"By the end of Heat Wave, Klinenberg has traced the lines of culpability in dozens of directions, drawing a dense and subtle portrait of exactly what happened during that week in July."Malcolm Gladwell, New Yorker
"Klinenberg argues that the heat wave wasn't so much a breakdown of nature as it was a breakdown of the social structure . . . I haven't been able to stop thinking about this bookbecause of the disturbing things we can control, and choose not to. . . . Quietly devastating."Caroline Leavitt, Boston Globe
"Heat Wave is not so much a book about weather, as about the calamitous consequences of forgetting our fellow citizens. . . . A provocative, fascinating book, one that applies to much more than weather disasters."Neil Steinberg, Chicago Sun-Times
"What makes Heat Wave such an essential book at this moment in American politics is that, using the 1995 heat wave as his paradigm, Klinenberg has written a forceful account of what it means to be poor, old, sick and alone in the era of American entrepreneurial government. . . . It's hard to pin down Heat Wave without believing you've just read a tale of slow murder by public policy."Charles Taylor, Salon.com
"Remarkable . . . Klinenberg's immediate aim is to explain the heat wave's unprecedented death toll, and he does so with chilling precision. But his ultimate achievement is far more significant. In exploring what made Chicago so vulnerable to disaster in 1995, Klinenberg provides a riveting account of the changes that reshaped urban America during the 1990s and, indeed, throughout the postwar era."Jim McNeill, American Prospect
"A damning indictment of the 'malign neglect' with which the old, frail and poor and isolated are treated in Chicago."John Adams, Times Higher Education Supplement
"A trenchant, multilayered and well-written social autopsy of disaster. . . . God is in the details, though, and Klinenberg painstakingly lays out for us both the structural and more proximate policies that led to the disastrous Chicago mortality figures of July 1995."Micaela di Leonardo, The Nation
"Heat Wave is an exquisitely written, impeccably researched work, and one could hardly imagine how anyone could do more in a single effort to reveal the deadly social fractures of the cities we live in. In this brilliant book, Klinenberg makes visible the ongoing disaster of poverty and isolation that is silently unraveling in some of the most affluent cities in North America."Joe Hermer, Canadian Journal of Urban Research
"Heat Wave is a great Chicago story and a truly important book about the ways we live and die in cities today. Eric Klinenberg has dug deep to explore the institutions and people of Chicagofrom the media to the mayor's office to the guys down the blockand to show us the crevices of the city that are usually out of sight. The result is a riveting tale of disaster, a book that we will be talking about for years."Studs Terkel
"Deeply moving events not only demand that we are appropriately moved, but also require that we investigate why they occur and how. By analyzing the social and political causes of so-called heat deaths, Eric Klinenberg has powerfully illuminated the causation and culpability associated with the terrible events in Chicago. The book is not only intellectually exciting but may also help to save a great many lives."Amartya Sen
Question: Take us back to July 1995 in the city of Chicago. How hot was it? What were the city and its residents going through?
Klinenberg: Chicago felt tropical, like Fiji or Guam but with an added layer of polluted city air trapping the heat. On the first day of the heat wave, Thursday, July 13, the temperature hit 106 degrees, and the heat indexa combination of heat and humidity that measures the temperature a typical person would feelrose above 120. For a week, the heat persisted, running between the 90s and low 100s. The night temperatures, in the low to mid-80s, were unusually high and didn't provide much relief. Chicago's houses and apartment buildings baked like ovens. Air-conditioning helped, of course, if you were fortunate enough to have it. But many people only had fans and open windows, which just recirculated the hot air.
The city set new records for energy use, which then led to the failure of some power gridsat one point, 49,000 households had no electricity. Many Chicagoans swarmed the city's beaches, but others took to the fire hydrants. More than 3,000 hydrants around Chicago were opened, causing some neighborhoods to lose water pressure on top of losing electricity. When emergency crews came to seal the hydrants, some people threw bricks and rocks to keep them away.
The heat made the city's roads buckle. Train rails warped, causing long commuter and freight delays. City workers watered bridges to prevent them from locking when the plates expanded. Children riding in school buses became so dehydrated and nauseous that they had to be hosed down by the Fire Department. Hundreds of young people were hospitalized with heat-related illnesses. But the elderly, and especially the elderly who lived alone, were most vulnerable to the heat wave.
After about forty-eight hours of continuous exposure to heat, the body's defenses begin to fail. So by Friday, July 14, thousands of Chicagoans had developed severe heat-related illnesses. Paramedics couldn't keep up with emergency calls, and city hospitals were overwhelmed. Twenty-three hospitalsmost on the South and Southwest Sideswent on bypass status, closing the doors of their emergency rooms to new patients. Some ambulance crews drove around the city for miles looking for an open bed.
Hundreds of victims never made it to a hospital. The most overcrowded place in the city was the Cook County Medical Examiners Office, where police transported hundreds of bodies for autopsies. The morgue typically receives about 17 bodies a day and has a total of 222 bays. By Saturdayjust three days into the heat waveits capacity was exceeded by hundreds, and the county had to bring in a fleet of refrigerated trucks to store the bodies. Police officers had to wait as long as three hours for a worker to receive the body. It was gruesome and incredible for this to be happening in the middle of a modern American city.
Question: How many people died as a result of the heat wave?
Klinenberg: In 1995 there were no uniform standards for determining a "heat related death," so officials had to develop them. Edmund Donoghue, Cook County's chief medical examiner, used state-of-the-art criteria to report 465 heat-related deaths for the heat wave week and 521 heat deaths for the month of July. But Mayor Richard M. Daley challenged these findings. "It's hot," the mayor told the media. "But let's not blow it out of proportion. . . . Every day people die of natural causes. You cannot claim that everybody who has died in the last eight or nine days dies of heat. Then everybody in the summer that dies will die of heat." Many local journalists shared Daley's skepticism, and before long the city was mired in a callous debate over whether the so-called heat deaths wereto use the term that recurred at the time"really real."
Medical examiners around the country confirmed that Donoghue's heat-related death criteria were scientifically sound and endorsed his findings. But perhaps the best measure of heat deaths comes from another figurethe "excess death" ratewhich counts the difference between the reported deaths and the typical deaths for a given time period. According to this measure, 739 Chicagoans above the norm died during the week of 14 to 20 Julywhich means that Donoghue had been conservative in his accounts.
Daley's skepticism had a big impact on the public debate, and it still does. Today if you ask Chicagoans about the heat wave they will likely tell you that not all the deaths were "really real." That's a direct legacy of the politics of the disaster.
Question: Who were these 739 people? Was there a "typical" victim?
Klinenberg: The US Centers for Disease Control and Prevention did a thorough study of individual-level risk factors for heat wave victims, and they came up with a list of conditions of vulnerability: living alone, not leaving home daily, lacking access to transportation, being sick or bedridden, not having social contacts nearby, and of course not having an air conditioner.
Given these factors, experts assumed that female victims would outnumber male victims in the heat wave deaths, because women are more prevalent among those who are old and who live alone. But in fact men were more than twice as likely to die as women. This is just one of the surprises that emerged during my study of the Chicago heat wave. To understand this we have to look at the social relationships that elderly women retain but that elderly men tend to lose.
The ethnic and racial differences in mortality are also significant for what they can teach us about urban life. The actual death tolls for African Americans and whites were almost identical, but those numbers are misleading. There are far more elderly whites than elderly African Americans in Chicago, and when the Chicago Public Health Department considered the age differences, they found that the black/white mortality ratio was 1.5 to 1.
Another surprising fact that emerged is that Latinos, who represent about 25 percent of the city population and are disproportionately poor and sick, accounted for only 2 percent of the heat-related deaths. I wrote Heat Wave to make sense of these numbersto show, for instance, why the Latino Little Village neighborhood had a much lower death rate than African American North Lawndale. Many Chicagoans attributed the disparate death patterns to the ethnic differences among blacks, Latinos, and whitesand local experts made much of the purported Latino "family values." But there's a social and spatial context that makes close family ties possible. Chicago's Latinos tend to live in neighborhoods with high population density, busy commercial life in the streets, and vibrant public spaces. Most of the African American neighborhoods with high heat wave death rates had been abandonedby employers, stores, and residentsin recent decades. The social ecology of abandonment, dispersion, and decay makes systems of social support exceedingly difficult to sustain.
Question: So would you call the heat wave deaths primarily a social disaster, rather than a natural one?
Klinenberg: Of course forces of nature played a major role. But these deaths were not an act of God. The authors of an article in the American Journal of Public Health said that the most sophisticated climate models "failed to detect relationships between the weather and mortality that would explain what happened in July 1995 in Chicago." Hundreds of Chicago residents died alone, behind locked doors and sealed windows, out of contact with friends, family, and neighbors, unassisted by public agencies or community groups. There's nothing natural about that.
The death toll was the result of distinct dangers in Chicago's social environment: an increased population of isolated seniors who live and die alone; the culture of fear that makes city dwellers reluctant to trust their neighbors or, sometimes, even leave their houses; the abandonment of neighborhoods by businesses, service providers, and most residents, leaving only the most precarious behind; and the isolation and insecurity of single room occupancy dwellings and other last-ditch low-income housing. None of these common urban conditions show up as causes of death in the medical autopsies or political reports that establish the official record for the heat disaster.
Chicago had such a high mortality rate because it is, as Mayor Daley quipped during the heat wave, the classic American city of extremes. It is a city of great opulence and of boundless optimism, butas William Julius Wilson saysChicago also suffers from an everyday "emergency in slow motion" that its leaders refuse to acknowledge. The heat wave was a particle accelerator for the city: It sped up and made visible the hazardous social conditions that are always present but difficult to perceive. Yes, the weather was extreme. But the deep sources of the tragedy were the everyday disasters that the city tolerates, takes for granted, or has officially forgotten.
Question: What about the response from the city? Did the city government do enough to warn residents of the danger, provide cool shelter, or help people who were in trouble? What could Chicago do differently in future heat waves?
Klinenberg: It is not fair to blame any single organization or individual for an event in which hundreds of people die alone. The heat disaster was a collective failure, and the search for scapegoatswhether the mayor, the media, or the medical systemis just a distraction from the real issues.
Yet there is no question that the city government did not do everything it could to prevent the catastrophe. The city failed to implement its own heat emergency plan, waiting until Saturday, July 15, after hundreds of bodies had already been delivered to the county morgue, to declare an official emergency. The Fire Department refused its paramedics' requests to call in more staff and secure more ambulances, thereby assuring continued delays in its emergency health response. The Police Department did not use its senior units to attend to the elderly residents they were supposed to protect. And since there was no system to monitor the hospital bypass situation, at one point eighteen hospitals were simultaneously refusing new emergency patients.
The city also aggressively used its tremendous public relations apparatus to first deny there was a disaster and then to define the disaster as natural and unpreventable. The city's public statements about the heat deaths, including the executive summary of a special mayor's commission, defended the government's role while obscuring the social roots of the death toll.
But the city did learn from its mistakes. In 1999, when Chicago experienced another severe heat wave, the city issued strongly worded warnings and press releases to the media, opened cooling centers and provided free bus transportation to them, phoned elderly residents, and sent police officers and city workers door-to-door to check up on seniors who lived alone. That aggressive response drastically reduced the death toll of the 1999 heat wave: 110 residents died, a fraction of the 1995 level but still catastrophic. The policy lesson is that there are limits to what any emergency plan can accomplish.
We know that more heat waves are coming. Every major report on global warmingincluding the recent White House studywarns that an increase in severe heat waves is likely. The only way to prevent another heat disaster is to address the isolation, poverty, and fear that are prevalent in so many American cities today. Until we do, natural forces that are out of our control will continue to be uncontrollably dangerous.