Extreme Heat and Health: Perspectives from Health Service Providers in Rural and Remote Communities in South Australia

Susan Williams,Arthur Saniotis,Jonathan Newbury,Dino Pisaniello,Peng Bi,Alana Hansen,Guy Robinson

doi:10.3390/ijerph10115565

Abstract

Among the challenges for rural communities and health services in Australia, climate change and increasing extreme heat are emerging as additional stressors. Effective public health responses to extreme heat require an understanding of the impact on health and well-being, and the risk or protective factors within communities. This study draws on lived experiences to explore these issues in eleven rural and remote communities across South Australia, framing these within a socio-ecological model. Semi-structured interviews with health service providers (n = 13), and a thematic analysis of these data, has identified particular challenges for rural communities and their health services during extreme heat. The findings draw attention to the social impacts of extreme heat in rural communities, the protective factors (independence, social support, education, community safety), and challenges for adaptation (vulnerabilities, infrastructure, community demographics, housing and local industries). With temperatures increasing across South Australia, there is a need for local planning and low-cost strategies to address heat-exacerbating factors in rural communities, to minimise the impact of extreme heat in the future.

Highlights

Extreme heat can lead to substantial heat-related morbidity and mortality [1], and climate projections for more frequent and severe heatwaves are directing attention to this public health issue.While the adverse health effects of heat are largely preventable, the physiological, social and contextual risk factors can be complex and inter-related
These locations ranged from inner regional to very remote according to the Accessibility/Remoteness Index of Australia (ARIA) [38], a standard classification and index of remoteness defined by accessibility by road to services
Communities across South Australia are facing increasing exposure to extreme heat which will likely impact on lifestyles, health and well-being, and health services

Summary

Introduction

Extreme heat can lead to substantial heat-related morbidity and mortality [1], and climate projections for more frequent and severe heatwaves are directing attention to this public health issue.While the adverse health effects of heat are largely preventable, the physiological, social and contextual risk factors can be complex and inter-related. Characteristics of place are important [3], with recent studies identifying vulnerable “hot spots” within cities, in relation to the built environment [4,5,6] The understanding of these risk factors at a community level is central to the development of locally appropriate heat emergency and adaptation plans [7,8,9]. The research literature asserts that hot weather is likely to have the greatest impact on urban residents, because the urban heat island effect (UHI) leads to temperatures in metropolitan areas being warmer than surrounding rural areas [10] This is supported by studies showing a higher risk for city dwellers than those living in non-urban areas [11,12]. There are reports of significant impacts of extreme heat on rural populations [13,14], with some studies indicating comparable or heightened vulnerability in rural areas in North America [15,16,17,18] and Taiwan [19]

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Conclusion