Abstract
Preventing heat-related illness and death requires an understanding of who is at risk and why, and options for intervention. We sought to understand the drivers of socioeconomic disparities in heat-related vulnerability in New York City (NYC), the perceived risk of heat exposure and climate change, and barriers to protective behaviors. A random digit dial telephone survey of 801 NYC adults aged 18 and older was conducted from 22 September–1 October, 2015. Thirteen percent of the population did not possess an air conditioner (AC), and another 15% used AC never/infrequently. In adjusted models, odds of not possessing AC were greater for non-Hispanic blacks compared with other races/ethnicities, odds ratio (OR) = 2.0 (95% CI: 1.1, 3.5), and for those with low annual household income, OR = 3.1 (95% CI: 1.8, 5.5). Only 12% reported going to a public place with AC if they could not keep cool at home. While low-income individuals were less likely to be aware of heat warnings, they were more likely to be concerned that heat could make them ill and that climate change would affect their health than participants with a higher household income, OR = 1.6 (95% CI: 1.0, 2.3). In NYC, lack of access to AC partially explains disparities in heat-related health outcomes. Our results point to opportunities for knowledge building and engagement on heat-health awareness and climate change adaptation that can be applied in NYC and other metropolitan areas to improve and target public health prevention efforts.
Highlights
Extreme heat is a global health threat and one of the leading weather-related causes of death in the United States (US) [1]
We found that participants with a low household income (OR = 2.0, 95% CI: 1.3, 3.0), non-Hispanic blacks (OR = 1.9, 95% CI: 1.2, 3.0), and participants who had seen, heard, or read about heat warnings (OR = 1.7, 95% CI: 1.2, 2.6) were more likely to check in on a family member, friend, or neighbor to make sure they were okay during very hot weather
While some research has indicated that low-income individuals are disengaged from the problem of climate change [30], our results suggest that having a lower household income significantly predicts one’s perception of climate change as a health threat, reflecting an accurate perception of having fewer resources to adapt
Summary
Extreme heat is a global health threat and one of the leading weather-related causes of death in the United States (US) [1]. Hot summer days and nights have become more common over the last few decades, and heat waves are expected to become more frequent and severe with continued climate change [2]. Improving public health interventions that address extreme heat requires an understanding of who is at risk, the reasons for this heightened susceptibility, and plausible options for intervention. Res. Public Health 2018, 15, 1433; doi:10.3390/ijerph15071433 www.mdpi.com/journal/ijerph
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