Nationwide, one in five of the lowest-income households have no access to air conditioning, while 30% rely solely on window units, according to exclusive analysis by the National Energy Assistance Directors Association (Neada) for the Guardian.

As many as 60% of American households live paycheck to paycheck, while one in three report forgoing basic necessities such as food or medicine to pay energy bills and avoid disconnection.

Heat is the deadliest weather phenomenon in the US and globally, killing almost half a million people worldwide each year, according to the World Health Organization. The death toll is rising as human-caused climate crisis drives more frequent, more brutal and longer heatwaves.

Last month marked 30 years since what was then an unprecedented five-day heatwave in Chicago that killed more than 730 people and sent thousands to hospital. The majority were elderly, Black, isolated, low-income residents either lacking air conditioning or the money to run it.

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It was the hottest day of the year so far when the central air conditioning started blowing hot air in the mobile home where Richard Chamblee lived in Bullhead City, Arizona, with his wife, children, and half a dozen cats and dogs.

It was only mid-June but the heat was insufferable, particularly for Chamblee, who was clinically obese and bed-bound in the living room as the temperature hit 115F (46C) in the desert city – situated 100 miles (160km) south of Las Vegas on the banks of the Colorado River.

The family could not afford to immediately replace or repair the AC system, so instead they bought a window unit and installed it next to Chamblee’s bed. They positioned fans, ice packs and cold drinks close by in an effort to keep Chamblee cool and hydrated, checking in on him every couple of hours.

But the mobile home is old, open-plan and poorly insulated. Despite their efforts, the temperature hovered close to 100F in the house, according to Chamblee’s son John.

Chamblee overheated and struggled to breathe. His core temperature measured 108F when he was rushed to the emergency room, but doctors were unable to cool him down, according to the death report obtained by the Guardian using the Freedom of Information Act (Foia). Chamblee’s heart stopped working.

We are no longer a functioning society.