Heat health planning: The importance of social and community factors

Extreme heat events frequently have adverse effects on population health. Within every population certain groups and individuals are at a greater risk of heat-related morbidity and mortality than others. While certain physiological characteristics (advanced age, chronic conditions, etc.) are known to increase the risk of illness and/or death during periods of extreme heat, the role of social and community level factors in aggravating or mitigating this risk is poorly understood. This paper reviews the literature on the social and community level factors that affect heat-related morbidity and mortality in order to identify shortfalls in current heat health response plans so that new approaches can be recommended. While social isolation, ethnicity, socioeconomic status, and neighborhood characteristics have all been identified as potential factors affecting the risk of heat-related illness and mortality, these are rarely, if ever, identified as heat health research priorities and are thus often neglected in heat emergency planning. Current research and programming practices are often prioritized from the top down where decisions are made at the federal level and research priorities are determined by national research bodies. This, unfortunately, may not allow enough flexibility to meet the needs of physically, socially and culturally diverse communities. A more socio-ecological approach to heat health research and planning would better allow for the identification of community level vulnerabilities and available resources and would encourage communities to work with regional or national partners to adapt response plans accordingly. The development of future plans should involve more partnerships at the community level so that social and community level factors that are currently overlooked may be included in heat health response strategies.