The Effect of Heat Events on Prehospital and Retrieval Service Utilization in Rural and Remote Areas: A Scoping Review

The impact of extreme heat on older regional and rural Australians: A systematic review

INTRODUCTION

Extreme heat causes a major health burden, especially for older Australians.

OBJECTIVE

To assess the impact of extreme heat on older regional and rural Australians, including clinical presentations, social implications, and health-seeking behaviours and adaptations.

DESIGN

A systematic review and narrative synthesis.

FINDINGS

Ten articles were included in the review with research on this topic limited. Extreme heat causes an increase in mortality and ambulance dispatches for older rural Australians. Social connectedness is negatively affected by extreme heat due to cancellation of events and individuals becoming housebound. Air conditioning is the main cooling mechanism used, although cost is a major concern. Despite this, older rural populations display a depth of knowledge regarding practical behavioural responses to adapt to extreme heat. Studies show older rural Australians do not consider extreme heat to be a threat to health.

DISCUSSION

Further research needs to examine the role extreme heat may play in contributing to experiences of loneliness. Air conditioning cannot be the ultimate solution in responding to extreme heat due to cost and increased carbon emissions. The low-risk perception of extreme heat for older rural people may inform effective heat health warnings and effective use of primary health care in heat-health education. Listening to First Nations knowledge in dealing with heat may provide a powerful mechanism in which to protect health.

CONCLUSION

The extensive health effects of extreme heat highlights the necessity of further research and strengthening of services in preparation for an ageing rural population enduring climate change.

The Impact of Climate Change on Aeromedical Retrieval Services in Remote Northern Australia: Planning for a Hotter Future

It is known that environmental heat is associated with increased morbidity manifesting as increasing demand on acute care health services including pre-hospital transport and emergency departments. These services play a vital role in emergency care, and in rural and remote locations, where resource capacity is limited, aeromedical and other retrieval services are a vital part of healthcare delivery. There is no research examining how heat impacts remote retrieval service delivery. The Northern Territory (NT) of Australia is characterised by very remote communities with limited acute healthcare capacities and is a region subject to regular extreme tropical heat. In this study, we examine the relationship between aeromedical retrievals and hot weather for all NT retrievals between February 2018 and December 2019. A regression analysis was performed on the number of retrievals by clinical reason for retrieval matched to the temperature on the day of retrieval. There was a statistically significant exposure response relationship with increasing retrievals of obstetric emergencies in hotter weather in the humid climate zone and surgical retrievals in the arid zone. Retrieval services appeared to be at capacity at all times of the year. Given that there are no obstetric services in remote communities and that obstetric emergencies are a higher triage category than other emergencies (i.e., more urgent), such an increase will impede overall retrieval service delivery in hot weather. Increasing surgical retrievals in the arid zone may reflect an increase in soft tissue infections occurring in overcrowded houses in the hotter months of the year. Given that retrieval services are at capacity throughout the year, any increase in demand caused by increasing environmental heat will have broad implications for service delivery as the climate warms. Planning for a hotter future must include building resilient communities by optimising local healthcare capacity and addressing housing and other socioeconomic inequities that amplify heat-related illness.