I've been reading the CDC's heat-safety guidance the way you'd read a short story, paying attention to what it assumes about its protagonist. The instructions are organized around three imperatives: Stay Cool. Stay Hydrated. Stay Informed. The National Weather Service tells people to "spend time in air-conditioned places" and to "slow down" and "reduce or reschedule strenuous activity." For older adults, the CDC gets specific: "Air conditioning is the number-one protective factor against heat-related illness and death." Stay in air-conditioned buildings as much as possible.
Read it once and it sounds like common sense. Read it twice and something starts to itch.
The advice is correct. That's worth saying upfront. Cooling works. Hydration works. Shade works. But every sentence is built on a verb that assumes the reader can do the thing the verb describes. Stay cool. Seek shelter. Reduce activity. The subject of every instruction is a person with a thermostat they control, a schedule they set, a door they can walk through when they decide to. The grammar of heat safety is the grammar of autonomy.
Once you see this, it reorganizes everything. The people most likely to die of heat are, overwhelmingly, people who cannot follow the instructions. They've heard them. Someone else holds the thermostat.
"Without Effective Cooling"
The NWS HeatRisk tool classifies dangerous heat on a five-level scale. At Level 3, the risk description warns of danger for "anyone without effective cooling and/or adequate hydration." At Level 4, the language escalates to "rare and/or long-duration extreme heat with little to no overnight relief."
That phrase, "without effective cooling," is doing something interesting. It acknowledges that the decisive variable is whether you can get out of the heat. The tool sees this clearly. The guidance it generates still assumes you can solve it by choosing to.
But "without effective cooling" describes a structural condition for millions of people, and the structure is made of other people's decisions.
The Energy Information Administration found that 6 million U.S. households were unable to use air conditioning due to broken or unaffordable equipment, and 1.4 million households reported someone requiring medical attention because the home was kept at an unsafe temperature.
The EIA's most recent residential survey also found that apartments were the least likely housing type to use AC and that households not using AC were more likely to rent than own.
Renters. That word should slow us down. A renter who needs air conditioning to survive a heat wave must pass through a series of intermediaries to get it: a landlord, a lease, a maintenance request, a repair timeline, a utility bill that someone else's wage structure may not cover. "Stay cool" presupposes a thermostat you control. For tenants, the thermostat is mediated by someone else's priorities.
The CDC calls air conditioning the number-one protective factor against heat death. Most states' legal infrastructure treats it as an amenity. Arizona is one of the few states with express statutory language requiring landlords to supply "reasonable" air conditioning when units are installed and seasonal conditions require it. Texas, where summer temperatures routinely exceed 100°F, has no statewide law requiring landlords to provide it at all. The gap between what public health agencies identify as essential and what the law requires anyone to provide is the permission gap at its starkest: the knowledge is settled, and the obligation is absent.
Maricopa County, which does have that statutory cooling requirement, documented 409 heat-associated deaths in 2025. Thirty percent occurred indoors. Among indoor deaths where AC status was known, 80 percent had an air conditioning unit present. Of those units, 78 percent were not functioning.
The machine was there. It was broken. And the person who died could not fix it, could not leave, could not make the air do what the guidance assumed it would do.
"Reduce Strenuous Activity"
The CDC's outdoor worker page tells workers to drink water before feeling thirsty, take breaks, and use shade or a "designated cool location."
Designated by whom? The employer. The site manager. The foreman. The person who controls the pace of labor, the length of the shift, whether a break happens and how long it lasts. For outdoor workers in construction, agriculture, and landscaping, "slow down" is a permission they receive or don't.
OSHA proposed a heat illness prevention standard in August 2024. The proposed rule would have established, for the first time, a federal requirement for employers to provide water, shade, rest breaks, acclimatization protocols, and heat illness prevention plans for outdoor and indoor work settings. Public hearings ran through mid-2025. The post-hearing comment period closed October 30, 2025. As of this writing, no final rule has been issued. No withdrawal has been announced either. The rulemaking sits in procedural suspension, its timeline uncertain. In April 2026, OSHA issued a revised enforcement directive on heat-related hazards, but an enforcement directive tells inspectors where to look. It does not create obligations for employers.
The space between a proposed rule and a final rule is the space in which the question of permission stays unanswered. Can a worker slow down? The CDC says they should. The advice exists. The obligation, nearly two years after OSHA proposed requiring it, does not.
"Seek Air-Conditioned Shelter"
The NWS tells people to seek air-conditioned shelter. The CDC suggests that people without air conditioning "use air conditioning for several hours per day if possible, including at a shopping mall or public library." If possible. The conditional is honest. But it quietly transfers the burden of survival from the built environment to the individual's ability to find somewhere else to be.
For some people, there is no somewhere else.
About 95,000 people incarcerated in the Texas Department of Criminal Justice system are housed in units without air-conditioned living areas. In March 2025, federal judge Robert Pitman ruled in Tiede v. Collier that the conditions these inmates endured were "plainly unconstitutional," likely constituting cruel and unusual punishment under the Eighth Amendment. The court documented nearly 6,000 heat-related grievances filed by TDCJ inmates in 2023 alone and 17 reported heat-related illnesses that same summer.
TDCJ's mitigation measures included respite rooms, cold showers, fans, ice water, and a reusable cup.
A reusable cup. The institution controls the building, the schedule, the walls, the locks, the ventilation system, the budget. Its answer to the heat is to hand the individual a cup and make the act of cooling their own responsibility, performed within an environment they cannot alter or leave. A small personal tool standing in for a structural obligation no one will fund.
Judge Pitman found the conditions unconstitutional. He also declined to order immediate air conditioning. Temporary cooling could cost $700 to $800 million, with annual fuel costs of $600 million. TDCJ estimated needing 65,000 tons of AC equipment, with water chillers taking more than a year to arrive after ordering. A subsequent ruling in March 2026 noted that evidence continued to support "a high level of heat-related risk for every person housed in an un-air-conditioned TDCJ cell." The case continues. The cells stay hot.
"Seek air-conditioned shelter" assumes you can seek. Incarcerated people cannot seek. They are where they have been placed.
The thermostat belongs to the institution that holds them, and the institution has been told its conditions are unconstitutional, and the conditions persist because the cost of the remedy exceeds the political will to fund it.
Compulsory Heat
A Government Accountability Office report found that 41 percent of school districts need HVAC updates in at least half their schools.
This is, in some ways, the sharpest version of the pattern. Attendance is compulsory. The state requires children to be in a building. The district controls the building's climate. The child cannot leave, cannot adjust the thermostat, cannot "seek air-conditioned shelter" because the shelter they've been legally placed in is the problem. When the HVAC system fails or was never adequate, the student's heat exposure is a direct product of a legal mandate to be present in an environment governed by someone else's budget. The permission gap here is enforced by truancy law.
And unlike a renter who might, in theory, break a lease, or a worker who might, in theory, quit, a student's presence is not negotiable. Their body is in the building because the law says it must be.
What the Advice Sees
Reading public health guidance as a document about power clarifies something. The advice tells you what its ideal subject looks like: a person with a home they control, a schedule they set, a body they can move freely from one environment to another. That person exists. Millions of people are not that person. And the distance between the advice and their reality is measured entirely in permission.
The institutions know this. The NWS acknowledges it every time it writes "without effective cooling." The CDC concedes it with "if possible." OSHA recognized it clearly enough to propose a rule, which has now sat for nearly two years without resolution. Judge Pitman named it "plainly unconstitutional" and then explained why the fix was too expensive to order. The EIA has counted 6 million households. The GAO has counted school districts.
The knowledge is there. What is absent, in case after case, is the mechanism that converts knowledge into someone's enforceable obligation to act. Survival becomes a jurisdictional question. The risk has been identified. The populations have been named. The conditions have been documented, sometimes ruled unconstitutional. And the thermostat remains in someone else's hand, because no binding instrument requires that hand to turn.
The person who dies of heat in an apartment with a broken AC unit heard the advice. The worker who collapses on a construction site in August knew that shade and water would help. The inmate in an un-air-conditioned Texas cell knows exactly what is happening to his body. They all received the guidance. They could not follow it.
I don't have a clean ending for this, and I think that's the point. The question the pattern raises is genuinely unresolved: what do we owe the people who cannot follow the advice? And who, exactly, is the "we" that owes it? Because right now, the answer seems to be: everyone knows, no one is required, and the heat keeps coming.
- Medically dependent, electricity dependent: HHS's emPOWER program tracks more than 4.6 million Medicare beneficiaries who rely on electricity-dependent medical equipment at home, raising the same permission question for power outages that this piece traces for heat.
- School heat data gaps: Guardian reporting found that the U.S. lacks federal school-building-condition data and has no clear threshold for when a school qualifies as heat-resilient, making the compulsory-attendance problem nearly impossible to measure nationally.
- Insurance and habitability costs: Treasury's Federal Insurance Office found that homeowners in the highest climate-risk ZIP codes paid 82 percent more in premiums than those in the lowest-risk areas, adding a financial permission layer to whether cooling infrastructure gets maintained or replaced.
- OSHA's enforcement-only path: OSHA issued a revised National Emphasis Program on heat hazards in April 2026, which directs inspectors but does not create the enforceable employer obligations the stalled proposed rule would have established.