998, the average annual mortality from exposure to heat among the illegal immigrants crossing the State’s southern border did not exceed three deaths per year. 5 Figure 3 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT* OCCURRING IN ARIZONA BY MONTH IN THE EIGHTEEN-YEAR PERIOD, 1992-2009 In Phoenix, Arizona, normal daily maximum temperature reaches ≥1000 F in early June and can remain at that level until mid-September. The historical data collected by the Western Regional Climate Center demonstrate that the temperature of 1000 can be reached as early as March and continue through October.5 Temperatures exceeding 1250 F have been observed in the desert area. The authors of “Impact of Excess Heat Events in Maricopa County, Arizona, 2000-2005”6 rightly point out that in a desert environment such as Maricopa County where summer temperatures average 98oF – 107oF, a heat wave7 is a summer-long experience. Not surprisingly, most deaths from excessive natural heat occurred during summer and late spring (Figure 3, Table 2, Table 3), with the highest number of deaths occurring during the month of July (589 in 1992-2009), followed by June (298), then August (285), May (131) and September (110). In 1992-2009, ninety-five percent of all deaths from exposure to heat to weather conditions occurred during the five months from May through September. ________________________ 5 http://www.wrcc.dri.edu/cgi-bin/clilcd.pl?az23183 Fuyuen Yip, W.D Flanders, A. Wolkin, D. Engelthaler, W. Humble, A. Neri, L. Lewis, L. Backer, C. Rubin. CDC: National Center for Environmental Health, Health Studies Branch, 2006 7 Defined by the National Weather Service as three or more consecutive days of maximum temperatures >90o F Number of deaths 750 589 500 299 285 250 131 0 1 3 9 JA N FEB MA R 110 29 A PR 20 MA Y JUN JUL A UG SEP O CT O B J E C T I V E 4 5 NO V DEC 6 *The underlying cause of death was classified as E900.0 by ICD-9 (1992-1999) or as X30 by ICD-10 (beginning in 2000). Included are deaths occurring in Arizona from excessive heat due to weather conditions as the cause of heatstroke or sunstroke among both residents of Arizona and non-residents. Excluded are deaths due to excessive heat of man-made origin. DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 6 Figure 4 PERCENT DISTRIBUTION OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT* OCCURRING IN ARIZONA BY MONTH AND RESIDENCE STATUS IN THE EIGHTEEN-YEAR PERIOD, 1992-2009 Percent of deaths in specified group: 50% Arizo na resident Regardless of the residence status, most deaths from excessive natural heat occurred during the month of July (Figure 4, Table 2). Compared to the residents of Arizona there were substantially more deaths among migrants to Arizona in March–June, and September-October from 1992 through 2009. In contrast, the number of deaths from excessive natural heat among Arizona residents exceeded the number of deaths among illegal border crossers both in July and August. 40% 30% 20% The difference in the seasonal pattern of mortality may mean that fewer migrants attempted to cross the border in July and August, the two summer months with the highest temperatures (Table 2). O B J Resident o f o ther E U .S. state o r Canada C T I V E Resident o f M exico o r o ther Central o r So uth American co untry 10% 0% JAN FEB MARCH APRIL MAY JUNE JULY AUG SEPT OCT NOV DEC *The underlying cause of death was classified as E900.0 by ICD-9 (1992-1999) or as X30 by ICD-10 (beginning in 2000). DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 7 Figure 5 PERCENT DISTRIBUTION OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT* OCCURRING IN ARIZONA BY AGE GROUP AND RESIDENCE STATUS IN THE EIGHTEEN-YEAR PERIOD, 1992-2009 In 1992-2009, deaths from exposure to excessive natural heat among migrants to Arizona occurred at younger ages compared to deaths from natural heat among the State’s residents (Figure 5). In fact, young adults 20-44 years old during 1992-2009 accounted for 71 percent of deaths from exposure to excessive natural heat among the migrants from Mexico and other Central/South American countries. In contrast, older adults 65 years or older have been at the highest risk of heatstroke or sunstroke among the age groups of Arizona residents. Less than one percent of all deaths from natural heat among migrants were 65 years and older, while 37.2 percent of fatalities due to exposure to heat among Arizona residents were this old. In fact, deaths from excessive heat ranked sixth among the leading causes of accidental death for Arizona elderly 65 years or older in 1998-2008 Percent of deaths in specified group: 75% & Resident o f M exico o r o ther Central o r So uth American co untry 60% 45% Arizo na resident ' ' 30% Resident o f o ther O state o r Canada U .S. (http://www.azdhs.gov/plan/report/im/im/im08/2/pdf/2-9.pdf ). Out of 646 death certificates of Arizona residents who died from exposure to excessive natural heat in 1992-2009, 554 provided injury location (e.g. home, parking lot, or desert). The number of death that occurred outdoors was 2.2 times greater than number of deaths indoors (381 vs. 173) The majority (75.1 percent) of outdoor deaths were <65 years of age. In contrast, 66.5 percent of at home deaths were among decedents 65 years or older. 15% 0% & ' Mexico/O ther Central or South American country O ther state/country Arizona & &' Infants &' & ' ' BJ E C T I V E Elderly & <1 0% Children 1-14 1.8% Adolescents 15-19 11.7% Young adults 20-44 70.9% M iddle-aged adults 45-64 11.7% 0% 2.1% 4.2% 41.1% 32.6% 16.8% 1.1% 2.6% 1.4% 20.7% 32% 37.2% 65+ 0.3% *The underlying cause of death was classified as E900.0 by ICD-9 (1992-1999) or as X30 by ICD-10 (beginning in 2000). DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 8 Figure 6 MEDIAN AGE AT DEATH FROM EXPOSURE TO EXCESSIVE NATURAL HEAT* BY RESIDENCE STATUS, EIGHTEEN-YEAR SUMMARY FOR 1992-2009 75 years One out of two Arizonans who died from exposure to excessive natural heat in 19922009 was older than 57 years of age (Figure 6, Table 5). 50 years 57 years 25 years 45 years 30 y e a rs In 1992-2009, compared to the residents of Arizona, on average visitors from other states were 12 years younger at the time of death, while illegal immigrants from Mexico/other Central or South American country were 27 years younger. 0 years A rizona O t her U.S. st at e or Canada Mexico/ot her Cent ral or Sout h A merican count ry ST A T E OR COUNT RY OF RE SIDE NCE *The underlying cause of death was classified as E900.0 by ICD-9 (1992-1999) or as X30 by ICD-10 (beginning in 2000). DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 9 Figure 7 MEDIAN AGE AT DEATH FROM EXPOSURE TO EXCESSIVE NATURAL HEAT* BY GENDER AND RACE/ETHNIC GROUP, EIGHTEEN-YEAR SUMMARY FOR 1992-2009 Male Female 100 75 In 1992-2009, Asian or Pacific Islander females ranked highest with median age at death from exposure to excessive natural heat at 74 years, exceeding by 44 years the median age at death for Hispanic or Latino females (Figure 7, Table 6). 50 68.5 25 58 53 32 68.5 55 O B J E C T A sian or P acifIic Islander V E 43 30 0 W hit e non Hispanic 74 63 Hispanic or Lat ino Black or A f rican A merican A merican Indian *The underlying cause of death was classified as E900.0 by ICD-9 (1992-1999) or as X30 by ICD-10 (beginning in 2000). DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 10 Figure 8 PERCENT DISTRIBUTION OF DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT* BY RESIDENCE STATUS AND AREA OF OCCURRENCE IN ARIZONA IN THE EIGHTEEN-YEAR PERIOD, 1992-2009 Border count ies St at e or count ry of residence: O ccurrence of deat h: Cent ral A Z count ies Nort hern A Z count ies 26.2% The recent peak in mortality from exposure to excessive natural heat was in 2005. Among the 116 deaths of migrants, 104 occurred in Pima and Yuma counties, most of them in the remote desert areas of the Tohono O’Odham Nation (Figure 9, next page). 64.2% Arizona 9.6% 34.7% 47.4% Other state/country 17.9% Mexico/Other Central or South American country O B J E C T I V 90.4% E 9.5% 0.2% 0% 25% 50% 75% *The underlying cause of death was classified as E900.0 by ICD-9 (1992-1999) or as X30 by ICD-10 (beginning in 2000). DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 In 1992-2009, the four counties along the southern border of Arizona (Cochise, Pima, Santa Cruz, and Yuma) accounted for 90.4 percent of deaths from excessive heat due to weather conditions among the illegal immigrants (Figure 8, Table 3). In contrast, the centrally situated counties, primarily Maricopa, accounted for the majority of deaths from heat due to weather conditions among both the residents of Arizona (64.2 percent) and visitors from other States (47.4 percent). 100% Case summaries of the 116 deaths of migrants to Arizona in 2005, including the geographic location of injury, the underlying cause of death, age, and gender of the deceased, are shown in Table 7. Another map (Figure 10) reveals the spatial pattern of mortality from exposure to excessive natural heat among the 77 Arizona residents who died from this cause in 2005. Their case summaries are shown in Table 8. It is not surprising that the majority (66.2 percent) of resident deaths from exposure to excessive natural heat occurred in the Metropolitan Area of Phoenix-Scottsdale-Mesa, the largest population center in the State. On five records shown in Table 8 (72, 74-77) the state/country of the decedent’s residence was, most likely, misclassified as Arizona. 11 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 12 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 13 Table 1 Characteristics of deaths from exposure to excessive natural heat occurring in Arizona by year, 1992-2009 Total 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Total State or country of residence 1,485 Arizona Other U.S. State or Canada Mexico/Other Central or South American country Other Unknown Geographic region of occurrence 50 54 23 74 57 56 63 119 129 118 225 646 8 15 40 47 35 95 2 3 4 1 9 137 111 85 110 19 49 30 21 17 34 50 37 0 12 4 0 1 5 6 8 77 63 34 33 37 9 15 6 3 7 666 0 1 1 2 10 4 13 23 35 45 80 72 72 116 49 67 30 46 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 9 0 68 0 0 0 0 0 0 0 0 0 0 0 1 1 23 10 3 10 20 5 6 13 22 16 9 24 28 38 48 86 89 77 153 72 67 42 60 Central Arizona counties 548 4 12 24 25 27 13 40 25 12 12 30 35 38 66 62 40 39 44 82 1 1 8 3 11 1 10 4 6 3 3 5 3 6 3 4 4 6 1,090 4 15 36 38 41 17 62 38 37 40 84 90 85 170 104 76 68 85 Male 394 6 4 9 12 13 6 12 19 19 23 35 39 33 55 33 35 17 24 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 White non-Hispanic 503 6 9 33 33 32 11 40 23 15 13 31 25 28 61 52 30 29 32 Hispanic or Latino 811 3 6 4 11 14 8 29 23 37 44 80 85 83 136 70 72 48 58 Black or African American 38 1 1 3 4 3 0 2 1 1 1 0 5 0 7 6 1 1 1 American Indian or Alaska Native 55 0 2 4 1 5 4 2 5 2 1 2 5 1 6 3 2 6 4 Unknown Asian or Pacific Islander Age group 45 855 Female Race/Ethnicity 19 Border counties Northern Arizona counties Gender 10 4 0 0 0 1 0 0 0 0 0 0 1 1 0 1 0 0 0 0 Unknown 74 0 1 1 0 0 0 1 5 1 4 5 8 6 14 6 6 1 15 0-4 21 0 1 1 0 1 1 1 0 0 0 0 4 3 3 1 2 3 0 5-9 2 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 15 0 1 0 0 1 0 0 0 0 0 3 1 0 3 3 1 0 2 15-19 92 1 0 0 1 2 0 8 2 4 3 9 8 8 17 8 9 8 4 20-24 136 0 1 1 2 3 1 5 1 6 10 13 16 21 21 10 7 8 10 25-29 146 0 1 1 1 2 0 5 5 8 9 16 17 18 20 9 16 7 11 30-34 132 1 0 1 4 3 1 1 6 5 8 18 9 7 22 12 15 9 10 35-39 121 0 1 3 2 4 3 9 4 6 3 9 14 6 21 12 9 3 12 40-44 130 0 1 3 6 1 4 6 4 6 6 11 11 14 13 11 14 11 8 45-49 104 0 2 2 1 6 3 7 4 4 3 11 6 10 16 13 2 8 6 50-54 103 1 4 4 4 1 2 4 6 1 5 5 4 5 17 12 10 8 10 55-59 65 2 1 5 2 6 0 4 1 1 1 5 7 2 7 10 5 2 4 60-64 53 0 1 2 6 3 0 2 3 3 2 0 4 2 6 10 3 3 3 65-69 51 1 0 3 4 2 0 4 1 5 2 2 3 3 5 4 3 3 6 70-74 51 1 2 7 4 3 3 5 1 2 2 3 4 2 8 2 0 2 0 75-79 59 2 1 7 3 5 3 4 8 1 0 3 2 1 4 5 2 2 6 80-84 47 0 0 2 2 3 1 1 4 2 2 1 4 3 8 4 4 4 2 85+ 55 1 1 2 8 6 0 4 2 1 1 4 2 3 7 4 4 3 2 102 0 1 1 0 2 1 4 5 1 5 6 13 10 27 7 5 0 14 10-14 Unknown DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 15 Table 1 Characteristics of deaths from exposure to excessive natural heat occurring in Arizona by year, 1992-2009 Total 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 County of occurrence Apache 6 0 0 0 0 3 0 0 0 0 0 1 1 0 0 1 0 0 0 Cochise 28 0 0 0 0 3 2 1 0 3 4 2 9 0 0 1 0 0 3 Coconino 18 0 0 1 1 3 0 0 2 1 0 0 1 1 1 0 2 0 5 Gila 2 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 Graham 3 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 444 3 9 13 17 18 11 37 23 11 10 27 25 32 56 53 30 32 37 51 1 1 6 2 5 1 10 0 5 3 2 3 2 4 1 1 3 1 7 0 0 1 0 0 0 0 2 0 0 0 0 0 1 1 1 1 0 Pima 624 2 5 10 12 7 4 11 11 26 37 75 65 57 116 50 54 34 48 Pinal 67 1 2 7 5 1 1 0 0 1 2 3 9 5 8 4 8 6 4 Santa Cruz 51 0 0 0 1 0 0 1 0 2 1 1 5 4 8 7 10 5 6 Yavapai 11 0 0 1 1 4 0 0 1 0 0 0 1 0 0 1 0 0 2 152 3 1 3 9 6 3 11 17 7 6 8 10 16 29 14 3 3 3 21 0 1 3 1 3 1 3 1 0 0 0 0 0 1 4 1 1 1 January 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 February 3 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 0 0 March 9 0 0 0 0 0 0 0 1 1 0 0 0 2 1 1 0 2 1 Maricopa Mohave Navajo Yuma La Paz Month of death April 29 1 0 1 0 0 0 0 0 2 0 5 1 3 7 2 3 2 2 May 131 0 1 4 1 4 1 0 1 11 14 6 22 9 23 10 9 3 12 June 299 0 6 13 2 15 2 7 17 15 17 37 18 20 20 35 31 35 9 July 589 5 5 18 24 22 8 33 18 16 16 30 48 38 120 77 35 25 51 August 285 4 7 6 19 8 8 26 10 7 7 22 29 30 30 11 23 13 25 September 110 0 0 3 2 3 4 8 5 3 8 17 8 15 16 1 7 3 7 20 0 0 0 2 0 0 0 4 0 0 0 3 0 4 0 3 1 3 4 0 0 0 0 0 0 0 0 1 1 0 0 0 2 0 0 0 0 October November December Autopsy performed No Yes 5 0 0 0 0 1 0 0 1 0 0 0 0 1 1 0 0 1 0 492 3 5 18 25 27 6 24 23 18 13 27 33 29 131 51 20 15 24 992 7 14 27 25 27 17 50 34 38 50 92 96 89 94 86 90 70 86 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 16 Table 2 Characteristics of Arizona Deaths from Exposure to Excessive Natural Heat by Residence Status, Eighteen-year Summary for 1992-2009 State or country of residence Total Total Year of death Gender Unknown 1,485 646 95 666 10 68 10 8 2 0 0 0 1993 19 15 3 1 0 0 1994 45 40 4 1 0 0 1995 50 47 1 2 0 0 1996 54 35 9 10 0 0 1997 23 19 0 4 0 0 1998 74 49 12 13 0 0 1999 57 30 4 23 0 0 2000 56 21 0 35 0 0 2001 63 17 1 45 0 0 2002 119 34 5 80 0 0 2003 129 50 6 72 0 1 2004 118 37 8 72 0 1 2005 225 77 9 116 0 23 2006 137 63 15 49 0 10 2007 111 34 6 67 1 3 2008 85 33 3 30 9 10 2009 110 37 7 46 0 20 Male 1,090 487 68 474 8 53 394 159 27 192 2 14 1 0 0 0 0 1 White non-Hispanic 503 409 53 12 6 23 Hispanic or Latino Unknown 811 129 27 637 2 16 Black or African American 38 29 8 0 1 0 American Indian or Alaska Native 55 51 4 0 0 0 4 3 1 0 0 0 Unknown 74 25 2 17 1 29 0-4 21 20 0 1 0 0 5-9 2 2 0 0 0 0 10-14 15 2 2 11 0 0 15-19 92 9 4 78 1 0 20-24 136 13 4 114 0 5 Asian or Pacific Islander Age group Other 1992 Female Race/Ethnicity Other U.S. State or Canada Arizona Mexico/Other Central or South American country DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 17 Table 2 Characteristics of Arizona Deaths from Exposure to Excessive Natural Heat by Residence Status, Eighteen-year Summary for 1992-2009 State or country of residence Total Geographic region of occurrence Unknown 146 15 11 114 0 6 30-34 132 22 11 97 1 1 35-39 121 34 6 77 1 3 40-44 130 50 7 70 1 2 45-49 104 57 9 35 1 2 50-54 103 65 7 28 1 2 55-59 65 42 11 10 0 2 60-64 53 43 4 5 0 1 65-69 51 48 2 0 1 0 70-74 51 46 3 1 0 1 75-79 59 51 7 0 1 0 80-84 47 43 3 0 1 0 85+ 55 52 1 1 1 0 Unknown 102 32 3 24 0 43 Border counties 855 169 33 602 0 51 Central Arizona counties 548 415 45 63 9 16 82 62 17 1 1 1 January 1 1 0 0 0 0 February 3 2 0 1 0 0 March 9 3 0 6 0 0 29 6 1 21 0 1 May 131 27 6 92 0 6 June 299 103 17 159 8 12 July 589 308 39 209 0 33 August 285 148 19 103 2 13 September 110 40 9 58 0 3 20 4 4 12 0 0 November 4 1 0 3 0 0 December 5 3 0 2 0 0 No 492 301 32 141 4 14 Yes 992 345 63 524 6 54 April October Autopsy performed Other 25-29 Northern Arizona counties Month of death Other U.S. State or Canada Arizona Mexico/Other Central or South American country DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 18 Table 3 Characteristics of Arizona Deaths from Exposure to Excessive Natural Heat by Region, Eighteen-year Summary for 1992-2009 Geographic region of occurrence Total Total Year of death Gender Race/Ethnicity Age group 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Male Female Unknown White non-Hispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander Unknown 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 Border counties 1,485 10 19 45 50 54 23 74 57 56 63 119 129 118 225 137 111 85 110 1,090 394 1 503 811 38 55 4 74 21 2 15 92 136 146 132 121 130 104 103 65 855 5 6 13 22 16 9 24 28 38 48 86 89 77 153 72 67 42 60 611 243 1 124 652 9 10 1 59 3 1 12 76 114 113 101 85 72 48 41 18 Central Arizona counties 548 4 12 24 25 27 13 40 25 12 12 30 35 38 66 62 40 39 44 423 125 0 323 152 29 26 3 15 18 1 2 13 17 31 27 29 55 46 57 40 Northern Arizona counties 82 1 1 8 3 11 1 10 4 6 3 3 5 3 6 3 4 4 6 56 26 0 56 7 0 19 0 0 0 0 1 3 5 2 4 7 3 10 5 7 19 Table 3 Characteristics of Arizona Deaths from Exposure to Excessive Natural Heat by Region, Eighteen-year Summary for 1992-2009 Geographic region of occurrence Total State or country of residence County of occurrence Month of death Autopsy performed 60-64 65-69 70-74 75-79 80-84 85+ Unknown Arizona Other U.S. State or Canada Mexico/Other Central or South American country Other Unknown Apache Cochise Coconino Gila Graham Maricopa Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma La Paz January February March April May June July August September October November December No Yes DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 Border counties 53 51 51 59 47 55 102 646 95 666 10 68 6 28 18 2 3 444 51 7 624 67 51 11 152 21 1 3 9 29 131 299 589 285 110 20 4 5 492 992 20 12 15 10 13 13 88 169 33 602 0 51 0 28 0 0 0 0 0 0 624 0 51 0 152 0 0 2 6 23 106 198 294 139 72 11 2 2 230 624 Central Arizona counties 28 34 28 41 30 37 14 415 45 63 9 16 0 0 0 2 3 444 0 0 0 67 0 11 0 21 0 0 1 6 19 85 272 122 32 7 2 2 215 333 Northern Arizona counties 5 5 8 8 4 5 0 62 17 1 1 1 6 0 18 0 0 0 51 7 0 0 0 0 0 0 1 1 2 0 6 16 23 24 6 2 0 1 47 35 20 Table 4 Deaths from Exposure to Excessive Natural Heat by Geographic Region of Occurrence in Arizona and Residence Status, Eighteen-Year Summary for 1992-2009 State or country of residence Arizona Other U.S. State or Canada Mexico/Other Central or South American country Other Unknown Total Geographic region of occurrence Northern Central Border Arizona Arizona counties counties counties 169 415 62 33 45 17 602 63 1 0 9 1 51 16 1 855 548 82 Total 646 95 666 10 68 1,485 Table 5 Median Age at Death from Exposure to Excessive Natural Heat by Geographic Region of Occurrence in Arizona and Residence Status, Eighteen-Year Summary for 1992-2009 State or country of residence Arizona Other U.S. State or Canada Mexico/Other Central or South American country Total Geographic region of occurrence Northern Central Border Arizona Arizona counties counties counties 60.5 55.0 59.5 33.0 49.0 49.0 30.0 28.0 24.0 33.0 52.0 55.0 Total 57.0 45.0 30.0 41.0 Table 6 Median Age at Death from Exposure to Excessive Natural Heat by Race/Ethnicity and Gender, Eighteen-Year Summary for 1992-2009 Race/Ethnicity White non-Hispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander Total DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 Gender Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Median age at death 53.0 68.5 57.0 32.0 30.0 31.0 58.0 68.5 59.0 55.0 63.0 55.0 43.0 74.0 58.0 41.0 39.0 41.0 21 Table 7 Deaths from Exposure to Excessive Natural Heat of the 116 Migrants to Arizona in 2005: Case Summaries Gender Age Place of injury as entered on the death certificate Injury place description City of death Descriptive cause of death Underlying cause of death ICD10 code Month of death 1 Female 16 N 32 24 674 W 112 54 868, AJO, AZ DESERT AJO PROBABLE HYPERTHERMIA X30 FEB 2 Male 35 N31.38.501 / W111.42.034, CHOULIC VILLAGE, AZ DESERT CHOULIC VILLAGE HEAT STROKE X30 MAR 3 Male 20 UKNOWN UNKNOWN TUCSON PROBABLE HYPERTHERMIA X30 APR 4 Male 27 I-10 AND EMPIRITA RD, TUCSON, AZ DESERT AREA TUCSON PROBABLE HYPERTHERMIA X30 MAY 5 Female 32 AVE 1 1/2 E COUNTY 25TH, YUMA, AZ DESERT YUMA HEAT EXPOSURE X30 APR 6 Male 34 N 32 51 691 W 114 604.02, YUMA, AZ DESERT YUMA EXPOSURE TO ENVIRONMENT HEAT X30 APR 7 Female 39 N 32 27.923 W 114 36.515, YUMA, AZ DESERT YUMA EXPOSURE TO ELEMENTS / HEAT X30 APR 8 Male 27 SR 86 MP 107, SELLS, AZ DESERT SELLS PROBABLE HYPERTHERMIA X30 MAY 9 Male 39 .6 MILES SO HERMANS RD AND 1 MILE W/O, VAHALLARD, AZ DESERT TUCSON HYPERTHERMIA X30 MAY 10 Male 30 3 MI W/O MP 25, SR 286, ROBLES JUNCTION AZ DESERT ROBLES JUNCTION HYPERTHERMIA X30 MAY 11 Male 34 FR 34, MP 50, VAYA CHIN VILLAGE, AZ DESERT VAYA CHIN VILLAGE HYPERTHERMIA X30 MAY 12 Male 15 1/2M S/O HERMANS RD 1M W/O VAHALLA RD, TUCSON, AZ UNKNOWN TUCSON HYPERTHERMIA X30 MAY 13 Male 18 UNKNOWN TUCSON HYPERTHERMIA X30 MAY 14 Female 32 DESERT GUNSIGHT VILLAGE HYPERTHERMIA X30 MAY 15 Female 21 UNKNOWN 3.7 MILES S/O FR 5 1/2 MILE W/O VILLAGE GUNSIGHT VILLLAGE I-19, MP 34 1000 YDS W, GREEN VALLEY, AZ DESERT GREEN VALLEY PROBABLE HYPERTHERMIA X30 APR 16 Male 40 25 MS OF I8 29 E, YUMA, AZ DESERT YUMA HEAT EXPOSURE X30 MAY 17 Male 40 UNKNOWN DESERT TUCSON COMPLICATIONS OF SEVERE HEAT STROKE X30 JUN 18 Male 20 UNKNOWN UNKNOWN TUCSON HYPERTHERMIA X30 MAY 19 Male 37 2 M S/O SR 86,MP147, ROBLES JUNCTION, AZ DESERT ROBLES JUNCTION HYPERTHERMIA X30 MAY 20 Female 48 AVE 1E & COUNTY 23, YUMA, AZ DESERT YUMA EXPOSURE TO THE ELEMENTS X30 MAY 21 Male 19 ARIVACA RD 3 MI N/O MP 15, ARIVACA, AZ DESERT ARIVACA HYPERTHERMIA X30 MAY 22 Male 31 3/10 MILE W/O FR 30, MP1 CROW HANG VILLAGE, AZ DESERT CROW HANG VILLAGE PROBABLE HYPERTHERMIA X30 JUN 23 Female 61 COUNTY 10TH AVE F, YUMA, AZ DESERT YUMA EXPOSURE TO THE ELEMENTS X30 MAY 24 Male 42 UKNOWN DESERT AREA KUKATEL VILLAGE HYPERTHERMIA X30 JUN 25 Male 31 UNKNOWN DESERT AREA TOPAWA VILLAGE PROBABLE HYPERTHERMIA X30 JUN 26 Male 33 3/4 MILE W/O 1-19 KM 53, GREEN VALLEY, AZ DESERT GREEN VALLEY PROBABLE HYPERTHERMIA X30 JUN 27 Male 38 7 MILES W/O MP8, ARIVACA RD, GREEN VALLEY, AZ DESERT GREEN VALLEY PROBABLE HYPERTHERMIA X30 JUN 28 Male 18 UNKNOWN UNKNOWN TUCSON HYPERTHERMIA X30 MAY 29 Male 37 N 32.25.174/W111.44.320, TUCSON, AZ DESERT TUCSON HYPERTHERMIA X30 MAY 30 Female 23 UNKNOWN DESERT TUCSON COMPLICATIONS OF HYPERTHERMIA X30 JUL 31 Male 13 N 31.53.153/W 111.47.223, AL CHUKSON VILLAGE, AZ DESERT AL CHUKSON HYPERTHERMIA X30 JUL 32 Female 17 6 MI S/O PISINOMO VILLAGE, PISINOMO VILLAGE, AZ DESERT TUCSON PROBABLE HYPERTHERMIA X30 JUL 33 Female 18 2.1 MILES S/O VILLAGE, AK CHIN VILLAGE, AZ DESERT AK CHIN VILLAGE PROBABLE HYPERTHERMIA X30 JUL 34 Male 48 3 M NW/O VILLAGE, VAMORI VILLAGE, AZ DESERT VAMORI VILLAGE PROBABLE HYPERTHERMIA X30 JUL 35 Female 39 N 31.48.474/W 111.59.630, COWLIC VILLAGE, AZ DESERT SELLS PROBABLE HYPERTHERMIA X30 JUL 36 Male 28 HWY 86 MP 103, SELLS, AZ DESERT WASH SELLS PROBABLE HYPERTHERMIA X30 JUN 37 Male 39 1.2 MILE W/O VILLAGE, VAMORI VLG, AZ DESERT VAMORI VILLAGE PROBABLE HYPERTHERMIA X30 JUL 38 Male 32 6/5 MILES W/O SANDARIO RD AND GARCIA STRIP, TUCSON,AZ DESERT TUCSON PROBABLE HYPERTHERMIA X30 JUL 39 Female 21 4 MILES S/O VILLAGE, VAMORI VILLAGE, AZ VAMORI VILLAGE PROBABLE HYPERTHERMIA X30 JUL DESERT DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 22 Table 7 Deaths from Exposure to Excessive Natural Heat of the 116 Migrants to Arizona in 2005: Case Summaries Gender Age Place of injury as entered on the death certificate Injury place description City of death Descriptive cause of death Underlying cause of death ICD10 code Month of death 40 Male 26 N.31.55.729/W 111.28.026, SASABE, AZ DESERT SASABE PROBABLE HYPERTHERMIA X30 JUL 41 Male 45 UNKNOWN UNKNOWN ARIVACA HYPERTHERMIA X30 JUN 42 Female 35 N 31.89.105/W 111.48.734, ROBLES JUNCTION, AZ DESERT 43 Female 14 44 Male 24 UNKNOWN 45 Female 26 N 31.28.317 W 111.16.369, NOGALES, AZ 46 Female 37 47 Female 48 49 50 Female 21 9.1 MILES E/O FR 19, MP 10, FRESNAL VILLAGE, AZ DESERT FRESNAL VILLAGE PROBABLE HYPERTHERMIA X30 JUL 51 Male 39 7850 N SILVERBELL RD, TUCSON, AZ DESERT TUCSON HYPERTHERMIA X30 JUL 52 Male 20 3000 W CAMINO KINO, GREEN VALLEY, AZ DESERT GREEN VALLEY PROBABLE HYPERTHERMIA X30 JUL 53 Female 18 5.2 MILES S/O PAPAGO FARMS, PAPAGO FARMS, AZ DESERT PAPAGO FARMS HYPERTHERMIA X30 JUL 54 Male 23 N31.44.075/W 111.4.079, ARIVACA, AZ DESERT ARIVACA PROBABLE HYPERTHERMIA X30 JUL 55 Male 55 N 32.05.916 W 113.22.169, YUMA, AZ DESERT YUMA HEAT EXPOSURE AND DEHYDRATION X30 JUL 56 Male 25 5.3 MILES SE/O VILLAGE, AK CHIN VILLAGE, AZ DESERT AK CHIN VILLAGE PROBABLE HYPERTHERMIA X30 JUN 57 Female 42 7 MILES E/O HWY 286 MP 8, ROBLES JUNCTION, AZ DESERT ROBLES JUNCTION PROBABLE HYPERTHERMIA X30 JUL 58 Male 32 1.9 MILES S/O VILLAGE, AK CHIN VILLAGE, AZ DESERT AK CHIN VILLAGE HYPERTHERMIA X30 JUL 59 Male 50 3 MILES S/O MP 8 ON ARIVACA RD, ARIVACA, AZ DESERT ARIVACA PROBABLE HYPERTHERMIA X30 JUL 60 Male 25 2.5 MILES E/O TEST 2, AJO WELL RD, AJO, AZ DESERT AJO PROBABLE HYPERTHERMIA X30 AUG 61 Male 31 UNKNOWN UNKNOWN RED ROCK PROBABLE HYPERTHERMIA X30 MAY 62 Male 27 16901 S OLD SONOITA HWY, VAIL, AZ DESERT VAIL HYPERTHERMIA X30 JUL 63 Male 46 FR 5, 6 MILES S/O SR 86, GUNSIGHT, AZ DESERT GUNSIGHT PROBABLE HYPERTHERMIA X30 AUG 64 Male 16 3E AND COUNTY 24, YUMA, AZ DESERT YUMA HEAT EXPOSURE, DEHYDRATION X30 JUL 65 Male 23 5.2 MILES NW/O SANDARIO RD, SR 86, ROBLES JUNCTION, AZ DESERT ROBLES JUNCTION PROBABLE HYPERTHERMIA X30 JUL 66 Male 16 5.6 MILES S/O SR 86 MP 101, SELLS, AZ DESERT SELLS PROBABLE HYPERTHERMIA X30 AUG 67 Male 38 32 35.405 N 113 41.522 W, YUMA, AZ DESERT YUMA EXPOSURE TO ELEMENTS, HEAT X30 JUL 68 Male 23 SR 286, MP 25, THREE POINTS, AZ DESERT AREA THREE POINTS HYPERTHERMIA X30 JUL 69 Male 14 5.6 MILES S/O SR 86, MP 101, SELLS, AZ DESERT SELLS PROBABLE HYPERTHERMIA X30 AUG 70 Male 24 N 31 42 072 W 111 05 349, NOGALES, AZ DESERT AREA NOGALES HYPERTHERMIA X30 JUL 71 Male 45 14500 W HERMAN'S RD, ROBLES JUNCANTION, AZ DESERT 72 Male 38 73 Male 17 CD 18 1/2 & LEVY RD, YUMA, AZ DESERT YUMA HEAT EXPOSURE X30 JUL 74 Male 27 UNKNOWN DESERT AREA CUCKELBUR VILLAGE HYPERTHERMIA X30 JUL 75 Male 54 2.5 MILES S/O VILLAGE, TOPAWSA VILLAGE, AZ DESERT TOPAWA VILLAGE HYPERTHERMIA X30 SEP 76 Male 19 6 MILES E/O SR, MP 77, AJO, AZ DESERT AJO PROBABLE HYPERTHERMIA X30 SEP 77 Male 52 UNKNOWN UNKNOWN NOLK VILLAGE HYPERTHERMIA X30 SEP 78 Male 50 3 MILES W/O SR 286, MP 31, ROBLES JUNCTION, AZ DESERT ROBLES JUNCTION PROBABLE HYPERTHERMIA X30 JUL ROBLES JUNCTION PROBABLE HYPERTHERMIA X30 JUL SELLS HYPERTHERMIA X30 JUL DESERT TUCSON COMPLICATIONS OF HYPERTHERMIA X30 JUL DESERT NOGALES PROBABLE HYPERTHERMIA X30 JUL N 31.39646/W 111.43.223, SELLS, AZ DESERT SELLS PROBABLE HYPERTHERMIA X30 JUL 24 I-10 W/B MP 254, TUCSON, AZ ROADWAY TUCSON HYPERTHERMIA X30 JUL Female 20 250 DUQUESNE RD, NOGALES, AZ DESERT NOGALES PROBABLE HYPERTHERMIA X30 JUL Female 20 UNKNOWN DESERT TUCSON COMPLICATIONS OF HYPERTHERMIA X30 JUL ROBLES JUNCTION PROBABLE HYPERTHERMIA X30 JUL ARIVACA PROBABLE HYPERTHERMIA X30 JUL DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 23 Table 7 Deaths from Exposure to Excessive Natural Heat of the 116 Migrants to Arizona in 2005: Case Summaries Gender Age Place of injury as entered on the death certificate Injury place description City of death Descriptive cause of death Underlying cause of death ICD10 code Month of death 79 Male 23 4 MILES W/O SR 286, MP 34, ROBLES JUNCTION, AZ DESERT ROBLES JUNCTION PROBABLE HYPERTHERMIA X30 JUL 80 Female 25 4E & CO 19TH ST, YUMA, AZ DESERT YUMA EXPOSURE TO THE ELEMENTS X30 AUG 81 Male 30 32 34 847 N 114 33.25, YUMA, AZ DESERT YUMA HEAT EXPOSURE X30 AUG 82 Male 30 GPS 32 22.94 N 113 37.635 OUTSIDE YUMA CITY BY WELLTON DESERT YUMA HEAT EXPOSURE X30 AUG 83 Female 31 SR 86, MP 31, ROBLES JUNCTION, AZ DESERT ROBLES JUNCTION PROBABLE HYPERTHERMIA X30 JUL 84 Male 18 N 31.44.72 W 11.54.25, VAMORI VILLAGE, AZ DESERT VAMORI VILLAGE PROBABLE HYPERTHERMIA X30 SEP 85 Female 23 UNKNOWN UNKNOWN PHOENIX MULTIORGAN FAILURE X30 OCT 86 Male 18 UNKNOWN UNKNOWN NOGALES HYPERTHERMIA X30 SEP 87 Male 45 AVE 25E NEAR MEX US BORDER, WELLTON, AZ DESERT WELLTON EXPOSURE TO ELEMENTS & HEAT X30 AUG 88 Male 36 N 32.12.579 / W 111.52.705, SIL NAKYA VILLAGE, AZ DESERT SIL NAKYA VILLAGE PROBABLE HYPERTHERMIA X30 AUG 89 Male 23 3/4 MILE S/O SUNSHINE AND CURTIS RDS, SILVERBELL, AZ DESERT SILVER BELL HYPERTHERMIA X30 SEP 90 Male 29 2.5 MILES N/O ARIVACA RD MP 13, ARIVACA, AZ DESERT ARIVACA HYPERTHERMIA X30 JUL 91 Male 28 GPS N32.25.612 W 114.26.276, YUMA, AZ DESERT YUMA EXPOSURE TO THE ELEMENTS (HEAT) X30 AUG 92 Male 21 1E AND 19TH, YUMA, AZ DESERT YUMA EXPOSURE TO THE ELEMENTS (HEAT) X30 AUG 93 Male 37 1/2 M N/O MP 5.5 ARIVACA RD, ARIVACA, AZ DESERT ARIVACA HYPERTHERMIA X30 MAY 94 Male 35 2961 HIGHWAY 82, SONOITA, AZ DESERT SONOITA PROBABLE HYPERTHERMIA X30 SEP 95 Female 34 UNKNOWN DESERT TUCSON PROBABLE HYPERTHERMIA X30 JUL 96 Male 15 SR 30, 1/2 MILE S/O VILLAGE, COBABI VILLAGE, AZ UNKNOWN COBABI VILLAGE PROBABLE HYPERTHERMIA X30 JUL 97 Male 28 2 M W/O MP 12, SR 286, SASABE, AZ DESERT SASABE EXPOSED TO HOSTILE ENVIRONMENT X30 OCT 98 Female 41 SR 286 MP 25 SABABE, AZ DESERT AREA SASABE PROBABLE HYPERTHERMIA X30 MAY 99 Female 32 1.5 MILE W/O FR 20, MP 9, SELLS, AZ DESERT SELLS PROBABLE HYPERTHERMIA X30 JUL 100 Male 37 4 MILES E/O HWY 286, MP 37, ROBLES JUNCTION, AZ DESERT ROBLES JUNCTION PROBABLE HYPERTHERMIA X30 SEP 101 Male 53 ELEPHANT HEAD ROAD W/O I-19, GREEN VALLEY, AZ DESERT GREEN VALLEY HYPERTHERMIA X30 MAY 102 Male 42 N 32 32.8 W 114 40.35, YUMA, AZ ALFALFA FIELD YUMA ENVIRONMENTAL HEAT EXPOSURE X30 SEP 103 Male 27 1/2 MILE W/O FR 19, MP 26, SAN SIMON VILLAGE, AZ DESERT SAN SIMON VILLAGE PROBABLE HYPERTHERMIA X30 JUL 104 Male 57 UNKNOWN DESERT AREA AZ CITY PROBABLE HYPERTHERMIA X30 NOV 105 Male 46 N 31.54.279/W 111.53.740, SELLS, AZ DESERT SELLS PROBABLE HYPERTHERMIA X30 SEP 106 Male 34 5 MI W/O ARIVACA AND UNIVERSAL RANCH RDS, ARIVACA,AZ DESERT ARIVACA HYPERTHERMIA X30 AUG 107 Male 21 3.5 MILES SW/O SR 86, MP 105, BIG FIELDS, AZ DESERT BIG FIELDS PROBABLE HYPERTHERMIA X30 JUL 108 Male 27 UNKNOWN DESERT AREA NOGALES HYPERTHERMIA X30 JUL 109 Male 17 20TH ST AND AVE 3E, YUMA, AZ DESERT 110 Male 27 N 31.52.66 W 111.48.66, LITTLE TUCSON VILLAGE, AZ DESERT 111 Male 50 N 32.09.892 W 112.03.556, COVERED WELLS VILLAGE, AZ DESERT 112 Female 32 1 MILE W/O MP 19 ARIVACA RD, AMADO, AZ DESERT YUMA LITTLE TUCSSON VILLAGE COVERED WELLS VILLAGE AMADO 113 Male 43 ARIVACA RD MP 16.5, ARIVACA, AZ DESERT ARIVACA 114 Female 29 4 MILES NW/O MP 6 ON ARIVACA RD, ARIVACA, AZ DESERT ARIVACA PROBABLE HYPERTHERMIA X30 JUL 115 Male 32 N 31 37.308/W 110 40.989 DEGREES, SONITA, AZ DESERT SONOITA PROBABLE HYPERTHERMIA X30 SEP 116 Male 20 UNKNOWN UNKNOWN TUCSON PROBABLE HYPERTHERMIA X30 JUN DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 PROBABLE HYPERTHERMIA X30 AUG PROBABLY HYPERTHERMIA X30 JUL PROBABLE HYPERTHERMIA X30 JUN PROBABLE HYPERTHERMIA X30 JUL PROBABLE HYPERTHERMIA X30 JUL 24 Table 8 Deaths from Exposure to Excessive Natural Heat of the 77 Arizona Residents in 2005: Case Summaries Gender Age Injury place description City of death Descriptive cause of death Underlying cause of death ICD10 code Month of death 1 Female 61 HOME TUCSON COMPLICATIONS OF SEVERE HYPERTHERMIA X30 APR 2 Male 43 PARK GLENDALE HYPERTHERMIA X30 MAY 3 Female 76 DESERT AREA PHOENIX COMPLICATIONS OF ENVIRONMENTAL HEAT EXPOSURE X30 JUN 4 Male 81 YARD PHOENIX COMPLICATIONS OF HYPERTHERMIA X30 JUN 5 Male 32 FIELD MESA COMPLICATION OF HYPERTHERMIA X30 JUN 6 Male 76 RESIDENCE PHOENIX HYPERTHERMIA X30 JUL 7 Female 89 PARKING LOT MESA COMPLICATIONS ASSOCIATED WITH HYPERTHERMIA X30 JUL 8 Female 90 UNKNOWN PHOENIX COMPLICATIONS ASSOCIATED WITH HYPERTHERMIA AND X30 JUL 9 Female PARKING LOT PHOENIX HYPERTHERMIA X30 JUL 10 Male 51 SIDEWALK PHOENIX COMPLICATIONS OF HYPERTHERMIA AND THERMAL INJURIES X30 JUL 11 Male 54 UNKNOWN PHOENIX COMPLICATIONS OF ACUTE LOBAR X30 JUN 12 Male 50 SIDEWALK PHOENIX COMPLICATIONS OF HYPERTHERMIA X30 JUL 13 Male 66 RESIDENCE PHOENIX HYPERTHERMIA X30 JUL 14 Male 64 TUCSON HEAT STROKE X30 JUL 15 Female 42 STREET TUCSON HYPERTHERMIA X30 JUL 16 Female 68 RESIDENCE PHOENIX HYPERTHERMIA X30 JUL 17 Male 71 DESERT AREA SURPRISE COMPLICATIONS OF HYPERTHERMIA AND DEHYDRATION X30 JUL 18 Male 53 YARD CHANDLER HYPERTHERMIA X30 JUL 19 Male 50 UNKNOWN PHOENIX ENVIRONMENTAL EXPOSURE X30 JUL 20 Male 71 RESIDENCE GLENDALE COMPLICATIONS OF HYPERTHERMIA X30 JUL 21 Male 92 RESIDENCE MESA COMPLICATIONS OF HYPERTHERMIA X30 JUL 22 Male 81 YARD SCOTTSDALE HEAT EXPOSURE AND UNDERLYING ARTERIOSCLEROTIC X30 JUL 23 Female 71 RESIDENCE PHOENIX COMPLICATIONS OF ENVIRONMENTAL HEAT EXPOSURE X30 JUL 24 Male 86 ROOF OF A RESIDENCE HOLBROOK COMPLICATIONS OF HYPERTHERMIA X30 JUL 25 Male 51 CARPORT MESA HYPERTHERMIA X30 JUL 26 Female 83 RESIDENCE SUN LAKES HYPERTHERMIA X30 JUL 27 Female 35 RESIDENCE PHOENIX HYPERTHERMIA AND DEHYDRATION X30 JUL 28 Male 89 RESIDENCE GLENDALE OLD AGE X30 JUL 29 Male 52 YARD PHOENIX COMPLICATIONS OF HYPERTHERMIA X30 JUL 30 Male 90 RESIDENCE PHOENIX COMPLICATIONS OF HYPERTHERMIA X30 JUL 31 Male 35 ALLEY PHOENIX COMPLICATIONS OF HYPERTHERMIA X30 JUL 32 Male 52 FIELD PHOENIX HYPERTHERMIA AND NARCOTIC INTOXICATION X30 JUL 33 Male 25 RESIDENCE PHOENIX HYPERTHERMIA AND METHAMPHETAMINE X30 JUL 34 Male 88 DESERT QUARTZSITE EXPOSURE X30 JUL 35 Male 50 FIELD TUCSON PROBABLE HYPERTHERMIA X30 JUL 36 Male 66 PARK PHOENIX HYPERTHERMIA X30 JUL 37 Male 45 STREET PHOENIX COMPLICATIONS OF ENVIRONMENTAL HEAT X30 JUL 38 Male 41 PARKING LOT PHOENIX HYPERTHERMIA X30 JUL 39 Female 1 PARKING LOT SAFFORD HYPERTHERMIA X30 JUL 1 DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 25 Table 8 Deaths from Exposure to Excessive Natural Heat of the 77 Arizona Residents in 2005: Case Summaries Gender Age Injury place description City of death Descriptive cause of death Underlying cause of death ICD10 code Month of death 40 Male 42 STREET PHOENIX HYPERTHERMIA X30 41 Male 70 PARK PHOENIX COMPLICATIONS OF HYPERTHERMIA X30 JUL 42 Male 38 UNKNOWN PHOENIX COMPLICATIONS OF HYPERTHERMIA X30 AUG 43 Female 83 AT HOME LAKE HAVASU CITY HYPERTHERMIA X30 JUL 44 Female 78 SIDEWALK MESA COMPLICATIONS ASSOCIATED WITH HEAT STROKE X30 AUG 45 Male 57 FIELD PHOENIX COMPLICATIONS OF ENVIRONMENTAL HEAT X30 JUL 46 Male 72 RESIDENCE MESA COMPLICATIONS OF ENVIRONMENTAL HEAT EXPOSURE X30 JUL 47 Male 45 ALLEY PHOENIX COMPLICATIONS OF HYPERTHERMIA AND SUN EXPOSURE X30 AUG 48 Female 68 HOME KINGMAN HYPERTHERMIA X30 JUL 49 Male 66 BUSINESS TEMPE COMPLICATIONS OF HYPERTHERMIA X30 JUL 50 Male 49 YARD PHOENIX COMPLICATIONS OF HYPERTHERMIA X30 JUL 51 Male 45 PARKING LOT PHOENIX HYPERTHERMIA X30 JUL 52 Male 50 STREET PHOENIX COMPLICATIONS OF HYPERTHERMIA X30 AUG 53 Male 48 WORK SITE PHOENIX ENVIRONMENTAL EXPOSURE X30 AUG 54 Male 41 BULLHEAD CITY HEAT STROKE X30 AUG 55 Male 31 DESERT AREA SCOTTSDALE HYPERTHERMIA AND DEHYDRATION X30 JUL 56 Male 70 HOME YUMA HEAT EXPOSURE X30 JUL 57 Female 83 HOME YUMA HEAT RELATED DEATH X30 JUL 58 Female 82 RESIDENCE PHOENIX HEAT EXPOSURE COMPLICATING UNDERLYING ARTERIOSCLEROTIC X30 AUG 59 Male 59 OUTSIDE CONVENIENT STORE TUCSON HYPERTHERMIA X30 AUG 60 Male 55 RESIDENCE MESA ENVIRONMENTAL HEAT EXPOSURE X30 AUG 61 Male 59 HOUSE SOMERTON PROBABLE HEAT RELATED DEATH X30 JUL 62 Male 63 HOME YUMA HEAT RELATED DEATH X30 JUL 63 Male 83 HOME YUMA CARDIOPULMONARY FAILURE X30 JUL 64 Male 51 UNKNOWN PHOENIX ENVIRONMENTAL EXPOSURE X30 AUG 65 Female 4 PARKING LOT PHOENIX COMPLICATIONS OF ENVIRONMENTAL HEAT EXPOSURE X30 SEP 66 Female 75 PARKING LOT TUCSON COMPLICATIONS OF ANOXIA ENCEPHALOPATHY X30 SEP 67 Male 64 TENT CAMP YUMA HEAT EXPOSURE X30 JUL 68 Male 40 CITY PARK MESA SEQUELAE OF HEAT STROKE X30 OCT 69 Male 61 ROAD YUMA CARDIOPULMONARY ARREST X30 AUG 70 Male 48 SIDEWALK PHOENIX HYPOXIC ENCEPHALOPATHY X30 AUG 71 Male 71 STREET PHOENIX COMPLICATIONS OF HYPERTHERMIA X30 NOV 72 Male 35 DESERT ARIVACA HYPERTHERMIA X30 JUL 73 Male 83 NURSING HOME YUMA PNEUMONIA X30 DEC 74 Male NA 3 MI W/O ST, RT 286, MP 32, ROBLES JUNCTION, AZ ROBLES JUNCTION EXPOSURE TO HOSTILE ENVIRONMENT X30 SEP 75 Male NA UNKNOWN ARIVACA PROBABLE HYPERTHERMIA X30 JUL 76 Male NA DESERT ARIVACA HYPERTHERMIA X30 JUN 77 Male NA DESERT GREEN VALLEY HYPERTHERMIA X30 JUN DEATHS FROM EXPOSURE TO EXCESSIVE NATURAL HEAT OCCURRING IN ARIZONA, 1992-2009 JUL 26 Our Web site at http://www.azdhs.gov/plan provides instantaneous access to a wide range of statistical information about health status of Arizonans. The Arizona Health Status and Vital Statistics annual report examines trends in natality, mortality, and morbidity towards established health objectives. Additional reports and studies include Differences in the Health Status Among Race/Ethnic Groups, Advance Vital Statistics by County of Residence, Mortality from Alzheimer's Disease, Injury Mortality among Arizona Residents (accidents, suicides, homicides, legal intervention, firearm-related fatalities, drug-related deaths, drowning deaths, falls among Arizonans 65 years or older), hospital inpatient and emergency room statistics for mental disorders, asthma, diabetes, influenza and pneumonia and substance abuse, Community Vital Statistics, Teenage Pregnancy, Selected Characteristics of Newborns and Mothers Giving Birth by Census Tract in Maricopa County, Pima County and South Phoenix Area, Health Status Profile of American Indians in Arizona, Deaths from Exposure to Excessive Natural Heat Occurring in Arizona, Obesity in Arizona: Prevalence, Hospital Care Utilization, Mortality, and Marital Status and Health. Health Status and Vital Statistics Section Bureau of Public Health Statistics PUBLIC HEALTH SERVICES ARIZONA DEPARTMENT OF HEALTH SERVICES