Racial and Socioeconomic Disparities in Heat-Related Health Effects and Their Mechanisms: a Review

Abstract

Adaptation to increasing extreme heat in a changing climate requires a precise understanding of who is most vulnerable to the health effects of extreme heat. The evidence for race, ethnicity, income, education and occupation, at the individual and area levels, as indicators of vulnerability is reviewed. The evidence for the social, behavioral and technological mechanisms by which racial and socioeconomic disparities in vulnerability exist is also reviewed. These characteristics include cardiorespiratory, renal and endocrine comorbidities; cognitive, mental or physical disabilities; medication use; housing characteristics; neighborhood characteristics such as urban heat islands, crime and safety; social isolation; and individual behaviors such as air conditioning use, opening windows and using fans and use of cooler public spaces. Pre-existing and future research identifying these more proximal indicators of vulnerability will provide information that is more generalizable across locations and time to aid in identifying who to target for prevention of heat-associated morbidity and mortality.

Factors of subjective heat stress of urban citizens in contexts of everyday life

“…This definition and measurement has been used in previous empirical studies on SHS among residents of the German cities Leipzig (Großmann et al, 2012), Aachen (Pfaffenbach and Siuda, 2010), and Nuremberg (Wittenberg et al, 2012). These clearly indicated that SHS in everyday life is not solely an issue at home and in the residential environment, but also at work.…”

“…stress (Großmann et al, 2012;Pfaffenbach and Siuda, 2010). Subjective heat stress hereby refers to the individual and selfreported assessment of respondents to what extent they experience high summer temperature as stress.…”

“…Some of them focused on the risk perception and the response to heat warnings of vulnerable groups such as the elderly (Abrahamson et al, 2009;Hansen et al, 2011;Sampson et al, 2013;Sheridan, 2007) and their social networks (Wolf et al, 2010). Others tried to understand the social dimensions of subjective heat stress and behavior during heat (Großmann et al, 2012) or the social production of heat wave impacts (Klinenberg, 2002). The studies employed qualitative or quantitative research designs and because of their timing, they differ as well regarding the temporal relation to heat experience.…”

“…The studies employed qualitative or quantitative research designs and because of their timing, they differ as well regarding the temporal relation to heat experience. In some of them, data collection took place during a heat wave (Großmann et al, 2012;Klinenberg, 2002;Sheridan, 2007), in others in the summer season without pronounced heat (Abrahamson et al, 2009;WhiteNewsome et al, 2011), in late spring (Pfaffenbach and Siuda, 2010), or during winter (Kalkstein and Sheridan, 2007).…”

Improving Heat-Related Health Outcomes in an Urban Environment with Science-Based Policy

“…A person's inability to regulate his/her thermal balance can be related to physiological factors, such as a deterioration of heat regulation due to age, medical conditions, or medications [36]. Behavioral mechanisms, such as maintaining hydration or refraining from overexertion, can be crucial.…”