Heat Warnings Research Articles

Individual awareness and response to health messaging related to extreme heat

Objective: The frequency, intensity, and duration of extreme heat days are increasing across the United States. This study is a nationally representative assessment to (i) identify specific temperature ranges that individuals consider to be a public health risk (ii) document how individuals change behaviors when informed of a heat hazard; and (iii) understand the specific communication channels that individuals rely on for information about extreme heat. Methods: The study used data from a nationally representative survey of 3624 adults who responded to the spring wave of the ConsumerStyles survey. The survey responses were linked with information about the annual number of extreme heat days, as recorded by the National Oceanic and Atmospheric Administration (NOAA), and number of heat alerts issued by the National Weather Service in respondents’ zip codes. Descriptive analyses were conducted to assess frequencies of responses by census region, age, gender, income, education, race, number of extreme heat days, and number of heat alerts. Results: Adults living in the Northeast and Midwest census regions consider health risk from heat at lower temperatures than adults in other regions. On average, men perceive health risk from heat at higher temperature than women. No patterns emerged between observed high temperature days in 2019 and what individuals considered to be a ‘hot day’. Individuals reported obtaining information about heat days mainly from the television, followed by radio and the internet. Changing outdoor activity schedule, staying hydrated, and seeking air-conditioned places were the most common responses among individuals who were aware of high ambient heat. Conclusion: Variation in perceptions of health risk from extreme heat across different parts of the country reinforce the need to calibrate local heat warnings. Information on how people access and respond to information on extreme heat will help target vulnerable groups during heat days.

Evaluating Mortality Response Associated with Two Different Nordic Heat Warning Systems in Riga, Latvia.

Background and objectives: Progressing climate change is accompanied by a worldwide increase in the intensity, frequency, and duration of heat wave events. Research has shown that heat waves are an emerging public health problem, as they have a significant impact on mortality. As studies exploring this relationship are scarce for Latvia, this study aims to investigate the short-term associations between heat waves and all-cause mortality as well as cause-specific mortality, during the summer months (May-September) in Riga. Materials and Methods: An ecological time series study using daily reported mortality and temperature data from Riga between 2009 and 2015 was employed. Heat waves were defined based on the categories of the Latvian and Swedish heat warning system. Using a Quasi-Poisson regression, the relationships between heat waves and all-cause as well as cause-specific mortality were investigated. Results: Heat waves in Riga were associated with a 10% to 20% increase in the risk of all-cause mortality, depending on the applied heat wave definition, compared to days with normal temperature. In addition, heat-related mortality was found to increase significantly in the ≥65 age group between 12% and 22% during heat waves. In terms of cause-specific mortality, a significant increase of approximately 15% to 26% was observed for cardiovascular mortality. No significant associations were found between heat waves and respiratory or external causes of mortality. Conclusion: These results indicate that there are short-term associations between heat waves and all-cause as well as cardiovascular mortality in Riga and that heat waves therefore represent a public health problem in this Baltic city.

Heat warning and public and workers' health at the time of COVID-19 pandemic

The humanity is currently facing the COVID-19 pandemic challenge, the largest global health emergency after the Second World War. During summer months, many countries in the northern hemisphere will also have to counteract an imminent seasonal phenomenon, the management of extreme heat events. The novelty this year concerns that the world population will have to deal with a new situation that foresees the application of specific measures, including adjunctive personal protective equipment (i.e. facemasks and gloves), in order to reduce the potential transmission of the SARS-CoV-2 virus. These measures should help to decrease the risk of the infection transmission but will also represent an aggravating factor to counteract the heat effects on the population health both at occupational and environmental level. The use of a specific heat health warning system with personalized information based on individual, behavioural and environmental characteristics represents a necessary strategy to help a fast adaptation of the population at a time where the priority is to live avoiding SARS-CoV-2 infection.

A cold-health watch and warning system, applied to the province of Quebec (Canada)

ContextA number of studies have shown that cold has an important impact on human health. However, almost no studies focused on cold warning systems to prevent those health effects. For Nordic regions, like the province of Quebec in Canada, winter is long and usually very cold with an observed increase in mortality and hospitalizations throughout the season. However, there is no existing system specifically designed to follow in real-time this mortality increase throughout the season and to alert public health authorities prior to cold waves. ObjectiveThe aim is to establish a watch and warning system specifically for health impacts of cold, applied to different climatic regions of the province of Quebec. MethodologyA methodology previously used to establish the health-heat warning system in Quebec is adapted to cold. The approach identifies cold weather indicators and establishes thresholds related to extreme over-mortality or over-hospitalization events in the province of Quebec, Canada. Results and conclusionThe final health-related thresholds proposed are between (−15 °C, −23 °C) and (−20 °C, −29 °C) according to the climatic region for excesses of mortality, and between (−13 °C, −23 °C) and (−17 °C, −30 °C) for excesses of hospitalization. These results suggest that the system model has a high sensitivity and an acceptable number of false alarms. This could lead to the establishment of a cold-health watch and warning system with valid indicators and thresholds for each climatic region of Quebec. It can be seen as a complementary system to the existing one for heat warnings, in order to help the public health authorities to be well prepared during an extreme cold event.

Developing a harmonized heat warning and information system for Ontario: a case study in collaboration

BackgroundHeat wave early warning systems help alert decision-makers and the public to prepare for hot weather and implement preventive actions to protect health. Prior to harmonization, public health units across Ontario either used independent systems with varying methodologies for triggering and issuing public heat warnings or did not use any system. The federal government also issued heat warnings based on different criteria. During heat events, adjacent public health units in Ontario and the federal government would routinely call heat warnings at different times with separate public messages, leading to confusion. This article describes the collaborative process and key steps in developing a harmonized Heat Warning and Information System (HWIS) for Ontario.SettingPublic health units across Ontario, Canada, collaborated with the federal and provincial government to develop the harmonized HWIS for Ontario.InterventionIn 2011, stakeholders identified the need to develop a harmonized system across Ontario to improve heat warning services, warning criteria, and health messaging. Through a 5-year process facilitated by a non-governmental organization, the three levels of government collaborated to establish the Ontario HWIS.OutcomesThe province-wide HWIS was implemented in 2016 with the Ontario Ministry of Health and Long-Term Care’s release of the harmonized HWIS Standard Operating Practice, which outlined the notification and warning process.ImplicationsThe lessons learned could help spur action in other provinces and jurisdictions internationally in the development of similar health evidence-based warning systems, including in particular those for protecting public health during extreme heat events.

Heat warnings and avoidance behavior: evidence from a bike-sharing system

Governments throughout the globe usually implement early warning systems to prevent health-related costs from exposure to extreme heat. In a warming world, this type of information-provision approach is believed to be an effective way to deal with this natural hazard, even when there is little evidence of its influence on individuals’ behavior. Using detailed information from 1 million trips recorded by a bike-sharing system in Buenos Aires, Argentina, this paper investigates the direct behavioral impact of heat warnings on cycling trips. The results show substantial avoidance behavior for female cyclists and older users: the number of trips for those groups decreases following a heat warning. Alternative specifications for temperature and falsification tests suggest that the findings are robust. As in other studies, this paper also shows that the impact is diluted as time under alert increases.

The Heat Health Warning System in Germany—Application and Warnings for 2005 to 2019

During intense heat episodes, the human population suffers from an increased morbidity and mortality. In order to minimize such negative health impacts, the general public and the public health authorities are informed and warned by means of an advanced procedure known as a “heat health warning system” (HHWS). It is aimed at triggering interventions and at taking preventive measures. The HHWS in Germany has been in operation since 2005. The present work is aimed at showing the updated structure of an advanced HHWS that has been developed further several times during its 15 years of operation. This is to impart knowledge to practitioners about the concept of the system. In Germany, dangerous heat episodes are predicted on the basis of the numerical weather forecast. The perceived temperature as an appropriate thermal index is calculated and used to assess the levels of heat stress. The thermo-physiologically based procedure contains variable thresholds taking into account the short time acclimatization of the people. The forecast system further comprises the nocturnal indoor conditions, the specific characteristics of the elderly population, and the elevation of a region. The heat warnings are automatically generated, but they are published with possible adjustments and a compulsory confirmation by the biometeorology forecaster. Preliminary studies indicate a reduction in the heat related outcomes. In addition, the extensive duration of the strongest heat wave in summer 2018, which lasted three weeks, highlights the necessity of the HHWS to protect human health and life.

The Role of Individual and Small-Area Social and Environmental Factors on Heat Vulnerability to Mortality Within and Outside of the Home in Boston, MA.

Climate change is resulting in heatwaves that are more frequent, severe, and longer lasting, which is projected to double-to-triple the heat-related mortality in Boston, MA if adequate climate change mitigation and adaptation strategies are not implemented. A case-only analysis was used to examine subject and small-area neighborhood characteristics that modified the association between hot days and mortality. Deaths of Boston, Massachusetts residents that occurred from 2000–2015 were analyzed in relation to the daily temperature and heat index during the warm season as part of the case-only analysis. The modification by small-area (census tract, CT) social, and environmental (natural and built) factors was assessed. At-home mortality on hot days was driven by both social and environmental factors, differentially across the City of Boston census tracts, with a greater proportion of low-to-no income individuals or those with limited English proficiency being more highly represented among those who died during the study period; but small-area built environment features, like street trees and enhanced energy efficiency, were able to reduce the relative odds of death within and outside the home. At temperatures below current local thresholds used for heat warnings and advisories, there was increased relative odds of death from substance abuse and assault-related altercations. Geographic weighted regression analyses were used to examine these relationships spatially within a subset of at-home deaths with high-resolution temperature and humidity data. This revealed spatially heterogeneous associations between at-home mortality and social and environmental vulnerability factors.

Performance of heat-health warning systems in Shanghai evaluated by using local heat-related illness data.

In response to more frequent heatwaves, various regional or national heat-health warning systems (HHWSs) have been developed recently as adaptation measures. A wide range of methodologies have been utilized to issue warnings, as there is no universal definition of "heat event" or "heatwave", nor are there quantified thresholds of human-health tolerance to extreme weather. The performance of these warning systems has rarely been evaluated with actual heat-health data, especially the morbidity data, in regions with severe impact. In this study, we assessed the performance of the Shanghai HHWS based on heat-related illness data collected by the Chinese Center for Disease Control and Prevention (China CDC) and then conducted a comparative analysis among the Shanghai HHWS, the China Meteorological Administration HHWS, the Chinese national standard for heatwave indexes, the heat index adopted by the USA's National Weather Service and the definition suggested by the World Meteorological Organization to understand their potential performance for application in Shanghai and to evaluate the temperature thresholds and different meteorological indices employed. The results show that: 1) during the research period, 50% of heat-related illnesses and 58.2% of heat-related deaths in Shanghai occurred on dates that had no heat warnings; 2) for the current threshold (35°C), the single metric of temperature outperformed the temperature-duration two-parameter method; 3) different from existing studies, while infants and seniors are deemed as vulnerable population groups to heat, young and middle-aged males were found to suffer more heat-related illnesses in hot weather. More detailed analyses reveal that the performance of heat-health warning systems needs to be evaluated and revised periodically, and warning thresholds utilized must be localized to reflect public tolerance to heat and to address the vulnerability of target population groups. Temperature is the dominant threshold in heat-related morbidity and mortality analysis. While a decrease in the temperature threshold would definitely increase the warning frequency and socioeconomic costs, it might also cause warning fatigue. The trade-off between these two aspects is essential for decision-makers and other stakeholders in HHWS design and improvement.

Dangerous Weather

Dangerous Weather Natalie Teal McAllister (bio) Jim wanted the ceiling fan and you wanted the window unit and Jim won until the baby was born. Jim won everything until the baby was born, and then the baby won everything thereafter. The baby had been born in August. The first night she was home neither the fan nor the window unit could keep up. She screamed and thrashed until Jim had her in just a diaper and you hovered over her and hoped she would cry herself to sleep because to touch her would surely have made the situation worse. Jim had central air installed within the week, but that was his idea, too. Thirty years later with the same unit outside, you should have known you were in trouble when you woke up to the sound of robins in the mulberry tree. In the still-dark morning, you can hear the last handful of crickets in the yard and a car on the main road three streets over. What you can’t hear is that air conditioner. ________ When you wake again the sun is up and even the birds are too hot to sing. It’s near 90 in the bedroom. You shuffle to the thermostat and let it confirm what you suspected. The dial reads closer to 85, but the bedroom is on the sun side of the house and stays warmer in every month of the year. You slide the knob as far to the left as it will go and wait for the machine to kick on. You tell yourself to give it five minutes. Be patient with the old thing. Two minutes later you slide into your flip flops and push open the back door. The unit is tucked into an odd corner of the house. Maybe it has been a few years since you’ve actually looked at it. You nudge the bottom of your flip flop into it. When that doesn’t work, you clap the palm of your hand against the metal grate. Then you do it again. The second time your hand comes up with a coat of rust and you give the unit up for dead. ________ You keep a collection of magnets on the refrigerator. Names of repair men and plumbing companies. People who want to sell you insurance. You peel off one for Randy Mr. Fix It. He picks up on the third ring. “Randy Mr. Fix It,” he says. “You break it, I fix it.” You tell him the situation with the unit. “Alright. I can fix that. Let me get you on the schedule.” You ask him what he means by schedule. “I mean yours isn’t the only one that’s broken.” You pull back the curtain on the back door and look over at your neighbor’s unit. As far as you can tell, it’s working. “The news said there’s an excessive heat warning,” you say. “That’s got to mean something.” You say it but you don’t believe it means anything to people like Randy. What else is this world but [End Page 156] a place where men can promise to care for you, to watch out for you, and never mean a second of it. Still you find the smallest part of your heart wants to believe otherwise. “I’m getting through them as fast as I can. I can try to get you in at 4:30. Last call of the day.” They said on TV it would be 110 by then. “If I get done sooner, I’ll get there sooner. I’ll do what I can.” “I could die in here before then,” you say. “That’s what they said.” He takes what feels like a full minute to answer. You spend that minute wondering—if you did die, when would they find you? Would it be come winter? Or would they notice when your mail piled up? What if you didn’t have much mail to speak of? Then it comes to you: it would be the overgrown lawn. That’s how they would know you were dead. “If I were you,” he says, “I...

Heat Warnings in Switzerland: Reassessing the Choice of the Current Heat Stress Index

High temperatures lead to heat-related human stress and an increased mortality risk. To quantify heat discomfort and the relevant dangers, heat stress indices combine different meteorological variables such as temperature, relative humidity, radiation and wind speed. In this paper, a set of widely-used heat stress indices is analyzed and compared to the heat index currently used to issue official heat warnings in Switzerland, considering 28 Swiss weather stations for the years 1981–2017. We investigate how well warnings based on the heat index match warning days and warning periods that are calculated from alternative heat stress indices. The latter might allow for more flexibility in terms of specific warning demands and impact-based warnings. It is shown that the percentage of alternative warnings that match the official warnings varies among indices. Considering the heat index as reference, the simplified wet bulb globe temperature performs well and has some further advantages such as no lower bound and allowing for the calculation of climatological values. Yet, other indices (e.g., with higher dependencies on humidity) can have some added value, too. Thus, regardless of the performance in terms of matches, the optimal index to use strongly depends on the purpose of the warning.

Lessons Learned from an Extreme Heat Event using ACES for Situational Awareness, Ontario, Canada

ObjectiveTo describe the lessons learned for public health decision-makers from an analysis of Acute Care Enhanced Surveillance (ACES) data for the heatwaves experienced in Ontario, Canada in the summer of 2018.IntroductionThe Acute Care Enhanced Surveillance (ACES) system provides syndromic surveillance for Ontario’s acute care hospitals. ACES receives over 99% of acute care records for emergency department (ED) visits; mean daily volume is 17,500 visits. ACES uses a maximum entropy classifier and generates more than 80 standard syndromes, fifteen of which are actively monitored for aberrational activity and are considered of higher public health relevance, including RESP (respiratory infection, non-croup), ILI (influenza-like illness), TOX (toxicological, chemical/drug exposure), AST (asthma), OPI (opioid exposure), CELL (cellulitis), GASTRO (gastroenteritis), ENVIRO (environmental, heat/cold exposure), MH (mental health), EOH (alcohol intoxication), DERM (rash), and SEP (bacteremia, sepsis).Syndromic surveillance provides a salient source of public health surveillance during extreme heat events; monitoring real-time ED visits can inform local public health authorities of health impacts, provide situation awareness to initiate and/or inform public health response, and help decision-makers allocate resources according to geographic (or demographic) vulnerability. While the use of syndromic surveillance has been well-characterized to monitor infectious disease outbreaks, its use to monitor the heat-health impacts is relatively novel for ACES users, specifically local public health authorities. This report describes the the data collected during an extended extreme heat event in Ontario, Canada, to highlight the value of syndromic surveillance during extreme heat events and make recommendations regarding incorporating ACES data into routine workflows.MethodsTemperature data were retrieved from Environment Canada historical databases for mid-June to mid-July 2018. Aggregate counts per day for total ED visits and and for individual syndromes were retrieved from ACES databases. Descriptive statistics were used to analyze all datasets.ResultsAn extreme heat event occurred in the southern region of Ontario in early summer, 2018. Environment Canada issues heat warnings for regions throughout Canada according to region-specific criteria; for southern Ontario, heat warnings are issued when 2 or more consecutive days of daytime maximum temperatures are expected to reach 31°C or when 2 or more consecutive days of humidex values are expected to reach 40. Extended heat warnings are issued when the event lasts beyond 2 days. An extended heat event occurred June 29 to July 5, 2018. Although the region is large, temperature data from Environment Canada’s climate monitoring station at Toronto’s Pearson Airport are shown (Figure 1) as an example of the temperatures observed for this time period in the region.ConclusionsLessons learned from an analysis of ACES data during an extreme heat event:1. The ENVIRO syndrome provides real-time monitoring of the health impacts during a heat event and may provide proxy for estimating the indirect effects of heat (e.g., impacts on chronic conditions). Public health authorities can monitor local health impacts during an extreme heat event.2. Patients seeking help at the ED do not appear to be skewed in acuity, sex nor age. This does not necessarily reflect the population that experiences the greatest impact from extreme heat, but rather those that are seeking help at the ED for the direct effects of heat. That said, an increase in ENVIRO counts does not indicate whether the increase is due to greater exposure to the heat (or sun), engaging in vigorous outdoor activity during the event (recreational or occupational), or lack of access to air conditioning.3. ED visits for ENVIRO can be geolocated to determine areas experiencing greater health impacts. This may allow allocation of resources to specifically address vulnerabilities. ACES has built-in mapping capabilities that allows a geovisualization of the home addresses for patients. Furthermore, aggregate counts for relevant syndromes are available for registered users on the Public Health Information Management System (PHIMS), a web-accessible GIS tool for situational awareness that gives public health decision-makers access to real time health impacts in concert with demographics, weather, and other emergency management information.

Evaluation of wearable sensors for physiologic monitoring of individually experienced temperatures in outdoor workers in southeastern U.S.

Climate-related increases in global mean temperature and the intensification of heat waves present a significant threat to outdoor workers. Limited research has been completed to assess the potential differences in heat exposures that exist between individuals within similar microenvironments. Yet, there is a paucity of individual data characterizing patterns of individually experienced temperatures in workers and the associated physiologic heat strain response. The objective of this study was to apply a wearable sensor-based approach to examine the occupational, environmental, and behavioral factors that contribute to individual-level variations in heat strain in grounds maintenance workers. Outdoor workers from three diverse climatic locations in the southeastern United States – high temperature, high temperature + high humidity, and moderate temperature environments – participated in personal heat exposure monitoring during a 5-day work period in the summer. We performed Cox proportional hazards modeling to estimate associations between multiple heat strain events per worker and changes in individually experienced temperatures. Heat strain risk was higher among workers with a place to cool-off, higher education, and who worked in hotter temperatures. A mismatch was observed between workers' perceptions of heat strain and actual heat strain prevalence across exposure groups. We also used a quasi-Poisson regression with distributed lag non-linear function to estimate the non-linear and lag effects of individually experienced temperatures on risk of heat strain. The association between increasing temperature and heat strain was nonlinear and exhibited an U-shaped relationship. Heat strain was less common during issued heat warnings demonstrating behavioral adaptive actions taken by workers. This study is one of the first temperature monitoring studies to quantify the individual-level exposure-response function in this vulnerable population and highlights the elevated risk of heat strain both immediately and several days after worker exposure to high temperatures.

Patterns of outdoor exposure to heat in three South Asian cities

Low socio-economic status has been widely recognized as a significant factor in enhancing a person's vulnerability to climate change including vulnerability to changes in temperature. Yet, little is known about exposure to heat within cities in developing countries, and even less about exposure within informal neighbourhoods in those countries. This paper presents an assessment of exposure to outdoor heat in the South Asian cities Delhi, Dhaka, and Faisalabad. The temporal evolution of exposure to heat is evaluated, as well as intra-urban differences, using meteorological measurements from mobile and stationary devices (April–September 2016). Exposure to heat is compared between low-income and other neighbourhoods in these cities. Results are expressed in terms of air temperature and in terms of the thermal indices Heat Index (HI), Wet Bulb Globe Temperature (WBGT) and Universal Thermal Climate Index (UTCI) at walking level. Conditions classified as dangerous to very dangerous, and likely to impede productivity, are observed almost every day of the measurement period during daytime, even when air temperature drops after the onset of the monsoon. It is recommended to cast heat warnings in terms of thermal indices instead of just temperature. Our results nuance the idea that people living in informal neighbourhoods are consistently more exposed to heat than people living in more prosperous neighbourhoods. During night-time, exposure does tend to be enhanced in densely-built informal neighbourhoods, but not if the low-income neighbourhoods are more open, or if they are embedded in green/blue areas.

Increasing Access to Cooling in the Community: A Trial Heat Relief Network for Toronto

Toronto Public Health (TPH) estimates that extreme heat contributes to an average of 120 excess deaths per year in Toronto. Very hot weather or extended periods of heat can increase health impacts among all people.Toronto Public Health coordinates the Hot Weather Response Plan under which key partners undertake activities aimed at reducing heat-related illness, including opening seven cooling centres when either a Heat Warning or Extended Heat Warning is in effect. Cooling Centres are designated air-conditioned locations that provide a place for people and their pets to escape the heat, rest, drink water, have a light snack and get information on how to prevent heat-related health impacts.To inform how Toronto can best offer cooling to vulnerable residents, in 2017, TPH conducted a jurisdictional scan of heat relief programs across North America and identified common features of heat relief facilities, including the following factors that make them more effective: 1) maximizing the number, and broadening the definition of facilities that are designated as heat relief facilities; 2) selecting facilities where people already choose to spend their time; and 3) allocating resources to promote and coordinate work. Based on the results of this scan, TPH will be promoting a Heat Relief Network that incorporates nearly 200 air conditioned libraries and community centres for the 2018 heat season.In addition, the Heat Relief Network will attempt to overcome barriers that prevent residents from using the existing Cooling Centre program including: limited access to transportation, fear or inability to leave home, stigma and reluctance to spend time in a place without activities.This presentation will focus on the population needs, program design, resident engagement and challenges encountered while implementing the Heat Relief Network.

Reducing Morbidity and Mortality Due to Extreme Heat: A Call for Evidence-Based Interventions

Extreme heat is an established and significant threat to public health across the globe. We estimate that in the US extreme heat events (defined as temperatures ≥ 97.5th percentile of local daily mean temperature) account for approximately 3,658 deaths per year, and the impact of heat on the risk of non-fatal events such as hospitalizations and emergency department visits is likely even larger. National analyses suggest that projected climate change could lead to thousands of additional deaths per year due to extreme heat. Additional adaptation measures at the individual, household, and community levels will be essential to avoid the worst of these health impacts.Many communities have already implemented adaptation measures in order to reduce heat-related morbidity and mortality in the present and the future. For example, in Philadelphia, New York City, and across New England, the research community and key stakeholders have collaborated to refine the guidelines for issuing National Weather Service (NWS) heat advisories or excessive heat warnings with the aim of better protecting people in the face of extreme heat events. Implementation of these and other adaptation measures should be viewed as a critical step in the right direction. However, there is relatively little evidence regarding the effectiveness of existing or emerging approaches to reduce heat health impacts, and the available evidence is mixed. For example, our recent findings suggest that NWS heat alerts between 2001 and 2006 were not associated with appreciable reductions in rates of death or hospitalization in most locations, potentially missing a valuable opportunity to avert a substantial number of heat-related deaths.Emerging results highlight the need to better link heat warning systems to effective intervention strategies to reduce heat-related health effects, as well as the need for adaptation efforts to be based on rigorous evidence of which approaches are likely to be most effective.

Comparison of Two Wet-Bulb Globe Temperature Estimation Methods for Assessment of Heat-Related Mortality: Evidence from 47 Japanese Prefectures

Background / Aim: The wet-bulb globe temperature (WBGT) has been widely used for the heat warning in Japan. However, since the WBGT instruments are not often readily available, it needs to be estim...

Awareness, Risk Perception, and Protective Behaviors for Extreme Heat and Climate Change in New York City

Preventing heat-related illness and death requires understanding 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 September 22-October 1, 2015. Thirteen percent of the population did not possess an air conditioner (AC), and another 15% used AC never/infrequently. Odds of not possessing AC were greater for non-Hispanic blacks compared with other races/ethnicities, 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.

Regional morbidity and mortality during heatwaves in South Australia.

Heatwaves can be a common occurrence in Australia, and the public health impacts can be severe. Heat warnings and interventions are being adopted widely to reduce the preventable health impacts. This study examines the effects of heatwaves on morbidity and mortality in different climatic regions in the state of South Australia, to inform the targeting of heat warnings according to regional needs. Heatwaves were defined using the excess heat factor (EHF), an index based on mean daily temperature indices that quantifies heatwave severity relative to the local climate. In all regions, there were increases in morbidity (daily rates of ambulance call-outs and heat-related emergency presentations and hospital admissions) on heatwave days compared to non-heatwave days, which increased with heatwave severity. This study demonstrates that a consistent measure for heatwave severity, based on EHF, can be used to underpin public health warnings for climatically diverse areas.

Awareness, Risk Perception, and Protective Behaviors for Extreme Heat and Climate Change in New York City.

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.