It’s not just the cities. Extreme heat is a growing threat to rural America.

Summer officially started with an explosion of hot temperature across a large part of the United States. The National Weather Service warns that the “extremely dangerous heat” cooks 160 million people under a heat of the heat extending from the Midwest to the East Coast the rest of this week. It is already fatal.

But although this is the first real taste for extreme heat for northeast cities, some parts of the country like Texas have been cooking since May. Alaska published its very first heat notice this month. Forecastists expect temperatures further at average during the summer.

The summers become warmer, a consequence of the global warming. As the climate warms, the frequency and intensity of heat waves increase and their timing changes, arriving earlier in the season.

But the damage caused by extreme heat is not distributed uniformly, and the most dangerous effects for people are not necessarily found in the hottest places. High temperatures often lead to more emergencies and to hospital visits when they represent a big leap from the average of a place, which means that cooler regions tend to undergo the worst heat damage. This includes places like Alaska and the Northwest Pacific, where temperatures rarely climb more than 80 degrees Fahrenheit and most houses have no air conditioning.

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Now, researchers have discovered that rural areas can suffer more extreme heat than we thought before. A report of the upstream water economy and the Federation of American Scientists has revealed that more than half of the rural postal codes in the United States, which include some 11.5 million Americans, have a “high” heat vulnerability, a consequence not only of temperatures but unique risk factors that occur well outside the big cities. But understanding the factors that aggravate the prejudice to the increase in temperatures could help save lives.

Which makes the campaign so vulnerable to extreme heat

The discussion around the geography of extreme heat tends to focus on the effect of the island of urban heat. Concrete, asphalt, steel and glass of dense urban areas act as a sponge for sun’s rays. Atmospheric pollution of cars, trucks, ovens and factories helps trap hot temperatures in cities, and this warmer air, in turn, accelerates the formation of pollutants such as ozone. On a hot summer day, a city center can be warmer 25 degrees fahrenheit than the surrounding regions. And with so many tight people in these metropolitan ovens, this adds to a massive burden of extreme heat.

But far from the city centers, where houses and buildings are moving away more and more, rural regions are faced with their own long-term challenges that exacerbate the dangers of extreme heat.

A major factor: the median age of the rural population is older than in cities. This counts, because at a physiological level, older adults have more to deal with heat than young people. People living in rural communities also have double chronic health problems that improve heat -caused damage such as high blood pressure and emphysema compared to people living in urban post codes.

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Rural infrastructure is another vulnerability. Although there may be more forests and farms in the country that can cool the air, buildings are often older, with less adequate insulation and cooling systems for this new era of serious heat. The manufactured and mobile houses, more common in rural areas, are particularly sensitive to heat. In the county of Maricopa in Arizona, which houses Phoenix, mobile houses represent 5% of the stock of housing, but represent 30% of the deaths of interior heat.

Even if rural residents have air conditioners and fans, they tend to have lower income and thus devote a higher share of their expenses for electricity, up to 40% more than the inhabitants of the city, which makes them less affordable so that they remain in the cool. It is if they can obtain electricity: rural areas are more vulnerable to breakdowns due to older infrastructure and long distances that the electric lines must be sent, creating greater opportunities like the branches of trees falling on the lines. According to the US Census Bureau, 35.4% of households in rural areas experienced a breakdown for a year, compared to 22.8% of households in urban areas.

Little -populated communities also have fewer public spaces, such as shopping centers and libraries, where people can spend a hot summer day. Rural savings also depend more on the outdoors, and there is still no federal regulation on the workplace in the workplace. Agricultural workers, construction teams and delivery drivers are particularly vulnerable to hot time, and an average of 40 workers die from extreme heat each year.

The health infrastructure is also lacking. “There is a long -standing crisis in health care in rural areas,” said Grace Wickerson, principal climate and health director at the Federation of American Scientists. There are not always nearby clinics and hospitals that can quickly treat thermal emergencies. “To really take care of someone when it is actually in heat stroke, it must be cooled in a few minutes,” said Wickerson.

The Phoenix fire service has now started using ice immersion for heat stroke victims when transporting patients in hospitals to buy precious time. But rural emergency speakers are less likely to have tools like this in their ambulances. “In Montana, which has not traditionally seen a lot of extreme warmth, you would not have these tools on your truck and would not have this awareness to do this cooling. When you see someone who also has to travel kilometers to get care, this will worsen its health -related results,” said Wickerson.

Emergency response times are generally much longer in rural areas, sometimes extending more than 25 minutes. People also have lower income and lower insurance rates far from cities. Hospitals in rural areas are also close. Thus, when severe heat sets in, rural health care systems can be easily exceeded. Before the data from Centers for Disease Control and Prevention and the US Census Bureau, Wickerson and his collaborators have mapped how all these underlying factors converge with extreme heat. They found that 59% of urban postal codes and 54% of rural postal codes are very vulnerable to extreme heat as defined by the CDC heat and health index, which means that they are much more likely to see health problems from extreme heat. Thus, although rural areas can be cooler, the people who live there are faced with dangers of heat comparable to those of the much warmer cities, and geographically, they cover a much wider extent of the country.

Thus, while temperatures in the sticks may not climb to the same peaks they do in the city center, urban heat islands are surrounded by an ocean of rural heat vulnerabilities.

There is no easy way to cool

There are ways to reduce the dangers of scorching time in large expanses of the country, but they are not fast or cheap. They require large upgrades in infrastructure – a more robust energy delivery, more shade and green spaces, better insulation, fresh roofs and more energy -efficient cooling.

The fight against extreme heat also requires greater structural investments to reverse the current crisis in rural health care where a shortage of doctors, hospital closings and longer emergency response times are convergent. But the republican budget proposal will make the opposite, reducing access to health care for millions of Americans who, in turn, lead to dozens of hospitals closing, mainly in rural areas.

Protection of people against dangerous heat also requires policy changes. Most states do not have workers protection on books for extreme heat. Occupational safety and health administration is creating the first federal thermal safety standard for employers, which forces them to give employees breaks, water and shadow when it is hot. But it is not clear to what extent the final regulations will be strong that the Trump administration worked to weaken the rules at all levels.

Local cities and governments could also impose rules that prevent public services from cutting electricity to customers during heat waves, similar to regulations that limit heat stops during the winter.

But there are limits to the quantity of people who can adapt to warmer temperatures. Even the places with a long history of heat management see more dead and hospitalizations while the implacable temperatures continue to rise. This means that reducing the current warming trend must also be part of the solution, reducing greenhouse gas emissions to slow climate change.