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

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.

Heat-health action plans in Europe: Challenges ahead and how to tackle them

“…Changing knowledge, attitudes, practices and beliefs (KAPB) regarding the effectiveness of an intervention is another approach that can be taken. Up to now surveys assessing KAPB in general populations towards health have been conducted in several countries, for example in China (Li et al, 2016;Xu et al, 2018;Ye et al, 2018), Japan (Takahashi et al, 2015), Portugal and Spain (Gil Cuesta et al, 2017), as well as in the United States (Madrigano et al, 2018). Findings from such studies could be translated into target-group specific health education.…”

Modeling and comparing central and room air conditioning ownership and cold-season in-home thermal comfort using the American Housing Survey

“…Lacking the financial resources to operate an air conditioner is likely a substantial barrier to home cooling ( 13 – 18 , 25 ). Cognitive impairment, having medical conditions aggravated by AC use, concerns about energy efficiency, and additional barriers to resources related to racial discrimination and neighborhood of residence ( 13 , 18 ) may also limit home cooling. Further research and action is needed to quantify socio-economic drivers of air conditioning usage and reduce racial disparities in access to cool spaces.…”

“…Therefore, having models to predict central air conditioning ownership and uncomfortably cold indoor temperature in residential homes could further our understanding of the mediating and modifying effects of these characteristics on health in the warm and cold seasons in epidemiologic studies. In turn, this information could be used to screen households for allocation of weatherization resources, with potential prioritization of 1) homes that lack central air conditioning, 2) homes that are deemed too cold in the winter, 3) homes that use energy inefficiently, which can also be predicted from housing characteristics ( 12 ), and 4) households that can’t afford to pay for utilities ( 13 – 18 ). These homes and households could also be prioritized in policies addressing health through improving housing conditions.…”

Heat-Related Illness Is Associated with Lack of Air Conditioning and Pre-Existing Health Problems in Detroit, Michigan, USA: A Community-Based Participatory Co-Analysis of Survey Data

“…Our findings regarding AC and heat-related illness were consistent with findings in a recent survey of New York City, New York, USA residents. In this survey, low-income individuals had a 3.1-times higher odds (95% CI: 1.8, 5.5) of not having AC, and in turn, these low-income individuals 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) [ 24 ].…”