Pima County Heat Deaths Declining Indoors, But Overall Mortality Persists as County Expands 2026 Response

TUCSON — Pima County health officials told the Board of Supervisors on Tuesday that indoor heat-related deaths have decreased in recent years, a trend they attributed to expanded community outreach and cooling center access, but warned that overall heat mortality remains stubbornly high as chronic disease and substance use continue to drive deaths. The presentation came during the board's inaugural study session, held May 12.

Pima County Health Department Director Dr. Cullen presented the county's 2025 heat season review and 2026 action plan, telling supervisors that heat-caused deaths — those directly attributable to heat — have declined over the three-year period from 2023 to 2025. However, she said overall heat-related deaths, which include deaths where heat was a contributing factor alongside chronic illness, have not shown a significant decrease. Deaths involving hypertension as a contributing factor increased 150% during that period. Dr. Cullen noted that more than half of heat-caused deaths occurred outdoors, while 20% of indoor deaths occurred in mobile or manufactured homes, and 90% of indoor deaths involved non-functioning or turned-off air conditioning. Emergency department and urgent care visits for heat-related illness rose 13% in 2025, with unhoused individuals comprising 9.1% of those visits — disproportionate to their share of the overall population.

For the 2026 heat season, Dr. Cullen said the county has 45 cooling centers registered, with 90% having opened May 4 and the remainder scheduled to open in early June. She said a second retrofitted shipping container cooling unit — known as a "cooltainer" — has been secured from the Arizona Department of Health Services and will be installed at Augie Acuña Los Niños Park, an area identified as high-risk through the county's heat vulnerability mapping. The first cooltainer, located in Ajo, was described as a success even when serving small numbers of residents. Dr. Cullen also said the county issued a request for quotes last week to fund extended cooling center hours into evenings and weekends, acknowledging that most centers currently close during standard business hours when temperatures remain dangerous. The county noted the earliest 100-degree day in 2026 was recorded March 19, compared to April 11 in 2025.

Board Chair Allen asked Dr. Cullen for a detailed report on implementation of the county's heat ordinance, noting that labor organizations including Jobs with Justice have been pushing for statewide enforcement authority. Dr. Cullen said that as of the previous day, no complaints had been formally filed with the county under the ordinance. She said she served on the state committee that developed heat safety recommendations for the governor and the Arizona Department of Occupational Safety and Health, adding that those recommendations mirrored Pima County's existing ordinance. She said the governing body of ADOSH recommended the standards remain guidance rather than regulation. Supervisor Cano said he was the first state legislator to introduce heat safety standards under the Ducey administration and asked the county to ensure its own contractors are complying with heat safety requirements.

Pima County Finance Director Art Cuaron presented the monthly financial update, reporting that general fund revenues are exceeding budget by $15.6 million and expenditures are trending $10.7 million below budget — an improvement of $3 million from the prior month. Those figures have produced a fund balance increase of $42.5 million, of which $37.3 million was included in the county administrator's recommended budget delivered April 17. After accounting for a required reserve increase to $94.1 million, the county's available unrestricted fund balance stands at $3.1 million. Key upcoming dates include a May 26 board meeting for the recommended budget presentation and tentative budget adoption, final budget adoption June 23, and tax levy adoption August 11.

Supervisor Cano raised concerns during the financial presentation about the reliability of revenue figures coming from the Treasurer's Office and Assessor's Office, asking whether the Finance Department was providing technical assistance to ensure accuracy. County Administrator Lesher said staff from multiple county departments are actively working with the Treasurer's Office on IT needs and the selection of a new banking partner, and that the county attorney's office has been engaged to clarify the board's authority over functions in the treasurer's and assessor's offices. "We do have some questions and concerns right now," Lesher said. Supervisor Cano said the board "has got to work on this collaboratively" and pointed to what he called a "roller coaster effect" on reported revenues. Supervisor Heinz asked whether the Finance Department independently verifies account balances rather than relying solely on treasurer reports; Cuaron confirmed the office conducts its own bank reconciliations.

Also discussed:

Retirements honored for Stephen King, permit regulatory compliance officer with the Regional Wastewater Reclamation Department (26 years), and Sherry Prochaska, business systems analyst with Information Technology (21 years)
Chair Allen flagged reports that the federal government is considering reducing the federal gas tax and asked staff to analyze potential impacts on county Highway User Revenue Fund receipts; Administrator Lesher said a broader transportation funding update would be appropriate
Arizona Border Counties Coalition update: State DOT confirmed a road-paving project in Sonora to the Sasabe port of entry; Cochise County is developing a first-ever port of authority board for the Douglas/Agua Prieta crossing
Administrator Lesher told the board that Santa Cruz County declined to join the newly renamed Southern Arizona Education Council, contrary to earlier expectations of a two-county partnership; staff has been asked to obtain a full status update from the organization