BackgroundIn many regions globally, buildings designed for harnessing heat during the cold exacerbate thermal exposures during heat waves (HWs) by maintaining elevated indoor temperatures even when high ambient temperatures have subdued. While previous experimental studies have documented the effects of ambient temperatures on cognitive function, few have observed HW effects on indoor temperatures following subjects’ habitual conditions. The objective was to evaluate the differential impact of having air conditioning (AC) on cognitive function during a HW among residents of AC and non-AC buildings using a prospective observational cohort study.MethodsWe followed 44 students (mean age = 20.2 years; SD = 1.8 years) from a university in the Greater Boston area, Massachusetts in the United States living in AC (n = 24) and non-AC (n = 20) buildings before, during, and after a HW. Two cognition tests were self-administered daily for a period of 12 days (July 9–July 20, 2016), the Stroop color-word test (STROOP) to assess selective attention/processing speed and a 2-digit, visual addition/subtraction test (ADD) to evaluate cognitive speed and working memory. The effect of the HW on cognitive function was evaluated using difference-in-differences (DiD) modelling.FindingsMean indoor temperatures in the non-AC group (mean = 26.3°C; SD = 2.5°C; range = 19.6–30.4°C) were significantly higher (p < 0.001) than in the AC group (mean = 21.4°C; SD = 1.9°C; range = 17.5–25.0°C). DiD estimates show an increase in reaction time (STROOP = 13.4%, p < 0001; ADD = 13.3%, p < 0.001) and reduction in throughput (STROOP = −9.9%, p < 0.001; ADD = −6.3%, p = 0.08) during HWs among non-AC residents relative to AC residents at baseline. While ADD showed a linear relationship with indoor temperatures, STROOP was described by a U-shaped curve with linear effects below and above an optimum range (indoor temperature = 22°C–23°C), with an increase in reaction time of 16 ms/°C and 24 ms/°C for STROOP and ADD, respectively. Cognitive tests occurred right after waking, so the study is limited in that it cannot assess whether the observed effects extended during the rest of the day. Although the range of students’ ages also represents a limitation of the study, the consistent findings in this young, healthy population might indicate that greater portions of the population are susceptible to the effects of extreme heat.ConclusionsCognitive function deficits resulting from indoor thermal conditions during HWs extend beyond vulnerable populations. Our findings highlight the importance of incorporating sustainable adaptation measures in buildings to preserve educational attainment, economic productivity, and safety in light of a changing climate.

Civilizational challenges have questioned the status quo of energy and material consumption by humans. From the built environment perspective, a response to these challenges was the creation of green buildings. Although the revolutionary capacity of the green building movement has elevated the expectations of new commercial construction, its rate of implementation has secluded the majority of the population from its benefits. Beyond reductions in energy usage and increases in market value, the main strength of green buildings may be the procurement of healthier building environments. Further pursuing the right to healthy indoor environments could help the green building movement to attain its full potential as a transformational public health tool. On the basis of 40 years of research on indoor environmental quality, we present a summary of nine environment elements that are foundational to human health. We posit the role of green buildings as a critical research platform within a novel sustainability framework based on social-environmental capital assets.

In the Northeastern U.S., future heatwaves will increase in frequency, duration, and intensity due to climate change. A great deal of the research about the health impacts from extreme heat has used ambient meteorological measurements, which can result in exposure misclassification because buildings alter indoor temperatures and ambient temperatures are not uniform across cities. To characterize indoor temperature exposures during an extreme heat event in buildings with and without central air conditioning (AC), personal monitoring was conducted with 51 (central AC, n = 24; non-central AC, n = 27) low-income senior residents of public housing in Cambridge, Massachusetts in 2015, to comprehensively assess indoor temperatures, sleep, and physiological outcomes of galvanic skin response (GSR) and heart rate (HR), along with daily surveys of adaptive behaviors and health symptoms. As expected, non-central AC units (Tmean = 25.6 °C) were significantly warmer than those with central AC (Tmean = 23.2 °C, p < 0.001). With higher indoor temperatures, sleep was more disrupted and GSR and HR both increased (p < 0.001). However, there were no changes in hydration behaviors between residents of different buildings over time and few moderate/several health symptoms were reported. This suggests both a lack of behavioral adaptation and thermal decompensation beginning, highlighting the need to improve building cooling strategies and heat education to low-income senior residents, especially in historically cooler climates.

The type, size, and location of renewable energy (RE) deployment dramatically affects benefits to climate and health. Here, we develop a ten-region model to assess the magnitude of health and climate benefits across the US We then use this model to assess the benefits of deploying varying capacities of wind, utility-scale solar photovoltaics (PV), and rooftop solar PV in different regions in the US-a total of 284 different scenarios. Total benefits ranged from $2.2 trillion for 3000 MW of wind in the Upper Midwest to $4.2 million for 100 MW of wind in California. Total benefits and highest cost effectiveness for CO 2 reduction were generally highest for RE deployment in the Upper Midwest and Great Lakes and Mid-Atlantic US and lowest in California. Health was a substantial portion of total benefits in nearly all regions of the US Benefits were sensitive to methane leakage throughout the gas supply chain.

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.