PHOENIX (AP) — Public health officials in Arizona’s most populous county on Wednesday reported they confirmed a staggering 645 heat-associated deaths last year — more than 50% higher than 2022 and another consecutive annual record in arid metro Phoenix.

The numbers in the preliminary report by the Maricopa County Department of Public Health alarmed officials in America’s hottest big metro, raising concerns about how to better protect vulnerable groups such as homeless people and older adults from the blistering summer heat.

The report said two-thirds of the county’s heat-related deaths in 2023 were people 50 years or older, and 71% were on days the National Weather Service issued an excessive heat warning.

“Deaths from heat are a major public health issue within our community, and it’s going to take support from every level to improve the situation,” said Dr. Rebecca Sunenshine, the county public health department’s medical director. “With a coordinated county-wide strategy, nearly every one of these deaths can be prevented.”

The heat-associated deaths confirmed in 2023 represented a huge jump from 2022, when there were 425 such deaths. There were 339 heat-associated deaths confirmed in 2021.

No other major metropolitan area in the U.S. has reported such high heat-associated death figures or spends so much time tracking and studying them.

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Maricopa County’s public health officials since 2006 have tracked deaths in which environmental heat was the cause or a major contributing factor. The department uses information from preliminary death reports completed by the county’s Office of the Medical Examiner, along with data in death certificates on file with the county’s Office of Vital Registration.

Last summer, Phoenix experienced the hottest three months since record-keeping began in 1895, including the hottest July and the second-hottest August. The daily average temperature of 97 F (36.1 C) in June, July and August passed the previous record of 96.7 F (35.9 C) set three years ago.

Phoenix also set a record in July with a 31-day streak of highs at or above 110 F (43.3 C).

In recognition of the growing problem of heat associated deaths, Arizona’s department of public health last week named a physician as the first statewide heat officer in the nation to address extreme environmental heat.

Dr. Eugene Livar was appointed to the state role under Gov. Katie Hobbs’ extreme heat preparedness plan.

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The cities of Phoenix and Miami have their own heat officers to oversee ways to protect people and the overall community from extreme heat as climate change leads to more frequent and enduring heat waves.

Phoenix, the hottest big city in the United States, also has an office of heat response and resiliency that aims to protect people and help them cope with the hot weather through programs like cooling stations and increased tree planting.

Sunenshine, of Maricopa County public health, said individuals, organizations of all sizes and local governments can help reduce heat deaths, especially during the traditional warm season stretching from May 1 to Oct. 31.

The county called on residents to check on people in their communities and social circles during the hot season, especially those who are older or living alone. It suggested that residents also help by volunteering at a cooling center to let it stay open later, or donate supplies, such as water, reusable bottles, hats, sunscreens and cooling towels.

That county public health department also released the results of an evaluation of the cooling and respite centers that operated around the county last year.

County officials hope to use the information to provide additional services during the upcoming summer, such as a bilingual heat relief call center to answer questions and help people get transportation to and from cooling centers.

About two-thirds of people who responded to a survey about cooling centers said they did not have a stable home. The results showed that the biggest barriers keeping people from using the centers are not even knowing they exist or where they are located, and lacking transportation to get to them.