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The temperature Friday was rising toward the high 90s when members of the Phoenix Rescue Mission approached Juan Manuel Beltrán Rendón, a weather-worn man sitting on a rock behind JC QuikStop.

Driver Cliff Danley tapped a finger on his head and said that’s where he keeps a map of all the homeless hangouts in Phoenix. One of them is this small lot behind a liquor store off Seventh Avenue and Cocopah Street, where Danley now spotted a few people.

The Ford Transit stopped in front of Beltrán Rendón, who sat under the shade of a neighbor's tree. Brian Farretta hopped out to give the 49-year-old man a couple of Kirkland water bottles, plus bags of toiletries.

Beltrán Rendón said he’s been homeless for at least three years, which would make him one of thousands of Arizonans who experience homelessness.

During the blistering summer months, the Phoenix Rescue Mission travels throughout Phoenix, Avondale, Glendale and Peoria to distribute water bottles and hygiene supplies to homeless people — one of the groups most at risk for heat death.

SPECIAL REPORT: 'The Human Cost of Heat'

“(Homeless) people are in extremely vulnerable states,” said Nathan Smith, a spokesman for Phoenix Rescue Mission.

Smith has seen this vulnerability himself during the nonprofit’s heat-relief campaign.  

“Some people are lying out there looking on the verge of death,” he said. “We’ve had to call the fire department to help us out. If people are at their worst, they’re really struggling.”

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In 2018 heat took 182 lives in the Phoenix area

A preliminary report by the Maricopa County Department of Public Health shows just how deadly the heat has become. The department confirmed there were 182 heat-associated deaths in Maricopa County in 2018. That’s the highest number of heat deaths for the last 13 years.

It's the third consecutive year the death toll has set a new record. In 2016, a total of 154 people died. In 2017, the number rose to 179.

For 2018, in 119 cases, environmental heat was the direct cause of death. In the other 63 cases, heat contributed to the cause of death.

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Among cases where the department could confirm the patient's living situation, 42 people who died were homeless. Others who died include outdoor workers and home-bound adults who may not have had adequate air conditioning.

The majority of deaths occurred outdoors and in men, according to the report.

But the report isn’t conclusive yet, said Dr. Vjollca Berisha, senior epidemiologist at Maricopa County Department of Public Health. Further analysis will provide a more detailed breakdown, such as whether there were more outdoor workers who died than in previous years.

One new number does puzzle Berisha, however.

“Typically we see deaths occur in the months of June, July and August,” Berisha said. “But last year, if you look at September, there were even more deaths than in June. I don’t know what could be the reason. We didn’t see this before and we’re checking why.”

It’s not uncommon for the Phoenix area to endure 100-degree heat in September. Heat monitoring over the years already shows the distressing trend: It’s not only hot in Phoenix, but it’s also getting hotter.

Berisha speculated that if the heat season grows longer, the region might expect more heat-related deaths in September.

But social drivers could be the real explanation.

Phoenix’s record-setting heat in 2016 was not solely responsible for more deaths that year, suggested a study authored by researchers Hana Putnam and David Hondula at Arizona State University.

At the 2019 American Meteorological Society meeting in Phoenix, Hondula gave a presentation on their findings titled “It’s not the heat, it’s the vulnerability.” The study attributed the 2016 spike in heat risk to demographic changes and social factors, which possibly include:

  • More unsheltered homeless people.
  • Aging population.
  • More construction.

A Jan. 21, 2019 count also found that for the sixth straight year, unsheltered homelessness increased in Maricopa County.

Heat Relief Network introduces resources for pets

To address health risks in the hotter months, the Maricopa Association of Governments launched the Heat Relief Network in 2005. The network comprises hydration and air-conditioned refuge locations throughout the Valley, such as Burton Barr Central Library, as well as places where people can donate water.

The refuges are shown on the Heat Relief Network online map.

To raise more awareness, a team of volunteers hits the streets to provide water, printed maps and transportation to the closest shelter, said Brande Mead, human services director for the association.

“One thing we don’t know (about the 2018 heat-associated deaths) is did any of them try to access the Heat Relief Network,” Mead said. “It’s disheartening because our goal is to prevent deaths.”

Mead acknowledged the Heat Relief Network has limitations and gaps in its coverage, including for people who don’t have internet access and elderly people who stay indoors.

This year the Heat Relief Network is introducing new resources for pets, such as collapsible water bowls and leashes. The network also includes 13 emergency hydration stations that allow pets.

Hopefully, this can improve services for homeless people who can’t enter shelters with their dogs, Mead said.

In response to indoor heat risks, the association provides educational programs to senior centers so residents can recognize the signs of heat stroke. Mead also advises residents to check in on their elderly, homebound neighbors on days with heat warnings.

People should be aware that heat doesn’t just affect the elderly, she said, mentioning two deaths that made the news recently.

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On April 22 in Glendale, an 18-month-old girl died after being left in a car.

On May 2, a 16-year-old boy died while hiking Picacho Peak with a Boy Scout group.

"Heat really is deadly in Arizona," Mead said. "It's really sad to hear."

More direct funding, as well as data and feedback, could lead to further improvements with the Heat Relief Network, Mead added.

The association has asked all its partners involved with the Heat Relief Network to record the number of people who use their station, the number of water bottles taken and the number of pets brought in. The public can also send their feedback to the Maricopa Association of Governments.

“We hope it can help us determine what the needs are,” Mead said. “It’s important to know, first off, what kind of impact we’re making, and second, planning for next year.”

MORE: How heat discriminates among vulnerable populations 

Substance abuse program could reduce heat risk 

Alcohol and heat are not a good combination, Danley said during his May 3 route with the Phoenix Rescue Mission. Half of all 2018 heat deaths involved alcohol or drug use. Many of the homeless people the nonprofit encounter are battling alcohol and opioid addictions, he said.

Isaac Healis, a volunteer that day, empathizes because he had been homeless before. For four years, he experienced what it was like to have an addiction while surviving Phoenix summers in the streets. After completing the Phoenix Rescue Mission's recovery program, he's been sober for the first time since he was around 12, he said.

"It's my calling to help out those where I once was," Healis said.

In 2005, Danley also found himself living on the streets for a couple of months, following a marriage that fell apart. He "bombed out" of two recovery programs for substance abuse before completing the Phoenix Rescue Mission's recovery program.

He's now a chaplain and before the heat-relief drive, he lead a group prayer.

The group stopped at the QuikTrip off 27th and Northern Avenues. A motley group of people living in transit was hanging out at the bus stop, including V., a woman who declined to give her full name.

She eyed the Phoenix Rescue Mission van with wariness but accepted a couple of water bottles and a contact card.

"It's a tough time," V. said, referring to the heat, which had now reached the high 90s. "But it's a tough time any time. If I'm not locked up, I'll get inside. I won't come out until nighttime.

"Sometimes it's better to be locked up just to be in there instead of out here," she admitted.

    How does the heat affect your health or everyday life? Reach the reporter at Priscilla.Totiya@azcentral.com or 602-444-8092. Follow her on Twitter: @PriscillaTotiya

    Environmental coverage on azcentral.com and in The Arizona Republic is supported by a grant from the Nina Mason Pulliam Charitable Trust. Follow The Republic environmental reporting team at environment.azcentral.com or at OurGrandAZ on Facebook, Twitter and Instagram.

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