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With temperatures climbing to record highs in San Diego County, especially in Borrego Springs, it's important to understand the way heat and extreme heat affect our bodies.

Extreme heat is defined as summertime temperatures that are much hotter and/or humid than average. Because some places are hotter than others, this depends on what's considered average for a particular location at that time of year. Humid and muggy conditions can make it seem hotter than it really is.

Although many may think health risks of extreme heat stop at heat stroke and exhaustion, "those are actually pretty rare," explained Aaron Bernstein, director of The Center for Climate, Health, and the Global Environment at Harvard T.H. Chan School of Public Health and pediatrician at Boston Children's Hospital.

Bernstein even classified heightened attention paid to these risks as a disservice to the public.

"While heat exhaustion and heat strokes do happen, really what's much more important is that [heat] can make existing diseases flare," Bernstein said.

Because organs do not function as well as normal during periods of extreme heat, risks for individuals with chronic medical problems like diabetes, COPD or heart disease spike during heat waves.

Other vulnerable populations include older individuals – especially those over 80 – pregnant individuals, infants, outdoor workers and those reliant on technology – dependent care, as the threat of power outages looms during intense heat.

"But heat can land you in a healthcare facility at any age," Bernstein said.

Monitor Those at High Risk: Although anyone at any time can suffer from heat-related illness, some people are at greater risk than others:

Infants and young children

People 65 years of age or older

People who are overweight

People who overexert during work or exercise

People who are physically ill, especially with heart disease or high blood pressure, or who take certain medications, such as for depression, insomnia, or poor circulation

Visit adults at risk at least twice a day and closely watch them for signs of heat exhaustion or heat stroke. Infants and young children, of course, need much more frequent watching.

Some factors that might increase your risk of developing a heat-related illness include:

High levels of humidity

Obesity

Fever

Dehydration

Prescription drug use

Heart disease

Mental illness

Poor circulation

Sunburn

Alcohol use

Warning signs of a heat stroke:

An extremely high body temperature (above 103°F)

Red, hot, and dry skin (no sweating)

Rapid, strong pulse

Throbbing headache

Dizziness

Nausea

Confusion

Unconsciousness

Alcohol usePediatric urologist Gregory Tasian of the Children's Hospital of Philadelphia said that the research going back to the 1970s shows that there is a higher prevalence of kidney stones in hotter areas – leading experts to dub the region the "stone belt." A combination of high temperatures and high humidity increases risk of kidney stones.

While a heat wave may not cause a kidney stone on its own, it could contribute to the condition for people who were already at risk. When you consider periods of high temperatures, "you're likely going to have more people who what I call tip over into the stones because they have other risk factors for it," Tasian said. This includes people who have had a history of kidney stones or have a family history of stone disease.

Heat can also affect those with certain mental health conditions. Commonly prescribed treatments for mental health disorders, including selective serotonin reuptake inhibitors (SSRIs), can make patients sweat more, exacerbating the threat of dehydration. Heat waves have also been associated with increased rates.

More days of high heat can also increase the rates of mental health emergencies in hospitals. Temperature spikes across the country are associated with a rise in emergency department visits for mental health reasons, according to study results presented by Amruta Nori-Sarma of Boston University in a briefing. Heat is an external stressor that can exacerbate not only physical conditions but also mental conditions. In extreme heat people may feel lethargic and fatigued. Heat and the body's reactions can also lead to stress, increased depression, and frustration and irritability. All of which can coalesce into anger with less provocation, which is code for cranky.

Heat waves – and its toll on our mental and physical health – are only becoming more frequent and intense with climate change.

"A child born in 2020 in the United States will experience around 35 times more dangerous heat waves, like the one that spread across most of the country in the past week or so, than a child born in the United States in the 19th century," Bernstein said. "[This is] because of climate change, because of our reliance on fossil fuels."

Heat-related deaths often lag from the peak of heat waves and could happen as much as 24 hours later, said professor of global health Kristie Ebi at the University of Washington. This makes it important to pay attention during the following days.

Heat related deaths and illnesses are preventable. Despite this, around 618 people in the United States are killed by extreme heat every year.

"It's a particular problem when temperatures do not fall as much as normal during the night," Ebi said. "So, pay attention, not just on day one, but on days two, three and four, because the accumulation of heat within the core of our bodies starts affecting our organs."

Bernstein added, "Heat does not spare any part of our bodies, but understanding the combination of factors that increase a person's vulnerability can help inform more targeted approaches to prevent hospitalizations and poor outcomes."

Part of the challenge of dealing with high temperatures is that there is no official definition of heat waves and how a population, as a whole, handles higher temperatures, may also depend on behavior and knowledge. Certain social factors like limited mobility, lack of access to air conditioning, language and cultural differences, and being socially isolated all need to be taken into account when identifying and targeting those most at risk, he stressed.

"Those individuals who work in jobs that require you to be outside are going to be the most impacted, and I think that certainly extends beyond kidney stones into the other effects of temperature on human health," Tasian said.

Being proactive and having resources in place to address the potential health consequences of heat waves before they strike is paramount.

Taking heat alert warnings from the National Weather Service as an example, Bernstein explained, "those alerts are being given at temperatures well above when many, if not most, of the people who are vulnerable are already sick and getting hospitalized," marking an opportunity for improvement.

Heat action plans at the local government or community level can include outreach to at-risk groups. These include unhoused people, people with chronic conditions and pregnant people. For example, they can make sure people know where local cooling centers are to take shelter during periods of high heat.

The library is the cooling center for Borrego Springs residents. However, some may not have cars or the ability to drive. Also, time at the library is limited and no pajama parties are allowed, even on the hottest and sweatiest of nights. There's always the question of emergency water and food, especially if the heat wave is accompanied by a power outage or rolling blackout.

When communities open cooling centers during heat waves, those who are socially isolated or people with limited mobility will likely not make the journey, again underscoring the importance of identifying at-risk members of the community beforehand and having a plan.

Summers are going to continue to grow longer with increased days of extreme heat. Maybe, Borrego should have a plan for identifying and communicating with our high-risk populations, as well as evening cool zones, emergency food and drink, paramedic transport, and medical readiness at the clinic.

Tips for Staying Cool

Wear Appropriate Clothing: Choose lightweight, loose-fitting clothing.

Stay Cool Indoors: Stay in an air-conditioned place as much as possible. If your home does not have air conditioning, go to the shopping mall or public library – even a few hours spent in air conditioning can help your body stay cooler when you go back into the heat. Call your local health department to see if there are any heat-relief shelters in your area.

Keep in mind: Electric fans may provide comfort, but when the temperature is in the high 90s, they will not prevent heat-related illness. Taking a cool shower or bath or moving to an air-conditioned place is a much better way to cool off. Use your stove and oven less to maintain a cooler temperature in your home.

Schedule Outdoor Activities Carefully: Try to limit your outdoor activity to when it's coolest, like morning and evening hours. Rest often in shady areas so that your body has a chance to recover.

Pace Yourself: Cut down on exercise during the heat. If you're not accustomed to working or exercising in a hot environment, start slowly and pick up the pace gradually. If exertion in the heat makes your heart pound and leaves you gasping for breath, STOP all activity. Get into a cool area or into the shade, and rest, especially if you become lightheaded, confused, weak, or faint.

Wear Sunscreen: Sunburn affects your body's ability to cool down and can make you dehydrated. If you must go outdoors, protect yourself from the sun by wearing a wide-brimmed hat, sunglasses, and by putting on sunscreen of SPF 15 or higher 30 minutes prior to going out. Continue to reapply it according to the package directions.

Tip: Look for sunscreens that say "broad spectrum" or "UVA/UVB protection" on their labels.

Do Not Leave Children in Cars: Cars can quickly heat up to dangerous temperatures, even with a window cracked open. While anyone left in a parked car is at risk, children are especially at risk of getting a heat stroke or dying. When traveling with children, remember to do the following:

Never leave infants, children or pets in a parked car, even if the windows are cracked open. Leaving a window open is not enough- temperatures inside the car can rise almost 20 degrees Fahrenheit within the first 10 minutes, even with a window cracked open.

Avoid Hot and Heavy Meals: They add heat to your body!

Stay Hydrated

Drink Plenty of Fluids: Drink more fluids, regardless of how active you are. Don't wait until you're thirsty to drink.

Warning: If your doctor limits the amount you drink or has you on water pills, ask how much you should drink while the weather is hot.

Stay away from very sugary or alcoholic drinks – these actually cause you to lose more body fluid. Also avoid very cold drinks, because they can cause stomach cramps.

Replace Salt and Minerals: Heavy sweating removes salt and minerals from the body that need to be replaced. A sports drink can replace the salt and minerals you lose in sweat.

If you are on a low-salt diet, have diabetes, high blood pressure, or other chronic conditions, talk with your doctor before drinking a sports beverage or taking salt tablets.

Keep Your Pets Hydrated: Provide plenty of fresh water for your pets, and leave the water in a shady area.

Stay Informed

Check for Updates: Check your local news for extreme heat alerts and safety tips and to learn about any cooling shelters in your area.

Know the Signs: Learn the signs and symptoms of heat-related illnesses and how to treat them.

Use a Buddy System: When working in the heat, monitor the condition of your co-workers and have someone do the same for you. Heat-induced illness can cause a person to become confused or lose consciousness. If you are 65 years of age or older, have a friend or relative call to check on you twice a day during a heat wave. If you know someone in this age group, check on them at least twice a day.