As Deadly Heat Waves Rise, Federal Policy Fails to Cover Air Conditioning

Federal Safety Net Covers Heating But Cooling is Optional. That Needs to Change, an LDI Fellow Writes

May 14, 2026

By:

Charles Leonard, PharmD, MSCE, MPH
and Anthony Nicome, MHS, MPH

Print:

This First Opinion originally appeared in STAT News on May 13, 2026.

During the first heat wave of 2025, 55-year-old Shauna Thomas was found dead in her suburban St. Louis apartment after spending at least three days without air conditioning or water. Police said she had “several medical issues” that may have contributed.

Clinicians, community leaders, and public health workers often advise people with chronic diseases such as diabetes to use air conditioning or go to an air-conditioned building. But that advice presumes that cooling is actually affordable and available.

Thomas’ tragic death underscores why cooling should be added to a key government program that provides heat.

Extreme heat is not simply uncomfortable. It’s a medical stress test. Early-season heat waves are already hitting Western parts of the country. The Eastern U.S. is likely to follow later this month. Forty million Americans live with diabetes, and heat can quickly drive dehydration, disrupt daily routines, and destabilize blood sugar, sometimes requiring urgent care. Reliable cooling can prevent many of these emergencies. When cooling equipment fails, energy costs make it unaffordable, or it’s simply not available, people lose the ability to manage chronic conditions.

Energy insecurity concentrates among lower‑income households, renters, and Black and Latino communities. In cities, housing quality, tree cover, and infrastructure shape neighborhood heat exposure, leaving some communities consistently hotter than others. These patterns reflect decades of disinvestment and housing policy decisions, not personal choices.

In regions where central air conditioning has been historically less common, rising temperatures now collide with homes never designed for extreme heat. Outside urban centers, older housing stock and thinner safety nets create similar risks. This is an environmental-justice challenge rooted in policy, infrastructure, and who bears the cost of inaction.

Read the full op-ed here.