The Escalating Global Heat Crisis – Impacts and Solutions
What are Heat-Related Illnesses and Who is Most Vulnerable?
Heat-related illnesses range from mild conditions like skin eruptions and heat fatigue to severe, life-threatening conditions such as heat exhaustion and heatstroke. Heat exhaustion symptoms include intense thirst, weakness, dizziness, fainting, and headaches, while heatstroke involves a rapid increase in body temperature above 40°C (104°F) accompanied by central nervous system abnormalities like confusion or coma.
Several groups are particularly vulnerable to these impacts:
Older Adults: Individuals aged 65 and older are at significantly higher risk due to reduced thirst perception, higher likelihood of taking medications affecting thermoregulation, and pre-existing chronic conditions like cardiovascular disease, diabetes, and respiratory illnesses. The 2003 Paris heatwave, for example, saw a 40% increase in deaths for 65-year-olds and a 70% increase for 85-year-olds.
Infants and Young Children: Their underdeveloped internal temperature regulation systems and decreased sweating capacity make them highly sensitive to external temperature variations.
Outdoor Workers and Athletes: Prolonged exposure to extreme heat and humidity, coupled with physical exertion and sometimes personal protective equipment, increases their risk of heat stress, illness, reduced vigilance, and occupational injury.
Individuals with Pre-existing Medical Conditions: High temperatures exacerbate and increase mortality rates in 90% of existing global causes of death, including heart disease, stroke, COPD, diabetes, and mental health conditions. Certain medications (e.g., antihistamines, antipsychotics) can also impair the body's ability to cool itself.
Socially Isolated Individuals and Low-Income Households: Those living alone, especially older adults, and low-income individuals often lack access to cooling resources like air conditioning due to cost, poor housing quality, or limited mobility, making them more susceptible to heat-related mortality indoors.
Unhoused Populations: Without access to air conditioning, water, or cooling stations, and often with strained access to medical care, unhoused individuals face extremely high heat illness risks.
Pregnant Women: Physiological changes during gestation make it harder for pregnant women to regulate body temperature, increasing risks of complications like hypertension, preeclampsia, low birthweight, stillbirth, and preterm birth. Black women in the United States face more than double the risk of hospitalization from heat exposure during pregnancy.
People with Disabilities: Reduced mobility and dependence on others can limit their ability to adapt to heat.
How do "Urban Heat Islands" (UHIs) exacerbate heat risks, and what role do urban planning and infrastructure play in mitigation?
Urban Heat Islands (UHIs) are metropolitan areas that are significantly warmer than their surrounding rural areas, often by as much as 22°F. This phenomenon intensifies heat risks in cities due to several factors:
Paved Surfaces: Materials like asphalt and concrete retain more heat than natural landscapes, contributing to higher surface and air temperatures.
Urban Density: Closely clustered tall buildings create "canyons" that trap warm air, making it harder for surfaces to cool overnight and leading to prolonged heat exposure for residents.
Lack of Green Spaces: Insufficient vegetation and green infrastructure reduce natural cooling processes like shading and evapotranspiration, which can lower peak summer temperatures by 1°C to 5°C.
Urban planning and infrastructure are crucial for mitigating UHI effects and promoting sustainable cooling:
Passive Cooling Strategies: Prioritizing green spaces, green infrastructure, and water-friendly designs (e.g., fountains, permeable pavements in low-traffic areas) can reduce cooling loads by over 25% even in hot climates.
Building Design: Renovating and designing public and private buildings with passive cooling elements (e.g., basements, open courtyards, proper window orientation, shading devices, highly insulative materials, bright colors for surfaces) can significantly reduce indoor heat gain and energy consumption. Some traditional architectural solutions for cooling also hold potential.
Urban Greening: Increasing tree canopy, creating more parks and parklets with shade, and designing "wind corridors" from surrounding green areas can lower urban temperatures and improve air quality. A study in Europe estimates that increased tree canopy in cities could reduce heat deaths by one-third.
"Cool" Infrastructure: Applying reflective coatings to streets and parking lots or choosing lighter colors for pavements can absorb less heat than traditional dark materials, though their effectiveness for pedestrians can vary.
Sustainable Cooling: A systemic approach is needed to minimize sensible heat, facilitate natural cooling, and ensure mechanical cooling has the lowest environmental footprint. This involves improving urban planning, using thermally favorable materials, and nature-based cooling practices to reduce the UHI effect and electrical demand.
What are Heat-Health Action Plans (HHAPs) and why are they critical for public health?
Heat-Health Action Plans (HHAPs) are comprehensive strategies designed to prevent adverse health effects from hot weather and heatwaves. They coordinate actions from health system preparedness to timely public advice and improvements in urban planning. HHAPs are considered a "core element" of public health responses to extreme heat, aiming to reduce heat-related mortality and morbidity.
Critical aspects of HHAPs include:
Early Warning Systems (HHWS): These systems establish temperature thresholds (e.g., 95th percentile of historical temperatures, specific heat index values) that trigger alerts. Warnings can be based on absolute thresholds or relative thresholds accounting for local acclimatization. Health data, such as daily illness and death events, are used to inform and refine these thresholds. For example, New York City and New England have lowered their heat warning thresholds by incorporating health outcome research.
Multi-tiered Warnings: HHWS typically have different warning categories (e.g., pre-alert, alert, emergency) that dictate the level of intervention.
Communication and Dissemination: Effective HHAPs require rapid and clear dissemination of warnings and health information to the public and stakeholders through various media, including TV, radio, newspapers, the internet, email alerts (like CDC's Health Alert Network), and automated phone systems. Messages are often customized for vulnerable groups.
Intervention Measures: HHAPs outline specific actions during heat events, such as:
Opening cooling centers and providing transportation to them.
Suspending utility shut-offs for non-payment during extreme heat.
Increasing outreach to vulnerable populations (e.g., unhoused individuals, isolated elderly) through door-to-door checks, social services, and community networks.
Rescheduling public events to avoid large outdoor gatherings.
Ensuring access to fluids and encouraging hydration.
Providing first-aid training for heat emergencies.
Governance and Collaboration: Effective HHAPs involve clear roles and responsibilities across national, regional, and local authorities, including health departments, meteorological services, emergency management, NGOs (like the Red Cross/Red Crescent), and community organizations. Intersectoral action is crucial for integrating health considerations into broader policies like urban planning.
Monitoring and Evaluation: Regular evaluation, including tracking health impacts (mortality, hospitalizations, emergency department visits) and assessing the effectiveness of interventions, is essential for continuous improvement. While direct causal links can be difficult to prove, studies have shown that HHAPs contribute to reducing mortality on hot days, especially among vulnerable subgroups.
How does extreme heat impact education and economic productivity, and what are the disparities in these impacts?
Extreme heat significantly impacts both education and economic productivity, with disproportionate effects on lower-income and marginalized communities.
Impact on Education:
Reduced Learning: Heat directly interferes with learning time. Studies show that a 1°F hotter school year can significantly lower academic achievement, with the most substantial impact seen during school days, not weekends or summer breaks.
Cognitive Impairment: Acute heat stress can temporarily reduce performance on standardized tests and cognitive assessments for students of all ages.
Exacerbated Inequalities: The negative impact of heat on academic achievement is three times greater for students in the lowest quintile of average income and for Black and Hispanic students compared to white students. This highlights how heat exacerbates existing educational disparities.
Lack of Adaptation: School-level air conditioning can almost fully offset the negative impacts of cumulative heat exposure, but many schools, particularly in hotter, poorer countries and communities, lack adequate cooling, compounding the learning deficit.
Impact on Economic Productivity:
Labor Capacity Loss: Extreme heat reduces labor capacity globally, leading to significant productivity losses, particularly in low and medium Human Development Index (HDI) countries. For example, India, Bangladesh, and Pakistan experienced losses equivalent to 216–261 working hours per employed person in 2020.
Outdoor Workers Most Affected: Outdoor workers in sectors like construction, agriculture, and street vending are particularly vulnerable to heat stress, with projections of millions of job losses by 2030 in regions like Latin America and the Caribbean due to heat stress alone.
Direct Damage to Capital and Income Flow: Climate hazards, including heatwaves, directly damage physical capital stock and potential income flow, affecting countries' overall wealth.
Underestimated Social Cost of Carbon: Current estimates of the social costs of carbon may be understated because they often model costs as non-accumulating reductions in GDP rather than direct, cumulative impacts on human capital.
Food Security: Higher temperatures shorten growing seasons and reduce crop yields, increasing food insecurity and disproportionately affecting already undernourished populations. This impacts agricultural labor, a sector where women constitute a large portion of the workforce in many developing nations.
What is "cooling inequity" and how does it relate to social and racial disparities?
"Cooling inequity" refers to the unequal access to cooling services, resources, and infrastructure, which deepens existing social and racial disparities, particularly in urban environments. This inequity is a significant public health issue with profound societal impacts.
Key aspects of cooling inequity include:
Unequal Access to Air Conditioning (AC): AC is the most effective protective strategy against heat-health impacts, yet access is highly uneven. Low-income households and communities of color, especially Black and Latinx households in the U.S., face higher energy cost disparities and often lack access to affordable, energy-efficient cooling units. Homes in these communities are also less likely to be weatherized and energy-efficient, limiting adaptability.
Indoor Heat Exposure: The majority of extreme heat deaths in high-income countries occur indoors, and indoor temperatures can remain dangerously high even after outdoor temperatures cool. This is exacerbated in poorly insulated homes without AC, disproportionately affecting vulnerable populations.
Urban Heat Island Effect and Segregation: Communities of color are disproportionately represented in urban heat islands, even when accounting for income and homeownership rates. Historically racist housing policies, such as redlining, have contributed to areas with fewer trees and higher temperatures, creating "urban death islands" in low-income and non-white neighborhoods.
Energy Poverty: The high cost of AC amplifies energy poverty globally, making it unaffordable for many vulnerable households to run cooling systems even when they have them.
Gendered Impacts: Women, especially poorer women in slum communities and those in informal labor sectors (e.g., manual laborers, domestic workers, garment workers), suffer disproportionately from lack of cooling. They often work in unventilated facilities, may lack access to fans or refrigeration, and face heat-trapping clothing requirements. Pregnancy also makes women more vulnerable to heat, with black pregnant women facing higher hospitalization rates.
Limited Public Resources: While cooling centers are a common intervention, barriers such as lack of transportation, awareness, or discrimination (e.g., unhoused individuals being asked to leave air-conditioned public venues) limit their effectiveness for those most in need.
Cycle of Disadvantage: The increased demand for AC, fueled by rising temperatures, necessitates massive investments in power generation, which can lead to higher energy costs, perpetuating the cycle of unaffordability for vulnerable groups and potentially causing power outages that further increase heat exposure risk.
Addressing cooling inequity requires a multi-faceted approach, including policy interventions, financial support for energy-efficient cooling and housing, and community-led initiatives to provide accessible cooling resources.
How is research on heatwaves evolving, and what new metrics and strategies are being developed?
Research on heatwaves is a rapidly growing field, doubling in publications within about five years, driven by the increasing frequency, intensity, and duration of these extreme weather events due to global warming. Scientists are working to understand the specific connection between heatwaves and human-made climate change, often discussing a weakening of the polar jet stream as a possible reason for increased stationary weather patterns leading to heatwaves.
Key developments in research and strategies include:
Understanding Heatwave Characteristics: While there's no universal definition, research examines how intensity (temperature thresholds) and duration impact mortality. Studies have shown that higher temperature thresholds generally lead to higher mortality risks, and that heatwave effects appear acutely and can last for 3-4 days.
New Metrics:Wet-Bulb Temperature (WBT): This metric combines temperature and humidity to measure the lowest temperature achievable by evaporative cooling. It is increasingly recognized as critical because it identifies conditions where human survivability limits are reached, even for healthy individuals, as the body cannot cool itself through sweating.
Excess Heat Index (EHI): Developed by the Bureau of Meteorology, this index considers the relationship of maximum and minimum temperatures averaged over three days to a climate reference value (95th percentile) to characterize heat events.
Apparent Temperature (AT) and Heat Index (HI): These indices combine air temperature with humidity (and sometimes wind speed) to determine how hot it "feels," and are widely used in warning systems, adjusted for local conditions and acclimatization.
Perceived Temperature (PT): Used in Germany, this index assesses thermal stress by determining the air temperature of a standard environment that would produce the same thermal stress as actual conditions, accounting for clothing and acclimatization (HeRATE approach).
Impact of Global Climate Phenomena: Research in 2023 linked the longest-lasting heatwave in the southwestern U.S. and Mexico to record-warm Atlantic Ocean sea surface temperatures and a developing El Niño, showing how remote oceanic conditions can modulate local extreme heat events.
Early Warning System Advancements:Health Data Integration: Public health agencies are using daily illness and death data to inform and refine heat warning thresholds, moving beyond purely climatic averages to incorporate health effects.
Spatiotemporal Analysis: Utilizing high spatial resolution temperature data, including satellite-derived thermal data, helps identify urban heat island effects in real-time and map vulnerability hotspots.
Seasonal Forecasting: Advances in climate prediction models offer the possibility of developing heat risk awareness at longer monthly and seasonal timescales (10-90 days in advance), allowing for greater preparedness.
Public Perception and Communication: Research explores how to make warnings more effective by considering factors like risk signature, public education, and addressing low risk perception among vulnerable groups. Naming heatwaves, similar to hurricanes, has been proposed to increase public seriousness, although studies on its effectiveness are mixed.
What are the wider societal and environmental impacts of extreme heat beyond direct health effects?
Extreme heat has pervasive and far-reaching societal and environmental impacts beyond immediate health concerns, affecting various aspects of human life and the natural world:
Socio-Economic and Income Inequity: Heat exacerbates existing inequalities, disproportionately affecting low-income populations and marginalized communities who often lack resources to adapt. This can lead to greater losses of earnings and reduced labor capacity, particularly in low and medium Human Development Index (HDI) countries.
Food Security: Higher temperatures contribute to shorter growing seasons and declining crop yields, adding pressure to already strained food systems and increasing food insecurity globally.
Violence and Crime: Elevated temperatures have been linked to increases in violence and crime.
Mental Health and Sleep: Extreme heat can negatively impact mental health, leading to increased negative expressions on social media, exacerbated psychological distress, and affecting sleep patterns. There is a strong association between heat and increased suicide rates.
Disease Transmission: Higher temperatures and other environmental changes increase the suitability for the transmission of various pathogens, including water-borne, airborne, food-borne, and vector-borne diseases like malaria and cholera. This can undermine advances in public health.
Infrastructure Strain and Power Outages: Extreme heat events significantly increase demand for energy, straining electrical grids and leading to power outages. These outages disable air conditioning, leaving more people vulnerable to heat-related deaths, as seen in cases where power failures contributed to fatalities during heatwaves.
Marine Heatwaves: Beyond land, oceans are experiencing record warm sea surface temperatures and heat content, leading to marine heatwaves. These phenomena threaten global biodiversity and the provision of ecosystem services, impacting marine ecosystems and potentially fisheries.
Wider Environmental Impacts: Heatwaves often occur alongside other environmental issues such as drought and wildfires, which further contribute to economic losses, air pollution, and disruptions to routine health services. For example, the 2023 heatwave in the southwestern U.S. and Mexico, compounded by drought, resulted in $14.5 billion in economic loss.
What are the recommended strategies for individuals and communities to prepare for and respond to heatwaves?
Preparing for and responding to heatwaves requires a combination of individual actions and community-level strategies to ensure safety and minimize health impacts:
Individual Strategies:
Stay Hydrated: Drink plenty of fluids, even if not thirsty. For prolonged exertion, replace salt and minerals with snacks or sports drinks (consult a doctor if on a low-salt diet).
Stay Cool:Spend as much time as possible in air-conditioned places. If home lacks AC, go to a predesignated cool location (e.g., public cooling center, library, mall).
Wear lightweight, loose-fitting, light-colored clothing.
Take cool showers or baths.
Use night air to cool homes by opening windows and shutters when outside temperatures are lower (if safe).
Turn off artificial lighting and unnecessary electrical devices to reduce indoor heat.
Hang shades, draperies, awnings, or louvers on windows receiving sun.
Limit Outdoor Activity: Schedule strenuous tasks for earlier or later in the day, cut down on exercise, and rest often in shady areas.
Protect from Sun: Wear wide-brimmed hats and sunglasses, and use sunscreen.
Medication Management: Store medicines below 25°C or in a refrigerator. Consult a doctor about how medications may influence thermoregulation.
Recognize Symptoms and Act Fast: Be aware of symptoms of heat exhaustion (dizziness, weakness, intense thirst, headache) and heatstroke (hot dry skin, delirium, convulsions, unconsciousness). Seek medical help immediately for severe symptoms. Learn basic first aid for heat emergencies.
Stay Connected: Sign up for local emergency alerts, monitor weather and news, and have backup battery or charging methods for phones and radios.
Community and Public Health Strategies:
Develop Heat Action Plans (HAPs): Cities and regions should create comprehensive HAPs that identify vulnerable populations and specific locations in need of relief.
Public Awareness Campaigns: Educate the public and community leaders about heat risks and mitigation strategies (e.g., gradual acclimatization, hydration, seeking cool locations). This can be done through interviews with local experts, community events, and social media.
Cooling Centers: Designate and operate public cooling shelters, ensuring accessibility (e.g., transportation, addressing discrimination against unhoused individuals).
Neighbor Outreach: Encourage friends, family, and neighbors to check on older adults and isolated residents, ensuring they have fluids and proper ventilation. Social services and community emergency response teams can conduct door-to-door checks.
Prevent Utility Shut-offs: Prohibit electricity disconnections for non-payment during heat emergencies to ensure continued access to cooling.
Urban Greening and Infrastructure: Implement long-term solutions like increasing tree canopy, promoting cool roofs and pavements, and designing buildings for passive cooling to reduce urban heat island effects.
Workplace Protections: Establish and enforce standards for occupational heat exposure, providing breaks, hydration, shade, and appropriate clothing for outdoor and physically demanding indoor workers.
Data-Driven Decisions: Use health data and meteorological forecasts to set and adjust heat warning thresholds, ensuring timely alerts and effective resource deployment.
Strategic Partnerships: Foster collaboration among government agencies, health services, NGOs, and local communities for coordinated response and resource allocation.
What are some of the challenges and limitations in implementing effective heatwave response measures?
Implementing effective heatwave response measures faces several significant challenges and limitations, despite growing awareness of the risks:
Lack of Public Awareness and Risk Perception:Many individuals, even in environmentally overburdened communities, are unaware of basic heat mitigation strategies (e.g., window shades, consistent hydration).
Vulnerable groups often do not perceive themselves to be at high risk, leading to a lack of proactive behavioral changes or uptake of protective measures.
General public knowledge about HHAPs and specific responses is far from widespread, and awareness doesn't always translate into action.
Data and Evaluation Gaps:Limited peer-reviewed research directly links the use of interventions like cooling centers to health outcomes, making it difficult to assess their precise effectiveness.
Coverage of information campaigns or training often goes unreported or unquantified.
Real-life empirical evidence on the health-protective effects of housing and built environment interventions for vulnerable groups is scarce, with much knowledge derived from controlled environments or models.
It is difficult to attribute health benefits directly to HHAPs with confidence due to confounding factors (e.g., widespread AC adoption).
Coordination and Governance Issues:Despite increased awareness, progress in prevention and response within the health sector, especially at subnational levels, has been limited.
Many national HHAPs lack detailed information or sufficient guidance for managing heat-health risks in health and social care settings.
Roles and responsibilities for non-state actors (e.g., businesses, private sector) are often not formally specified, limiting their participation.
Integrating health considerations into mainstream urban planning and management is challenging due to a lack of intersectoral coordination mechanisms.
Access and Equity Barriers:The cost of energy for air conditioning remains a major barrier for low-income households, even for those with AC units, contributing to "energy poverty."
Lack of transportation, discrimination, or perceived stigma can prevent vulnerable populations (e.g., unhoused individuals) from accessing cooling centers.
The rapid transition to web-based and mobile communication platforms for warnings may exclude vulnerable groups less familiar with newer technologies.
Infrastructure and Resource Constraints:Power outages, caused by severe weather or overuse of the power grid during heatwaves, disable AC and increase vulnerability.
Many hospitals and care facilities, especially older ones, are not adequately equipped for heatwaves, with limited AC or inefficient ventilation.
Staff shortages can limit the management of heat risks in care settings.
HHAPs are often under-resourced in terms of funding and human capital, despite high benefit-to-cost ratios.
Complexity of Heat Hazards:The physiologically based definition of heatwaves (e.g., 5+ consecutive days 5°C above average maximum) varies by region, making standardized approaches difficult.
Heatwaves are geographically diffuse, unlike more localized hazards like hurricanes, making warning systems complex.
Combining heat warnings with air quality warnings (e.g., ozone) is complex because they may target different populations (indoor vs. outdoor).
Behavioral and Organizational Issues in Care Settings:Fixed daily routines in care homes can make it difficult to accommodate intense heat periods.
Management structures may not allow front-line staff to alter indoor temperatures effectively.
A cultural focus on cold as the main climate risk in some regions leads to high indoor temperatures not being considered undesirable.
How do global climate trends and phenomena contribute to the increasing severity and frequency of heatwaves?
Global climate trends and phenomena are directly responsible for the increasing severity and frequency of heatwaves, making them a "hot topic" in climate change research.
Global Warming and Greenhouse Gases: The well-documented phenomenon of global warming, primarily driven by an upsurge in anthropogenic greenhouse gas emissions, is the fundamental cause. Global concentrations of carbon dioxide continue to rise, making a long-lasting reduction in temperatures unlikely this century.
Increased Frequency, Intensity, and Duration: Heatwaves are becoming more frequent, more intense (both relatively and absolutely), and longer-lasting across the globe. For example, the number of hot days has increased by 10 days per decade since 1960 in much of southeastern Europe and Scandinavia. Under severe climate scenarios, events as intense as the 2010 Russian Federation heatwave are projected to become the norm, occurring as often as every two years in regions like southern Europe, North America, South America, Africa, and Indonesia.
Oceanic Warming: Global oceans, particularly the tropical Atlantic, have experienced record-warm sea surface temperatures (SSTs) and oceanic heat content. These warm oceanic temperatures are linked to the positive phase of the Atlantic Multidecadal Variability and increased energy imbalance from greenhouse gases.
Modulation of Atmospheric Circulation: Warm North Atlantic SSTs can modulate local and remote atmospheric circulation, influencing precipitation patterns and leading to phenomena like "heat domes" (anomalous anticyclonic circulation patterns). The 2023 heatwave in the southwestern U.S. and Mexico, for instance, was fueled by record-warm Atlantic SSTs, which contributed to an anomalous heat dome and disrupted the North American Monsoon, leading to record-low precipitation and prolonged extreme heat.
Weakening of the Polar Jet Stream: Scientists discuss that global warming may be causing a weakening of the polar jet stream. This weakening can increase the probability of stationary weather patterns, which can result in prolonged extreme events like heatwaves.
Feedback Loops: The increased use of air conditioning as temperatures rise contributes to more greenhouse gas emissions (especially from electricity generated by fossil fuels and hydrofluorocarbons), creating a vicious cycle that further exacerbates warming rates. Anthropogenic heat production from AC also worsens the urban heat island effect.
Terrestrial Temperature Records: 2023 was the second warmest year on record, with over 20% of the land surface setting extreme warm records, consistent with the expected physical responses to a warming climate. This widespread warming sets the stage for more severe heatwave events.
I. The Growing Threat of Extreme Heat
Extreme heat is an escalating global hazard, becoming "more frequent, longer, hotter, and deadlier as a result of climate change." (IFRC Heat Action Day Guide). This phenomenon is not merely an inconvenience but a significant public health, economic, and social crisis with profound environmental implications.
Key Facts & Ideas:
Record-Breaking Temperatures: "The year 2023 was the second warmest on records, only surpassed by 2024 (Monthly Global Climate Report for Annual 2024)." (The longest-lasting 2023 Western North American heat wave was fueled by the record-warm Atlantic Ocean). This includes the boreal summer months (June-August) of 2023, which were the "hottest summer with more than 20% of the land surface setting extreme warm records." (The longest-lasting 2023 Western North American heat wave was fueled by the record-warm Atlantic Ocean).
Intensified Heatwaves: Heatwaves are increasing in "frequency, in relative and absolute intensity and in duration, with a significant increasing trend... since 1950." (WHO Heat and health in the WHO European Region: updated evidence for effective prevention). Projections indicate that "heat waves will occur more often and last longer, and that extreme precipitation events will become more intense and frequent in many regions." (Vol.-(0123456789)1 3Theoretical and Applied Climatology (2021) 146-781–800).
Understated Social Cost of Carbon: Current estimates of the social costs of carbon may be "understated, as the costs of carbon are often modeled as non-accumulating reduction in GDP as opposed to direct, cumulative impacts on human capital." (Arsht-Rock Compendium).
II. Health Impacts of Extreme Heat
Heat poses a significant and often underestimated threat to human health, leading to a range of illnesses, increased mortality, and exacerbated pre-existing conditions.
Key Facts & Ideas:
High Mortality and Morbidity:
Globally, "489,075 annual heat-related excess deaths" are recorded (Arsht-Rock Compendium).
In 2019, heat-related deaths in people over 65 reached an estimated 345,000, an 80.6% increase from 2000-2005 levels. (Arsht-Rock Compendium).
The June 2021 heatwave in Washington State, Oregon, and British Columbia resulted in "803 officially reported heat-related deaths" and almost 1,200 suspected excess deaths, which is "2.8 times as many people as the 2020 Atlantic hurricane season." (Arsht-Rock Compendium).
Indoor heat exposure is a major concern, with "the majority of extreme heat deaths occur[ring] indoors" in high-income countries. (CDC Heat Response Plans Summary of Evidence). Homes and buildings can remain dangerously hot even after outdoor temperatures drop. (CDC Heat Response Plans Summary of Evidence).
Vulnerable Populations:
Elderly: Adults over 65 are particularly vulnerable, experiencing "3.1 billion more person-days of heatwave exposure annually in 2012-2021 than in 1986-2005." (Arsht-Rock Compendium). They are at greater risk due to chronic conditions, medications affecting heat response, reduced thirst, and social isolation. (CDC Heat Response Plans Summary of Evidence, Harvard Cooling Urban Heat).
Infants and Young Children: Their underdeveloped temperature regulation systems and decreased sweating capacity make them highly susceptible. (CDC Heat Response Plans Summary of Evidence). Heat has been linked to increased emergency room visits for pediatric diseases. (WHO Heat and health in the WHO European Region: updated evidence for effective prevention).
Pregnant Women: Heat exposure can lead to complications like hypertension, preeclampsia, premature rupture of membranes, low birthweight, stillbirth, and preterm birth. (Arsht-Rock Compendium, Harvard Cooling Urban Heat, WHO Heat and health in the WHO European Region: updated evidence for effective prevention). Black women in the US face "more than double the risk of hospitalization from emergency and urgent reasons" due to extreme heat during pregnancy. (Arsht-Rock Compendium).
Outdoor Workers and Athletes: They are at increased risk due to prolonged exposure, physical labor, and the use of personal protective equipment (PPE). (CDC Heat Response Plans Summary of Evidence).
People with Pre-Existing Conditions: High temperatures exacerbate and increase mortality rates in 90% of existing global causes of death, including cardiovascular, respiratory, and neurological diseases. (Arsht-Rock Compendium, WHO HEAT WAVES EURO). Certain medications can interfere with thermoregulation. (WHO Heat Waves and Health Guidance).
Unhoused Populations: These individuals lack access to air conditioning and may struggle to find water or cooling centers, facing a "heat illness risk level 300 percent higher than that of the general population in 2023" in Phoenix, AZ. (Harvard Cooling Urban Heat).
Low-Income Communities: Disproportionately affected due to "poorly designed infrastructure, limited access to air conditioning (A/C), and a lack of acclimatization." (Arsht-Rock Compendium). Energy cost disparities and inequitable access to weatherized, energy-efficient homes contribute to higher heat stress. (Arsht-Rock Compendium, WHO Heat Waves and Health Guidance).
Mental Health Impacts: Heatwaves are associated with increased negative expressions on social media, agitation, aggression, violence, and a higher risk of suicide and conflicts. (Arsht-Rock Compendium, WHO Heat and health in the WHO European Region: updated evidence for effective prevention).
Disease Transmission: Higher temperatures "increasing the suitability for the transmission of many water-borne, airborne, food-borne, and vector-borne pathogens." (Arsht-Rock Compendium).
III. Economic and Social Ramifications
The impacts of extreme heat extend beyond direct health effects, profoundly affecting economies, food security, and exacerbating existing social inequalities.
Key Facts & Ideas:
Productivity Losses: Heat reduces global productivity, with greater losses in low and medium Human Development Index (HDI) countries. (Arsht-Rock Compendium). The ILO estimates "2.5 million Latin American and Caribbean jobs could be lost to heat stress alone by 2030, affecting particularly outdoor workers in construction, agriculture, and street vendors." (Arsht-Rock Compendium).
Educational Attainment: "The rate of learning decreases with an increase in the number of hot school days" (Arsht-Rock Compendium, Heat and Learning Harvard Kennedy). This impact is "three times as large for black and Hispanic students as for white students" and for students in the lowest income quintile. (Heat and Learning Harvard Kennedy). Air conditioning in schools "almost fully offsets the impacts of cumulative heat exposure." (Heat and Learning Harvard Kennedy).
Food Insecurity: Higher temperatures lead to shorter growing seasons and declining crop yields, adding "additional pressure to already strained food systems around the world." (Arsht-Rock Compendium). This disproportionately affects those already facing undernutrition. (Arsht-Rock Compendium).
Gendered Impacts: Lack of access to cooling impacts women differently due to "gender-based structures around daily tasks and access to resources." (Gender-Cooling-SEforALL). Women in poorer settings and those working in the informal sector (e.g., manual laborers, domestic workers, garment workers, farmers) are particularly vulnerable to heat stress due to factors like outdoor cooking, lack of fans, heat-trapping clothing, and unsafe working environments. (Gender-Cooling-SEforALL).
Urban Heat Island (UHI) Effect: Cities are significantly warmer than surrounding rural areas due to paved surfaces, urban density, and heat-trapping building canyons. (Harvard Cooling Urban Heat, WHO HEAT WAVES EURO). This exacerbates heat-related risks, particularly for vulnerable populations living in these areas, often in "inner city central areas of low socioeconomic status." (WHO Heat and health in the WHO European Region: updated evidence for effective prevention). "About 60% of the urban population experienced warming twice as large as the world" between 1950 and 2015. (Arsht-Rock Compendium).
IV. Adaptation and Mitigation Strategies
Addressing the heat crisis requires a multi-faceted approach, combining early warning systems, infrastructure improvements, policy changes, and public education.
Key Facts & Ideas:
Heat-Health Warning Systems (HHWS):These systems are crucial for timely public health responses. Philadelphia, USA, is cited as the "only city with a heat warning system that saves lives" due to its health-based metrics. (Arsht-Rock Compendium, WHO Heat Waves and Health Guidance).
HHWS typically involve "thresholds of human-health tolerance to extreme weather" that trigger warnings. (WHO heat-waves-and-health---guidance-on-warning-system-development).
Many existing heat warning thresholds may be "set too high to adequately protect health." (CDC Heat Response Plans Summary of Evidence). Health data can be used to refine these thresholds. (CDC Heat Response Plans Summary of Evidence).
Effective dissemination to the public is critical, utilizing various media (radio, TV, internet) and clear, understandable messaging. (WHO Heat Waves and Health Guidance).
Heat Action Day (HAD): An annual global event on June 2nd, spearheaded by the Red Cross Red Crescent, focused on public education, with a 2025 theme of "how to recognize heat exhaustion and heat stroke." (IFRC Heat Action Day Guide).
Cooling Solutions and Infrastructure:Air Conditioning (AC): While effective for individual protection, AC has significant drawbacks, including high energy demand (projected US$1.7 trillion investment needed globally for power generation capacity alone), contribution to anthropogenic heat, and greenhouse gas emissions. (Arsht-Rock Compendium, WHO Heat and health in the WHO European Region: updated evidence for effective prevention). Equitable access to AC is a major challenge due to cost. (WHO Heat and health in the WHO European Region: updated evidence for effective prevention).
Passive Cooling Strategies: "Proven to achieve a reduction in cooling loads of more than 25 per cent, even in very hot climates." (Arsht-Rock Compendium). These include:
Urban Greening: Trees and vegetation reduce temperatures by "1° to 5°C" through shading and evapotranspiration. (Arsht-Rock Compendium, Harvard Cooling Urban Heat). Increased tree canopy in cities could "reduce heat deaths by one third." (Harvard Cooling Urban Heat).
Cool Roofs/Pavements: Reflective materials and lighter colors reduce heat absorption. Cool roofs can "cool a building surface by 36 degrees F and the surrounding air by 5 degrees F." (Harvard Cooling Urban Heat).
Building Design: Prioritizing green space, water features, proper building orientation, window design, insulation, and ventilation can significantly reduce indoor heat loads and energy consumption. (Arsht-Rock Compendium, Harvard Cooling Urban Heat, WHO Heat and health in the WHO European Region: updated evidence for effective prevention).
Cooling Centers: Provide accessible cool environments, though research on their direct health outcomes is limited. Barriers to use include lack of transportation, awareness, and discrimination. (CDC Heat Response Plans Summary of Evidence).
Fans: Effective in circulating cooler air, but their effectiveness at very high temperatures (above 37°C) or in hot and dry conditions is questionable and may even worsen internal temperature. (CDC Heat Response Plans Summary of Evidence, WHO Heat Waves and Health Guidance).
Policy and Governance:Heat Action Plans (HAPs): Require a lead agency, multi-level governance, stakeholder engagement, and clear intervention strategies. (WHO Heat Waves and Health Guidance). Despite high cost-benefit ratios (e.g., 11x for London, 913x for Madrid), HAPs are often "not adequately resourced in terms of funding or human resources." (WHO Heat and health in the WHO European Region: updated evidence for effective prevention).
Building Codes and Energy Performance Standards: Crucial for driving passive cooling strategies and energy efficiency in buildings. (Arsht-Rock Compendium).
Prohibiting Power Shut-offs: During heat emergencies, utilities should be prevented from disconnecting service for nonpayment to ensure access to cooling. (Harvard Cooling Urban Heat, WHO Heat Waves and Health Guidance).
Intersectoral Action: Integrating heat-health considerations into urban planning, emergency management, and other policies is vital but often lacking. (WHO Heat and health in the WHO European Region: updated evidence for effective prevention).
Public Awareness and Outreach:Educating the public about heat-related illness symptoms (heat exhaustion, heatstroke) and prevention strategies (hydration, seeking cool places, limiting outdoor activity) is critical. (IFRC Heat Action Day Guide, Harvard Cooling Urban Heat, RED CROSS Extreme-Heat-Safety-Checklist).
Neighborhood outreach programs, including "buddy systems" for checking on vulnerable individuals, are effective. (CDC Heat Response Plans Summary of Evidence, WHO Heat Waves and Health Guidance).
V. Research Gaps and Future Directions
Despite increased research, significant gaps remain, particularly regarding real-world effectiveness of interventions and comprehensive data collection.
Key Facts & Ideas:
Effectiveness of Interventions: More research is needed to determine the direct health outcomes of interventions like cooling centers and specific building modifications. (CDC Heat Response Plans Summary of Evidence, WHO Heat and health in the WHO European Region: updated evidence for effective prevention).
Data Collection: There is a need for "sex-disaggregated collection of data to support tracking access to cooling" and to better understand gendered impacts. (Gender-Cooling-SEforALL).
Indoor Heat and Vulnerable Groups: More empirical evidence is needed on how housing interventions impact thermal comfort and health protection for vulnerable groups in real-life settings, and what "thermal comfort" truly means for these populations. (WHO Heat and health in the WHO European Region: updated evidence for effective prevention).
Addressing Barriers to Action: Further applied research is needed on "regulatory, financial, procedural, knowledge and other barriers that may prevent effective action on heat and health." (WHO Heat and health in the WHO European Region: updated evidence for effective prevention).
Syndromic Surveillance: Utilizing real-time health data (e.g., emergency department visits) can help inform and adjust heat warning thresholds and response measures. (CDC Heat Response Plans Summary of Evidence).
In conclusion, extreme heat is a multifaceted crisis demanding urgent, coordinated, and sustained action across various sectors. While the challenges are immense, a growing body of knowledge and emerging strategies offer pathways to enhance resilience and protect vulnerable populations. Detailed Timeline of Main Events in Heatwave Research and Public Health Response
This timeline focuses on the evolution of understanding, policy, and response to heatwaves as a public health issue, drawing from the provided sources.
Pre-20th Century:
Millennia Ago: Humans have historically worried about the effects of heat on their bodies, particularly when moving to new, hotter regions. Early English colonists in the Caribbean, Africa, and India died due to heat. Medical advice manuals in America warned of exertion dangers during summer heat.
Early 19th Century: 1833: Luke Howard publishes "The Climate of London," contributing to the early understanding of urban climates.
Early to Mid-20th Century:
1930s: Racist housing practices (redlining) begin, leading to less tree cover and higher temperatures in historically redlined areas, a disparity still observed today.
1940: First papers appear on "heat stroke" (later "heat stress") in scientific literature.
1949: Louis Friedfeld publishes on "Prophylaxis and Treatment of Heat-Reaction States" in the New England Journal of Medicine.
1950s: Changes in extreme weather and climate events, including increases in warm temperature extremes, begin to be observed, linked to human influences.
1950-2015: 27% of the 1,692 largest cities in the world and 65% of the urban population warmed more than the world average (about 0.6 °C). Approximately 60% of the urban population experienced warming twice as large as the global average.
1951: The Lord Mayor of Stuttgart, Germany, orders municipal agencies to consult climatologists for urban planning.
1960s: Shift in heat mortality risk observed: from young adult laborers to poor and elderly individuals, often with pre-existing conditions and living in low-quality housing.
1966: A major heatwave in St. Louis, Missouri, results in significant heat deaths.
1968: WHO publishes "The physiological basis for health standards for dwellings," recommending 15-25 °C.
1969: A. Henschel et al. analyze heat deaths in St. Louis during the July 1966 heatwave.
1970: F.W. Oechsli and R.W. Buechley publish on excess mortality in Los Angeles related to hot spells.
1970s: Research begins to focus on the impact of urban structure on heat mortality, recognizing the "urban heat island" effect.
1972: John F. Clarke publishes "Some effect of the urban structure on heat mortality" in Environmental Research.
1975: Marmor's study suggests air-conditioning is effective in preventing heat stroke.
1976: Germany's Federal Building Code stipulates that climate, air pollution, and health must be important factors in urban planning. Heatwaves in Birmingham and London, England, cause increased deaths.
1978: Humphreys publishes on the relationship between monthly mean outdoor temperature and comfort temperature.
1980s:
July 1980: A severe heatwave in the US, particularly in Memphis, St. Louis, and Kansas City, shatters records, resulting in over 10,000 deaths. Reports highlight age, poverty, pre-existing conditions, and race (inter-city black elderly) as risk factors.
1981: Heatwave in Portugal leads to increased mortality. HEW/CDC publishes information on how to prepare for heatwaves. Landsberg HE publishes "The urban climate."
1982: CDC develops the "Summer Mortality Surveillance Project" to track heat threats, with 16 cities participating by 1983. T.R. Oke publishes "The energetic basis of the urban heat island." T.S. Jones and E.M. Kilbourne publish on morbidity and mortality from the July 1980 heatwave and heat-stroke risk factors, respectively.
1983: U.S. Senate, Special Committee on Aging, publishes "Heat Stress and Older Americans: Problems and Solution."
1984: Steadman, R.G. publishes "A universal scale of apparent temperature."
1986: B. Givoni publishes "Design for climate in hot, dry cities," advocating for cities to be planned to reverse the heat island phenomenon.
1987: Heatwave in Athens, Greece, results in increased mortality.
1989: The EPA investigates global warming's impact, forecasting severe disruptions and increased mortality due to extreme heat. Kalkstein and Davis publish "Weather and human mortality – an evaluation of demographic and interregional responses in the United-States."
Late 1980s: Development of heat/health warning systems (HHWS) as part of broader Heat Plans begins, catalyzed by severe heat events.
1990s:
1990: Phoenix, Arizona, records a maximum temperature of 50°C.
1992: NWS sets official thresholds for Heat Index warnings in the US at 41°C maximum and 27°C minimum over two consecutive days, with regional adjustments allowed.
1995: Phoenix, Arizona, records a maximum temperature of 49.4°C. A major heatwave in Chicago results in over 700 deaths, with the city's HHWS being the earliest system developed in the US. The heatwave caused 368 deaths in Chicago.
1996: J.C. Semenza et al. publish on heat-related deaths during the July 1995 Chicago heatwave.
1999: Excess deaths in people over 65 reached 345,000, an 80.6% increase compared to 2000-2005 average. Global mortality linked to non-optimal ambient temperatures reaches 489,075 annually (2000-2019 data).
2000s:
April 2000: Heatwave in India causes 7 deaths.
May 2002: Heatwave in India causes 1030 deaths, and in Pakistan, 113 deaths.
2003: The extreme European heatwave causes approximately 70,000 excess deaths, primarily in France and Italy. Heatwaves in Bangladesh (May-June) cause 62 deaths, and India (May-June) causes 1210 deaths. A WHO project begins to develop and implement a heat health warning system for Rome.
July 2004: Heatwaves in China cause 39 deaths, and in Japan, 10 deaths.
July 2005: Heatwave in China causes 200 deaths, and in Bangladesh, an unspecified number of deaths. Heatwave in India causes 329 deaths, and in Pakistan, 106 deaths.
May 2006: Heatwave in India causes 47 deaths, and in Pakistan, 84 deaths.
2008: WHO Regional Office for Europe publishes guidance on heat–health action planning (HHAP).
2009: A 2009 study suggests significant health impacts occur at temperatures below typical heat alert thresholds, implying many thresholds are set too high.
2010s:
2010: The heatwave in Russia causes about 55,000 excess deaths, many in Moscow. Ahmedabad heatwave leads to disproportionate suffering among poorer women.
2011-2015: Study in North Carolina found extreme heat at night posed a greater hazard to pregnant mothers.
2012: Adults over 65 experienced 3.1 billion more person-days of heatwave exposure annually (2012-2021) compared to 1986-2005. Maryland, Ohio, Virginia, and West Virginia experience 32 heat-related deaths, with power outages contributing to at least 22% of these deaths.
2013: A Cochrane review states that existing evidence on fan effectiveness during heatwaves is inconclusive. Research on heatwaves becomes a "hot topic" in climate change research, with scientific literature doubling in about 5 years.
2014: Adults over 65 experienced 300 million more days of heatwave exposure in the US in 2020 compared to 1986-2005.
2015: Globally, 27% of urban centers showed increased urban greening since 2010.
2016: Philadelphia, USA, is identified as the only city in the United States with a heat warning system that saves lives, using health-based metrics.
2017: The CDC releases technical guidance on cooling centers. Some 70% of global losses from natural catastrophes are uninsured, equating to $1.3 trillion over the past 10 years.
2018: 53 children die from heatstroke after being left or trapped in vehicles in the US.
2019: Heat-related deaths in people older than 65 reached a record high of an estimated 345,000. In Europe, 108,000 deaths were attributable to heat exposure. Globally, food insecurity affected 2 billion people.
2020s:
2020: Increased negative expressions on Twitter during heatwaves, a 155% increase from the 2015-2019 average. India, Bangladesh, and Pakistan experienced work hour losses 2.5-3 times the world average due to heat.
June 2021: 803 officially reported heat-related deaths in Washington State, Oregon, and British Columbia, with almost 1,200 suspected excess deaths.
June 2022: IFRC launches the first "Heat Action Day (HAD)." CDC reports 702 average annual heat-related deaths and over 67,000 heat-related emergency department visits in the US.
July 2023: The longest-lasting heatwave in the Southwest US and Northern Mexico occurs (mid-June to early August), responsible for 303 deaths in Maricopa County, Arizona, in just two weeks. It was also the costliest weather and climate disaster of 2023 in North America ($14.5 billion in economic loss). Global oceans, particularly the tropical Atlantic, experience record warm sea surface temperatures. Phoenix, Arizona experiences 18 consecutive days of maximum temperatures exceeding the 95th percentile threshold by as much as 4.5 °C.
2023: The second warmest year on record, only surpassed by 2024.
2024: Projected to be the warmest year on record.
May 9, 2024: V. Kelly Turner, PhD, presents to the Community Data Health Initiative at Harvard University.
June 2, 2025: Fourth annual Heat Action Day (HAD) takes place, with the theme "how to recognize heat exhaustion and heat stroke."
Future (2030): ILO estimates 2.5 million Latin American and Caribbean jobs could be lost to heat stress alone.
Future (2040): Indonesia could account for half of all air conditioner unit sales growth, from 40 million units in 2017 to 300 million.
Future (2050): 20% of the most populated cities could experience warming higher than 4°C. Heat stroke-related deaths in the US are expected to more than double, reaching approximately 5,000 annually. 80% of Sub-Saharan African countries likely to have more than 45 heatwave days per year, compared to less than 15% currently.
Future (2071-2099): Projections under severe climate scenarios estimate an overall excess of 46,690 to 117,333 premature deaths per year in 38 countries in the WHO European Region.
Future (2080): A heatwave in the UK could cause a three-fold increase in mortality compared to 2003, with 278 deaths compared to 90.
Future (2100): 25% of cities could warm more than 7°C. Without climate mitigation and adaptation, extreme heat could kill 30 times more people in the EU than currently. The limit for human survivability from heat and humidity may be reached in many regions if global warming is not addressed.
Cast of Characters
This list includes individuals and organizations mentioned as principal actors, authors of significant works, or key entities in the context of heatwave research and response.
Individuals (Authors, Researchers, and Officials):
A. Bouchama: Department of Comparative Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. Co-author of a chapter on Thermophysiology and Heat Risk Factors.
Aimee Raval: Expert at Natural Resources Defense Council (NRDC), author of "Climate Change and Gender: Addressing Heat-Related Health Impacts on Women in India."
Alfred Archer: World Health Organization.
Alice Uwamaliya: Member of the Sustainable Energy for All (SEforALL) report development team.
Aline Chiabai: Author of work on evaluating adaptation measures.
Amee Raval: NRDC expert, focused on climate change and gender in India.
Amiot, M. (P. Munday, R. Sifon-Arevalo): Authors of the "ESG Research Report: Weather warning: Assessing countries’ vulnerability to economic losses from physical climate risks."
Anjali Jaiswal: Co-author of NRDC report "Rising Temperatures, Deadly Threat," focused on the disproportionate impact on poorer women in Ahmedabad.
Anna Zivian: Co-author of NRDC report "Rising Temperatures, Deadly Threat."
Annette Aharonian: Member of the Sustainable Energy for All (SEforALL) report development team.
Betsy Gardner: Editor, Data-Smart City Solutions and Producer, Data-Smart City Pod, Data-Smart City Solutions, Harvard Kennedy School.
Bettina Menne (B. Menne): WHO Europe, Rome, Italy. Co-author of a chapter on Thermophysiology and Heat Risk Factors. Also Programme Manager, Climate change, sustainable development and green health services, WHO Regional Office for Europe. Joint editor of "Heatwaves and Health: Guidance on Warning-System Development."
Brian Dean: Member of the Sustainable Energy for All (SEforALL) report development team.
C. Koppe (Christina Koppe): Deutscher Wetterdienst, Business Unit Human Biometeorology, Freiburg, Germany. Main author of "Heat and health in the WHO European Region: updated evidence for effective prevention." Co-author of "Heatwaves: risks and responses."
Celine Salcedo-La Viña: Author of "Beyond Title: How to Secure Land Tenure for Women."
Chad Milando: Co-author of "Mixed methods assessment of personal heat exposure, sleep, physical activity, and heat adaptation strategies among urban residents in the Boston area, MA."
Christopher A. Neilson: Co-author of "The effect of school construction on test scores, school enrollment, and home prices."
Christina Koppe: Deutscher Wetterdienst, Business Unit Human Biometeorology, Freiburg, Germany. Lead author of "Heat and health in the WHO European Region: updated evidence for effective prevention."
Daniel Berlant: Assistant Deputy Director, Cal Fire. Explains why wildfires are named.
David Wallace-Wells: Author of "The Mysteriously Low Death Toll of the Heat Waves in India and Pakistan."
Derek Bok: Professor of the Practice of Urban Policy at Harvard Kennedy School.
Donoghue: Medical examiner in Chicago during the 1995 heatwave.
Eduarda Zoghbi: Member of the Sustainable Energy for All (SEforALL) report development team.
Elie Bou-Zeid: Co-author of "Kirigami-inspired wind steering for natural ventilation."
Eric Klinenberg: Author of "Heat Wave: A Social Autopsy of Disaster in Chicago."
Fergus Nicol: LEARN, London Metropolitan University, London, United Kingdom. Contributed to "WHO HEAT WAVES EURO.pdf."
G.R. McGregor (Glenn McGregor): School of Environment, University of Auckland, New Zealand. Main author of a chapter on Heatwaves. Lead editor of "Heatwaves and Health: Guidance on Warning-System Development." President of the International Society of Biometeorology.
Gerd Jendritzky: Deutscher Wetterdienst, Business Unit Human Biometeorology, Freiburg, Germany. Main author of "Heat and health in the WHO European Region: updated evidence for effective prevention."
Hannah Girardeau: Member of the Sustainable Energy for All (SEforALL) report development team.
Hanna: Co-author of work on heat and worker health.
Helio Lopez: First author of "The longest-lasting 2023 western North American heat wave was fueled by the record-warm Atlantic Ocea.pdf."
J.B.S. Haldane: British physiologist who conducted studies on overheating during exertion in hot conditions.
Jamie Madrigano: Co-author of "A Case-Only Study of Vulnerability to Heat Wave-Related Mortality in New York City (2000-2011)."
Jessica Brown: ClimateWorks Foundation/Kigali Cooling Efficiency Program (K-CEP). Acknowledged for input to the SEforALL report.
Jianping Xue: Co-author of "The longest-lasting 2023 western North American heat wave was fueled by the record-warm Atlantic Ocea.pdf."
Jisung Park: University of California, Los Angeles. Co-author of "Heat and Learning Faculty Research Working Paper Series."
John Balbus: Co-author of "Climate change and women’s health: Impacts and policy directions."
John F. Clarke: Author of "Some climatological aspects of heat waves in the contiguous United States" and "Some effect of the urban structure on heat mortality."
Jonathan Smith: Georgia State University. Co-author of "Heat and Learning Faculty Research Working Paper Series."
Jorge E. Gonzalez: Co-author of "The longest-lasting 2023 western North American heat wave was fueled by the record-warm Atlantic Ocea.pdf."
Joshua Goodman: Harvard Kennedy School. Co-author of "Heat and Learning Faculty Research Working Paper Series."
Julie L. White-Newsome: Co-author of "Climate change and health: indoor heat exposure in vulnerable populations."
K. Ito: Co-author of "Equitable Access to Air Conditioning: A City Health Department’s Perspective on Preventing Heat-related Deaths."
K.L. Ebi (Kristie Ebi): Global Change and Health, WHO Regional Office for Europe. Joint editor of "Heatwaves and Health: Guidance on Warning-System Development."
K. Lane: Co-author of "Equitable Access to Air Conditioning: A City Health Department’s Perspective on Preventing Heat-related Deaths."
Kate Murphy: Program Manager for Stephen Goldsmith, Data-Smart City Solutions, Harvard Kennedy School.
Keith Glassbrook: Co-author of "Delivering Urban Resilience: Costs and benefits of city-wide adoption of smart surfaces across Washington, D.C., Philadelphia and El Paso."
Kevin McFarlin: Co-author of "Investing in schools: capital spending, facility conditions, and student achievement."
Kristie Ebi: Independent consultant, California, USA. Joint editor of "Heatwaves and Health: Guidance on Warning-System Development."
Kristin Barrett: Provided research support for the Harvard University "cooling_urban_heat.pdf" report.
L.S. Kalkstein: Developed the first HHWS in Philadelphia in 1995. Co-author of "The Philadelphia hot weather–health watch warning system." Co-author of "Heat watch–warning systems in urban areas."
Lisa C. Smith: Co-author of "The Importance of Women’s Status for Child Nutrition in Developing Countries."
Lucia Stein-Montalvo: Co-author of "Kirigami-inspired wind steering for natural ventilation."
Lutz Bornmann: Max Planck Institute for Solid State Research and Max Planck Society. Co-author of "Heat waves: a hot topic in climate change research."
M. Azhar: Author of study on gender-based heatwave impacts in Ahmedabad.
M. S. O'Neill: Co-author of "Disparities by race in heat-related mortality in four US cities: the role of air conditioning prevalence."
Mary K. O'Neill: Co-author of work on heat-related hospitalizations.
Meriam Otarra: Member of the Sustainable Energy for All (SEforALL) report development team.
Michael Hurwitz: College Board. Co-author of "Heat and Learning Faculty Research Working Paper Series."
Michael van Lieshout: Author of work on integrated assessment models for thermal stress.
Miquel Miró: Co-author of "The longest-lasting 2023 western North American heat wave was fueled by the record-warm Atlantic Ocea.pdf."
Nisha Kumar: Program Manager, Bloomberg's Community Data Health Initiative at Harvard Kennedy School.
Paola Michelozzi (P. Michelozzi): Dept. of Epidemiology ASL RM/E, Rome, Italy. Co-author of a chapter on Thermophysiology and Heat Risk Factors.
Paul Olson: Co-author of "Equitable Access to Air Conditioning: A City Health Department’s Perspective on Preventing Heat-related Deaths."
Peter Berry: Health Canada, cited for "deactivation notice" for heat warnings.
Philip L. Kinney: Co-author of "A Case-Only Study of Vulnerability to Heat Wave-Related Mortality in New York City (2000-2011)."
Pierre Bessemoulin: President of CCl (2005–2010), Toulouse, France. Joint editor of "Heatwaves and Health: Guidance on Warning-System Development."
R.S. Kovats (Sari Kovats): London School of Hygiene and Tropical Medicine, University of London, London, UK. Co-author of a chapter on Thermophysiology and Heat Risk Factors. Co-author of "Heat stress and public health: A critical review."
Rebecca Voelker: Author of "Probe of Heat Wave Deaths Under Way."
Reynaldo Martorell: Co-author of "The Importance of Women’s Status for Child Nutrition in Developing Countries."
Robin Haunschild: Max Planck Institute for Solid State Research. Co-author of "Heat waves: a hot topic in climate change research."
Robert Wood Johnson Foundation: Provided funding for the Harvard University "cooling_urban_heat.pdf" report.
S. Kovats: Co-author of "Heatwaves: risks and responses."
Sari Kovats: Centre on Global Change and Health, London School of Hygiene and Tropical Medicine, United Kingdom. Main author of "Heat and health in the WHO European Region: updated evidence for effective prevention."
Scott Sheridan: Kent State University, Department of Geography, Kent, OH, USA. Contributed to "WHO HEAT WAVES EURO.pdf." Author of "Heat watch–warning systems in urban areas."
Sejla Mehic: Member of the Sustainable Energy for All (SEforALL) report development team.
Stephen Goldsmith: Derek Bok Professor of the Practice of Urban Policy at Harvard Kennedy School. Provided inspiration and feedback for the Harvard University "cooling_urban_heat.pdf" report.
Stephen Kent: Member of the Sustainable Energy for All (SEforALL) report development team.
Stacie Fujii: Environmental Defense Fund Fellow to the African American Mayors Association and Founder at SWF Partners LLC. Provided support and guidance for the Harvard University "cooling_urban_heat.pdf" report.
Usha Ramakrishnan: Co-author of "The Importance of Women’s Status for Child Nutrition in Developing Countries."
V. Kelly Turner, PhD: Presented on heat and urban heat islands, and co-authored "Shade is an Essential Solution for Hotter Cities."
Werner Marx: Max Planck Institute for Solid State Research and Max Planck Society. Co-author of "Heat waves: a hot topic in climate change research."
Xiaoyi Jin: ClimateWorks Foundation/Kigali Cooling Efficiency Program (K-CEP). Acknowledged for input to the SEforALL report.
Yianna Lambrou: Co-author of "Energy and Gender in rural sustainable development."
Organizations and Institutions:
Adrienne Arsht Rockefeller Foundation Resilience Center: Focuses on heat and other resilience aspects globally. Funded Chief Heat Officers in various cities. Its Extreme Heat Resilience Alliance and Heat Action Platform are key resources for heat planning.
African Development Bank (AfDB): Recommends addressing gender equality in agricultural value chains.
American National Red Cross: Provides information and guidance on extreme heat safety.
APEC (Asia-Pacific Economic Cooperation) Climate Centre (APCC): Republic of Korea. Lead Centre of long-range forecasts.
Atlantic Council: Published "EXTREME HEAT The Economic and Social Consequences for the United States."
Boston City: First city in the nation to deploy a green building standard through municipal zoning requirements. Has a "Boston Tree Canopy and Heat Island Map."
Brown University: Collaborated with health department researchers from Rhode Island, Maine, and New Hampshire on heat-health impacts.
Cal Fire: California firefighting agency, whose Assistant Deputy Director Daniel Berlant explains the need for quickly naming wildfires.
Center for Disaster Philanthropy: Provides information on the 2020 Atlantic hurricane season.
Centers for Disease Control and Prevention (CDC): Key US public health agency, issuing guidelines, warnings, and reports on heat-related illness and mortality. Developed the "Summer Mortality Surveillance Project." Offers "Health Alert Network (HAN)" for public health information.
Chicago Department of Public Health: Has a "Heat Watch 2023" program and partners with Northwestern University on an intergovernmental research and practice working group.
Children’s Investment Fund Foundation: Provides funding for SEforALL's work.
Climate Central: Publishes "Climate Matters" reports on heat and hospitalizations.
ClimateWorks Foundation/Kigali Cooling Efficiency Program (K-CEP): Provides input and funding for cooling solutions.
College Board: Administers surveys to collect data on school-level air conditioning penetration.
Copernicus Climate Change Service (C3S): Provides access to quality-controlled data on global climate.
Deutscher Wetterdienst (DWD): German National Weather Service, uses "Perceived Temperature, PT" as an output parameter.
Environmental Protection Agency (EPA): US agency that investigated global warming's impact in 1989. Publishes "Climate Change and Children’s Health and Well-Being in the United States."
European Commission: Funded projects like PHEWE, cCASHh, and EuroHeat.
European Centre for Medium-Range Weather Forecasts (ECMWF): Provides data on warming trends in Europe.
EURO-CORDEX (World Climate Research Programme’s Coordinated Regional Climate Downscaling Experiment): Projects warming in EU countries.
Eurostat: Provides statistics on population and aging in Europe, as well as household air conditioning penetration.
Food and Agricultural Organization (FAO): Recommends governments address gender equality in agriculture.
Georgia State University: Institution of Jonathan Smith.
Global Heat Health Information Network (GHHIN): Provides technical briefs on protecting health from hot weather.
Harvard Kennedy School: Institution of Joshua Goodman and Stephen Goldsmith, and publisher of "Heat and Learning Faculty Research Working Paper Series."
Human Rights Watch: Published "Increasing Temperatures Because of the Climate Change Crisis is a Reproductive Justice Issue in the United States."
ICLEI: Partner in Heat Action Day.
IFRC (International Federation of Red Cross and Red Crescent Societies): Launched Heat Action Day in 2022.
IKEA Foundation: Provides funding for SEforALL's work.
ILO (International Labour Office/Organization): Estimates job losses due to heat stress and establishes standards for occupational heat exposure.
International Society of Biometeorology: Its President, Glenn McGregor, is a lead editor for WHO/WMO guidance.
Johns Hopkins University: Partnered with the city of Baltimore on climate solutions, including heat response.
Joseph Rowntree Foundation: Published report "Care provision fit for a future climate."
Kigali Cooling Efficiency Program (K-CEP): Partnered with Sustainable Energy for All (SEforALL) in developing the "Cooling for All and Gender" report.
Lancet Countdown: Publishes reports on health and climate change.
Maine's Extreme Heat Plan: Outlines agency responsibilities for power outages during heat events.
Maricopa County, Arizona: Tracks heat-related deaths and has heat response plans.
Max Planck Institute for Solid State Research: Institution of Werner Marx and Robin Haunschild.
MCR2030: Partner in Heat Action Day.
Met Office (United Kingdom): Research on heatwaves.
Meteo-France: French meteorological service that issues weather charts of vigilance.
Ministry for Foreign Affairs of Iceland: Provides funding for SEforALL's work.
Ministry of Foreign Affairs of Denmark: Provides funding for SEforALL's work.
National Center for Environmental Health (NCEH), Centers for Disease Control and Prevention (CDC): Authors of "CDC Heat Response Plans Summary of Evidence."
National Institute of Public Health Surveillance (France): Estimated 14,802 excess deaths during the 2003 heatwave in France.
National Oceanic and Atmospheric Administration (NOAA): Provides weather-related fatality and injury statistics.
National Weather Service (NWS): Issues heat alerts and warnings in the US.
Natural Resources Defense Council (NRDC): Published "Rising Temperatures, Deadly Threat."
New Hampshire public health practitioners: Post heat information at local grocery stores, hospitals, community centers, and homeless shelters.
New York City (NYC): Has assessed the public health risk of heat waves and set criteria for alerts.
New York State Department of Health: Shared results of their heat-morbidity study with local NWS offices.
Northwestern University: Partnered with the city of Chicago on building resilience to extreme weather events.
Occupational Safety and Health Administration (OSHA) of the US Department of Labour: Established standards for occupational heat exposure.
Philadelphia City: Has a "Hot Weather-Health Watch/Warning System" that saves lives.
Pinal County Public Health Services District (PCPHSD): County health department in Arizona that implements heat surveillance during the summer.
Public Health England: Carried out an independent evaluation of the national HHAP.
Queensland Health: Australian health organization that uses Apparent Temperature for heat warnings.
Red Cross Red Crescent Climate Centre (RCCC): Partner in Heat Action Day.
Rhode Island Health Department: Collaborated with Brown University on heat-health impacts.
Rockefeller Foundation: Provides funding for SEforALL's core work. Published "Waste and Spoilage in the Food Chain."
San Francisco: Has a dedicated homeless outreach team and considers power outage issues in its Extreme Heat Response Plan.
Sasaki: Architecture firm, involved in the Bruce C. Bolling Municipal Building renovation.
S&P Global Ratings: Published the "ESG Research Report: Weather warning: Assessing countries’ vulnerability to economic losses from physical climate risks."
Sustainable Energy for All (SEforALL): Published "Cooling for All and Gender: Towards Inclusive, Sustainable Cooling Solutions." Acknowledged funding from various organizations for their core support.
The Telegraph: News outlet that published "Give heatwaves names so people take them more seriously, say experts, as Britain braces for Hottest Day."
Trust for Public Land (TPL): Mentioned in relation to New York City Playgrounds.
U.S. Environmental Protection Agency (EPA): Publishes guidance on reducing urban heat islands.
Union of Concerned Scientists: Published "Too hot to work: Assessing the threats climate change poses to outdoor workers."
United Nations Environment Programme: Published "Women in the Refrigeration and Air-conditioning Industry."
University of California, Los Angeles (UCLA): Institution of Jisung Park.
University of Delaware: Developed the Rome heat health warning system.
Vivid Economics: Partnered with Adrienne Arsht Rockefeller Foundation Resilience Center on "EXTREME HEAT The Economic and Social Consequences for the United States."
World Health Organization (WHO): Issues guidance on heatwaves and health, including action plans and warning systems. Defines a heatwave as 5+ consecutive days where max temperature is 5°C (9°F) higher than average max temperature. Also reviewing evidence for low carbon health care.
World Meteorological Organization (WMO): Partnered with WHO on "Heatwaves and Health: Guidance on Warning-System Development." Defines a heatwave.
World Weather Attribution (WWA): Partner in Heat Action Day.
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