The heat is on — and the emergency is inside our homes

It felt like 120 degrees in some Philly neighborhoods last summer — the hottest season on record worldwide — thanks to the urban “heat island” effect.

On June 22, the city declared its first heat health emergency of 2025. We’re just getting warmed up — and for thousands of residents, the real emergency is inside their homes.

Extreme heat is not just uncomfortable — it’s deadly, and it hits our most vulnerable neighbors hardest. Heat-related deaths among older citizens have increased by about 85% in the past two decades.

When temperatures are very high, it is important for people to stay cool. It’s also important to stay indoors. Extreme heat worsens air quality, as seen by the Code Orange alert, encouraging folks to stay inside.

But what happens when it’s not safe to stay in your own home?

Thousands of customers have endured the sweltering heat in their homes without any power for multiple days, thanks to a recent storm — one of the worst the city has experienced. Climate change doesn’t just bring powerful storms and heat waves, it also fuels public health emergencies.

As a primary care internist and pediatrician, I worry.

I worry that children with asthma will be rushed to the emergency room because they can’t breathe. I worry about my patients with high blood pressure, because their medications may place them at higher risk for heat-related illness and complications. I worry about patients living with heart disease, kidney disease, and mental illness, who may end up in the hospital when the heat worsens their health.

Even those who have electricity remain at risk. Rising energy costs force families to make impossible trade-offs: food, medications, or the energy bill? Every day of a heat wave, their lives are in jeopardy. Due to historical redlining and systemic racism, we know our low-income neighbors and communities of color are at the highest risk. And it doesn’t help that Philadelphia’s old housing makes it harder to stay cool.

Energy support to stay cool can be a matter of life and death. A program called the Low Income Home Energy Assistance Program helps families struggling with energy insecurity, or the inability to cover the cost of energy bills, pay for summer air-conditioning and other cooling needs. Unfortunately, last summer funding ran out, and the Energy Coordinating Agency was forced to turn more than 1,000 Philadelphians away, putting them on a wait list for A/C units. They were told to try again this year due to insufficient funds.

But this summer, many won’t have anywhere to turn. The Trump administration has taken a bulldozer to our public health infrastructure. It fired the entire staff that runs this $4 billion program. There is no funding to repair or replace existing A/C equipment for recipients, and if someone’s A/C breaks this week, there is no staff to assist them.

Climate scientists expect summers to continue getting hotter each year. Physicians fear we will see more people in the hospital as a result. Climate change is here now, and it is killing us. It feels like the world is on fire, and we are barely moving to grab any fire extinguishers.

We must act quickly and strengthen state programs to better support Philadelphians experiencing severe heat and to prevent unnecessary deaths. In addition, we need to campaign for Pennsylvania to follow the lead of more than 20 other states that have implemented protection from utility disconnection during severe heat waves.

Prioritizing cooling support will lower medical costs, improve health, and save lives in the midst of what has become our new normal.

We’re in the heat of the crisis, and it’s time to act like it.

Joniqua Ceasar is a primary care internist and pediatrician in Philadelphia who serves on the board of Physicians for Social Responsibility Pennsylvania.