Staying cool in a changing climate: Reaching vulnerable populations during heat events

Abstract

The frequency and intensity of hot weather events are expected to increase globally, threatening human health, especially among the elderly, poor, and chronically ill. Current literature indicates that emergency preparedness plans, heat health warning systems, and related interventions may not be reaching or supporting behavior change among those most vulnerable in heat events. Using a qualitative multiple case study design, we comprehensively examined practices of these populations to stay cool during hot weather ("cooling behaviors") in four U.S. cities with documented racial/ethnic and socio-economic disparities and diverse heat preparedness strategies: Phoenix, Arizona; Detroit, Michigan; New York City, New York; and Philadelphia, Pennsylvania. Based on semi-structured in-depth interviews we conducted with 173 community members and organizational leaders during 2009-2010, we assessed why vulnerable populations do or do not participate in health-promoting behaviors at home or in their community during heat events, inquiring about perceptions of heat-related threats and vulnerability and the role of social support. While vulnerable populations often recognize heat's potential health threats, many overlook or disassociate from risk factors or rely on experiences living in or visiting warmer climates as a protective factor. Many adopt basic cooling behaviors, but unknowingly harmful behaviors such as improper use of fans and heating and cooling systems are also adopted. Decision-making related to commonly promoted behaviors such as air conditioner use and cooling center attendance is complex, and these resources are often inaccessible financially, physically, or culturally. Interviewees expressed how interpersonal, intergenerational relationships are generally but not always protective, where peer relationships are a valuable mechanism for facilitating cooling behaviors among the elderly during heat events. To prevent disparities in heat morbidity and mortality in an increasingly changing climate, we note the implications of local context, and we broadly inform heat preparedness plans, interventions, and messages by sharing the perspectives and words of community members representing vulnerable populations and leaders who work most closely with them.

Internet-Based Heat Evaluation and Assessment Tool (I-HEAT): Feasibility Analysis of a Visualization and Decision-support Tool for Extreme Heat Preparedness in Detroit, Michigan

“…The research team is currently working to identify ways to expand I-HEAT with additional data that reflect community resources and health behaviors (e.g., transportation, social services, air conditioner usage), as these factors also contribute to vulnerability (Sampson et al 2013). For example, after the workshop, cooling center locations were added to the web interface to help users see if and how current heat preparedness interventions aligned with the locations of vulnerable populations.…”

Outdoor thermal comfort by different heat mitigation strategies- A review

“…As heat waves are the first natural cause of mortality [5,[21][22][23][24][25], this research focuses on the impact of UHI on thermal comfort of people in urban open spaces. During a two week heat wave in August 2003, 70,000 people passed away [22].…”

What do New Yorkers Think about Impacts and Adaptation to Heat Waves? An Evaluation Tool to Incorporate Perception of Low-Income Groups into Heat Wave Adaptation Scenarios in New York City

“…Whereas the relation between heat vulnerability and socio-demographic factors, such as age, race, gender, and poverty, is well examined [12][13][14][15][16], the role of economic factors such as different income levels (not only considering the poor and low-income, but also middle-and high-income people) is under-researched. Being a prominent vulnerability factor, income may play an important role in how citizens experience heat waves.…”