Survey of extreme heat public health preparedness plans and response activities in the most populous jurisdictions in the United States

Abstract

Background Increasingly frequent and intense extreme heat events (EHEs) are indicative of climate change impacts, and urban areas’ social and built environments increase their risk for health consequences. Heat action plans (HAPs) are a strategy to bolster municipal EHE preparedness. The objective of this research is to characterize municipal interventions to EHEs and compare U.S. jurisdictions with and without formal heat action plans. Methods An online survey was sent to 99 U.S. jurisdictions with populations > 200,000 between September 2021 and January 2022. Summary statistics were calculated to describe the proportion of total jurisdictions, as well as jurisdictions with and without HAPs and in different geographies that reported engagement in extreme heat preparedness and response activities. Results Thirty-eight (38.4%) jurisdictions responded to the survey. Of those respondents, twenty-three (60.5%) reported the development of a HAP, of which 22 (95.7%) reported plans for opening cooling centers. All respondents reported conducting heat-related risk communications; however, communication approaches focused on passive, technology-dependent mechanisms. While 75.7% of jurisdictions reported having developed a definition for an EHE, less than two-thirds of responding jurisdictions reported any of the following activities: conducting heat-related surveillance (61.1%), implementing provisions for power outages (53.1%), increasing access to fans or air conditioners (48.4%), developing heat vulnerability maps (43.2%), or evaluating activities (34.2%). There were only two statistically significant (p ≥ .05) differences in the prevalence of heat-related activities between jurisdictions with and without a written HAP, possibly attributable to a relatively small sample size: surveillance and having a definition of extreme heat. Conclusions Jurisdictions can strengthen their extreme heat preparedness by expanding their consideration of at-risk populations to include communities of color, conducting formal evaluations of their responses, and by bridging the gap between the populations determined to be most at-risk and the channels of communication designed to reach them.

Urban heat mitigation by green and blue infrastructure: Drivers, effectiveness, and future needs

“… 25 Thus, the increasing frequency, amplitude, and duration of heatwaves forces governments to take action against the increasing risk of heat-related mortality and morbidity. The increasing implementation of cooling centers 26 , 27 , 28 , 29 is a clear indicator that governments are beginning to take action to protect their populations from extreme heat.…”

“… 45 Several urban heat mitigation studies have also assessed the potential of urban water management for improving urban cooling through the retention of water in the urban environment. 29 , 30 , 31 , 46 , 47 , 48 As an example, the integration of natural water features within cities can effectively cool surrounding areas such as lakes and ponds (10%–50% cooler inside between 30 and 200 m than at edges), rivers (5%–15% cooling effect), and urban wetlands (5%–20% cooling effect). 49 , 50 High amounts of tree canopy cover, green space, green roofs and walls, and open space have been reported to decrease urban heat through evapotranspiration cooling.…”

Perceptions of the health risk from hot days and the cooling effect of urban green spaces: a case study in Xi’an, China

“…Directing attention to the needs of urban residents under thermal environmental risks can provide a reference for the government to formulate reasonable adaptation policies and effective urban ecological construction. International research on hot days perception and adaptation began in the 1980s, and qualitative interviews with vulnerable groups have become the focus in recent years ( 10 , 11 ). As Chinese society gradually attaches importance to improving the quality of human settlements, relevant studies have attracted more attention ( 12 ).…”

Preparing for Extreme Heat: Are Cooling Outdoor Spaces Accessible by People with Disabilities?

“…Climate change adaptation plans are being developed around the world but rarely account for people with disabilities, 1 – 3 who tend to be more vulnerable to extreme weather events. 4 These events include heat waves 5 , 6 that contribute to thousands of annual excess deaths in the United States 7 and elsewhere.…”

“…Marie O’Neill, a professor of epidemiology and environmental health sciences at the University of Michigan, who also was not involved in the study, points to a recent survey on extreme heat public health preparedness plans in U.S. jurisdictions. 3 She notes that fewer than half of the 38 jurisdictions that responded to the survey had plans to address the needs of people with mobility challenges or preexisting medical conditions.…”