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Cornu T, Marchal B, Renmans D. How do urban green spaces influence heat-related mortality in elderly? A realist synthesis. BMC Public Health 2024; 24:457. [PMID: 38350957 PMCID: PMC10865713 DOI: 10.1186/s12889-024-17973-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/03/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND An important consequence of climate change for urban health is heat-related mortality. Vulnerable groups, especially elderly, will be the most affected. A solution put forward in many reports and policy documents is the introduction or expansion of urban green spaces. While they have a proven effect in decreasing the ambient temperature and reducing heat related mortality, the causal pathways are far from clear. Moreover, results vary for different contexts, population types and characteristics of green spaces as they are 'complex systems thrusted into complex systems'. To our knowledge, there is no systematic synthesis of the literature that examines the mechanisms by which and the circumstances under which green spaces work to decrease heat-related mortality for elderly. METHODS We performed a realist synthesis- a theory-driven review method- to develop a complexity- and context-sensitive program theory. As a first step, a causal loop diagram was constructed which describes the possible pathways through which urban green spaces influence heat-related mortality in elderly. In a second step, one of the pathways - how they may lead to a reduction of heat-related mortality by increasing social capital - was further explored for underlying mechanisms, the context in which they work and the differentiated patterns of outcomes they generate. Literature was searched for evidence supporting or contradicting the initial programme theory, resulting in a refined theory. RESULTS Results show how urban green space can impact on heat-related mortality in elderly by its influence on their exposure to outdoor and indoor heat, by improving their resilience as well as by affecting their access to treatment. Urban green spaces and their interactions with social capital affect the access to health information, social support, and the capacity for effective lobbying. Several mechanisms help to explain these observed demi-regularities, among others perceived behavioural control, perceived usefulness, receptiveness, ontological security, and self-interest. If and how they are triggered depends on the characteristics of the urban green space, the population, and other contextual factors. CONCLUSION Looking into the impact of urban green spaces on heat-related mortality in elderly, researchers and policy makers should take interest in the role of social capital.
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Affiliation(s)
- Tom Cornu
- Chair Care and the Natural Living Environment, University of Antwerp, Antwerpen, Belgium.
| | - Bruno Marchal
- Complexity and Health unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Dimitri Renmans
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
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Chen CH, Lin WY, Lee KY, Sun WJ, Huang LY, Guo YLL. Adaptation behaviors modify the effects of body fat on heat-related symptoms among Taiwanese elderly. Int J Hyg Environ Health 2024; 255:114296. [PMID: 37979230 DOI: 10.1016/j.ijheh.2023.114296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND The aging process increases body fat and susceptibility to heat-related illnesses. The relationship between body composition and symptoms associated with exposure to extreme heat among the elderly is unclear. Additionally, the influence of individual adaptive behaviors in mitigating these risks has not been adequately explored. OBJECTIVES This study aimed to evaluate the association between body composition and heat-related symptoms as well as the potential modifying effects of heat adaptation behavior. METHODS The body composition of elderly individuals was measured using bioelectrical impedance analysis. Face-to-face interviews were conducted a year later to determine the heat-related symptoms and adaptive behaviors practiced for the extremely hot days of the previous year. The association between body composition indices and the presence of more than two symptoms was assessed using logistic regression analysis, while stratified analysis and interaction term in models were used to evaluate the effect modifications of adaptive behaviors. RESULTS Of the 859 participants, 16% reported more than two heat-related symptoms. Increased body fat mass index (fat mass in kg/squared height in meters) was associated with an elevated risk of more heat-related symptoms (odds ratio 1.11, 95% confidence interval 1.02-1.20). Each combination of staying indoors, using an umbrella and hat, and using air conditioning at noon reduced the risk association between body fat and symptoms. For females, a combination of reducing physical activity and staying indoors provided similar protective effect. Surprisingly, bathing more frequently in hot weather with heated instead of non-heated water augmented the risk correlation. Neither fan usage nor window opening displayed protective effects. CONCLUSIONS Elevated body fat levels, indicative of obesity, corresponded with an increased risk of heat-related symptoms. Integrating multiple adaptive behaviors can diminish the negative health impact of body fat on heat-induced symptoms. However, certain commonly adopted practices might not confer expected benefits.
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Affiliation(s)
- Chi-Hsien Chen
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan
| | - Wen-Yi Lin
- Department of Occupational Medicine, Health Management Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Jung Sun
- Department of Community Medicine, Center of R/D in Community Based Palliative Care, Holistic Mental Health Center, Taipei City Hospital, Taipei, Taiwan; Family Medicine Division, Taipei City Hospital Zhongxing Branch, Taipei, Taiwan
| | - Li-Ying Huang
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Division of Endocrinology and Metabolism, Department of Internal Medicine, and Department of Medical Education, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | - Yue-Liang Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan; National Institute of Environmental Sciences, National Health Research Institutes, Miaoli County, Taiwan; Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei, 100, Taiwan.
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Deshayes TA, Pancrate T, Goulet EDB. Effect of electric fan use in isolation or combined with ice slurry/cold water ingestion and lower-leg immersion in young men during intermittent physical activity in hot-humid conditions. Appl Physiol Nutr Metab 2023; 48:851-862. [PMID: 37698186 DOI: 10.1139/apnm-2023-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Using a randomized crossover protocol, 10 young men completed four 180 min exposures (38 °C, 60% relative humidity), alternating between 30 min of walking and 30 min of sitting where fluid or ice slurry were served. Participants underwent four trials: (i) 5 mL·kg body mass-1 of 20 °C water (CON); (ii) 5 mL·kg body mass-1 of 20 °C water + fan at 4 m·s-1 (FAN); (iii) fan + 3 mL·kg body mass-1 of ice slurry + 2 mL·kg body mass-1 of 4 °C water (FAN + ISCW); and (iv) FAN + ISCW + lower-leg immersion in 20 °C water (FAN + ISCW + LLI). Sweat and body mass losses were higher with FAN than CON, FAN + ISCW, and FAN + ISCW + LLI. Mean and peak changes in Δrectal temperature, heart rate, and perceived heat and thirst from baseline were not statistically and practically different between FAN and CON. FAN + ISCW + LLI decreased sweat loss compared with FAN + ISCW and mean and peak changes in Δrectal temperature, heart rate, and perceived thirst compared with CON. FAN + ISCW + LLI also attenuated the changes in Δrectal temperature (peak) and thirst (mean and peak) compared with FAN. In conclusion, FAN slightly exacerbates fluid loss but does not attenuate the changes in Δrectal temperature, heart rate, and perceived heat and thirst during intermittent physical activity in hot-humid conditions. However, coupling ISCW or ISCW + LLI with the use of a fan attenuates the increase in these outcomes compared with no intervention and to a greater extent for rectal temperature and thirst when fan is coupled with ISCW + LLI than when it is used in isolation.
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Affiliation(s)
- Thomas A Deshayes
- Faculty of physical activity sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- Research Center on Aging, University of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
| | - Timothée Pancrate
- Faculty of physical activity sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
| | - Eric D B Goulet
- Faculty of physical activity sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- Research Center on Aging, University of Sherbrooke, Sherbrooke, QC J1H 4C4, Canada
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Bolte G, Dandolo L, Gepp S, Hornberg C, Lumbi SL. Climate change and health equity: A public health perspective on climate justice. JOURNAL OF HEALTH MONITORING 2023; 8:3-35. [PMID: 38105794 PMCID: PMC10722520 DOI: 10.25646/11772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/05/2023] [Indexed: 12/19/2023]
Abstract
Background The discourse on climate justice has developed from the theoretical approaches and discussions on environmental justice. A central tenet of the concept of environmental and climate justice is that environmental and climate issues cannot be seen in isolation from issues of social justice. Methods A conceptual model was developed on the relationship between climate change impacts, social dimensions, adaptive capacities, biological sensitivity, and health equity in order to systematically analyse climate justice. Based on an exploratory literature review and the evaluation of the individual contributions of the status report on climate change and health, the evidence in Germany on social inequalities in exposure to climate change impacts and vulnerability to their direct and indirect health effects was summarised. Results This paper provides an overview of the international debate and examples of evidence on climate justice in Germany. Climate justice in the sense of avoidable, unjust social inequalities in exposure, vulnerability, and the effects of climate mitigation and adaptation measures on health inequalities is still insufficiently addressed in Germany. Conclusions A consistent integration of equity issues into climate policy is necessary. With reference to the international literature, options for action and research needs are identified.
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Affiliation(s)
- Gabriele Bolte
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, Bremen, Germany
| | - Lisa Dandolo
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, Bremen, Germany
| | - Sophie Gepp
- Centre for Planetary Health Policy, Berlin, Germany
| | - Claudia Hornberg
- Bielefeld University, Medical School OWL, Sustainable Environmental Health Sciences, Bielefeld, Germany
| | - Susanne Lopez Lumbi
- Bielefeld University, Medical School OWL, Sustainable Environmental Health Sciences, Bielefeld, Germany
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Fransson A, Björklund Carlstedt A, Gustafsson S. Older adults' occupations in heat waves: A scoping review. Scand J Occup Ther 2023; 30:1000-1015. [PMID: 37402383 DOI: 10.1080/11038128.2023.2231165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 03/01/2023] [Accepted: 04/06/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Heat waves impact the health of older adults, and occupations are important for health. An overview of research focussed on older adults' occupations in heat waves can be useful for occupational therapy practice. OBJECTIVE To identify what the literature shows about older adults' experience and performance of, and participation in, occupations in heat waves. MATERIAL AND METHOD This scoping review included a literature search in five academic databases, four databases for grey literature, and a manual search. Literature in English regarding older adults 60+ and their occupations in heat waves were eligible. FINDINGS Twelve studies were included. Findings showed that older adults adapt their occupations using bodily, environmental, and social interaction strategies and by changing their daily routines. Personal, environmental, social, and economic factors facilitate and maintain occupations in heat waves. CONCLUSION Older adults adapt their occupations in heat waves and different factors impact how they can be adapted. Future research is needed to explore how older adults experience their occupations in heat waves, and to deepen the knowledge about their heat-adaptive strategies. SIGNIFICANCE The findings support the role of occupational therapists in the design and practice of interventions managing the impact of heat waves in daily life.
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Affiliation(s)
- Amanda Fransson
- Hälso- och Sjukvårdsorganisationen, Karlskrona kommun, Sweden
| | - Anita Björklund Carlstedt
- Department of Rehabilitation, Ageing Research Network (ARN-J), Jönköping University, School of Health and Welfare, Jönköping, Sweden
| | - Susanne Gustafsson
- Department of Rehabilitation, Ageing Research Network (ARN-J), Jönköping University, School of Health and Welfare, Jönköping, Sweden
- The Gothenburg University Centre for Ageing and Health (AgeCap), Gothenburg, Sweden
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Kastaun S, Herrmann A, Müller BS, Klosterhalfen S, Hoffmann B, Wilm S, Kotz D. Are people interested in receiving advice from their general practitioner on how to protect their health during heatwaves? A survey of the German population. BMJ Open 2023; 13:e076236. [PMID: 37770266 PMCID: PMC10546099 DOI: 10.1136/bmjopen-2023-076236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/01/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVE Climate change increases the frequency, intensity and length of heatwaves, which puts a particular strain on the health of vulnerable population groups. General practitioners (GPs) could reach these people and provide advice on protective health behaviour against heat. Data is lacking on whether and what topic of GP advice people are interested in, and whether specific person characteristics are associated with such interests. DESIGN Cross-sectional, nationwide, face-to-face household survey, conducted during winter 2022/2023. SETTING Germany. PARTICIPANTS Population-based sample of 4212 respondents (aged 14-96 years), selected by using multistratified random sampling (50%) combined with multiquota sampling (50%). MAIN OUTCOME MEASURE Interest in receiving GP advice on health protection during heatwaves (yes/no), and the topic people find most important (advice on drinking behaviour, nutrition, cooling, cooling rooms, physical activity or medication management). Associations between predefined person characteristics and the likelihood of interest were estimated using adjusted logistic regressions. RESULTS A total of 4020 respondents had GP contact and provided data on the outcome measure. Of these, 23% (95% CI=22% to 25%) expressed interest in GP advice. The likelihood of expressing interest was positively associated with being female, older age (particularly those aged 75+ years: 38% were interested), having a lower level of educational attainment, having a migration background, living in a more urban area, and living in a single-person household. It was negatively associated with increasing income. Advice on medication management received highest interest (25%). CONCLUSIONS During winter season 2022/2023, around one quarter of the German population with GP contact-and around 40% of those aged 75+ years-was estimated to have a stated interest in receiving GP advice on protective health behaviour during heatwaves, especially on medication management. Climate change is creating new demands for healthcare provision in general practice. This study provides initial relevant information for research and practice aiming to address these demands.
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Affiliation(s)
- Sabrina Kastaun
- Institute of General Practice, Centre for Health and Society, Patient-Physician Communication Research Unit, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of General Practice, Centre for Health and Society, Addiction Research and Clinical Epidemiology Unit, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Alina Herrmann
- Institute of General Practice, University of Cologne, Cologne, Germany
- Institute for Global Health (HIGH), Climate, Change, Nutrition and Health, Heidelberg University, Heidelberg, Germany
| | - Beate S Müller
- Institute of General Practice, University of Cologne, Cologne, Germany
| | - Stephanie Klosterhalfen
- Institute of General Practice, Centre for Health and Society, Addiction Research and Clinical Epidemiology Unit, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Stefan Wilm
- Institute of General Practice, Centre for Health and Society, Patient-Physician Communication Research Unit, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Daniel Kotz
- Institute of General Practice, Centre for Health and Society, Addiction Research and Clinical Epidemiology Unit, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Behavioural Science and Health, University College London, London, UK
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Ravanelli N, Morris N, Morrison SA. 24-h movement behaviour, thermal perception, thirst, and heat management strategies of children and adults during heat alerts: a pilot study. Front Physiol 2023; 14:1179844. [PMID: 37228814 PMCID: PMC10203601 DOI: 10.3389/fphys.2023.1179844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
Background: Heat waves caused by climate change are increasingly challenging the wellbeing of individuals across the lifespan. Current efforts to understand the thermal perceptions and behaviours of people throughout the lifespan during heat waves are limited. Methods: Since June 2021, the Active Heatwave project has been recruiting households to better understand how individuals perceive, cope, and behave during heat waves. Using our novel web platform, participants were prompted to answer our Heat Alert Survey on days when a participants geolocation corresponded to a broadcasted local heat alert. Participants provided 24-h movement behaviour, thirst, thermal perception, and cooling strategies via validated questionnaires. Results: A total of 285 participants (118 children) from 60 distinct weather station locations globally participated between June and September 2021 and 2022. At least 1 heat alert (834 total) were identified from 95% (57/60) of the weather stations. Children reported spending more time performing vigorous intensity exercise compared to adults (p < 0.05), but no differences in thermal sensation, thermal comfort, or thirst sensation (all p > 0.31) were observed. For thirst management, 88% of respondents used water to relieve thirst, although notably, 15% of adults reported using alcohol. Regardless of age, staying indoors was the most common heat management strategy, whereas visiting cooling centres was the least. Conclusion: The present study presents a proof-of-concept combining local heat alert notifications with e-questionnaires for collecting near-real-time perceptual and behavioural data for both children and adults during heat waves. The observed patterns of behaviour suggest that present public heat-health guidelines are often ignored, children engage in fewer heat management strategies compared to adults, and these disparities highlight the need to improve public health communication and knowledge dissemination around promoting effective and accessible cooling solutions for children and adults.
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Affiliation(s)
- Nicholas Ravanelli
- School of Kinesiology, Lakehead University, Thunder Bay, ON, Canada
- Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, ON, Canada
| | - Nathan Morris
- William J. Hybl Sports Medicine and Performance Center, Department of Human Physiology and Nutrition, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | - Shawnda A. Morrison
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Ratwatte P, Wehling H, Kovats S, Landeg O, Weston D. Factors associated with older adults' perception of health risks of hot and cold weather event exposure: A scoping review. Front Public Health 2022; 10:939859. [PMID: 36438241 PMCID: PMC9686383 DOI: 10.3389/fpubh.2022.939859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/20/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction Hot and cold weather events are increasingly becoming a global burden resulting in premature and preventable morbidity and mortality, particularly in vulnerable groups such as older people and people with chronic health conditions. However, risk perception regarding weather is generally poor among vulnerable groups which often acts as a barrier to the uptake of critical health-protective behaviours. A more cohesive understanding of determinants of risk perception is needed to inform public health risk communication and behaviour change interventions that promote protective health behaviours. This scoping literature review aimed to understand factors influencing perception of personal health risks in vulnerable groups as a result of exposure to hot and cold weather events. Methods A five-stage scoping review framework was followed. Searches were run across Medline, PsychInfo, Web of Science and EMBASE. Papers were included if they provided rationale for risk perceptions in vulnerable groups in indoor/domestic environments and focussed on samples from OECD countries. Results In total, 13 out of 15,554 papers met the full inclusion criteria. The majority of papers focused on hot weather events: one study exclusively examined cold weather events and one study addressed both cold and hot weather events. Included papers focused on older adults aged 65+ years. The papers identified eight factors that were associated with older adults' personal health risk perception of hot and cold weather events: (1) Knowledge of the relationship between hot/cold weather and health risks, (2) presence of comorbidities, (3) age and self-identity, (4) perceived weather severity, (5) Beliefs associated with regional climate, (6) past experience with weather, (7) misconceptions of effectiveness of protective behaviours, and (8) external locus of control. Conclusions Future research should explore risk communication methods by implementing the identified risk perception determinants from this review into health protection interventions targeting older adults. Further understanding is needed regarding risk perceptions in non-elderly vulnerable groups, for examples individuals with chronic diseases or disabilities.
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Affiliation(s)
- Priyanjali Ratwatte
- Behavioural Science and Insights Unit (BSIU), UK Health Security Agency (UKHSA), Porton Down, United Kingdom
- Climate Change and Health Unit, UK Health Security Agency (UKHSA), Porton Down, United Kingdom
- Behavioural Science and Evaluation, Health Protection Research Unit (BSE HPRU), London, United Kingdom
| | - Helena Wehling
- Behavioural Science and Insights Unit (BSIU), UK Health Security Agency (UKHSA), Porton Down, United Kingdom
- Behavioural Science and Evaluation, Health Protection Research Unit (BSE HPRU), London, United Kingdom
| | - Sari Kovats
- Environmental Change and Health, Health Protection Research Unit (ECH HPRU), Chilton, United Kingdom
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Owen Landeg
- Behavioural Science and Evaluation, Health Protection Research Unit (BSE HPRU), London, United Kingdom
- Extreme Events and Health Protection, UK Health Security Agency (UKHSA), Porton Down, United Kingdom
| | - Dale Weston
- Behavioural Science and Insights Unit (BSIU), UK Health Security Agency (UKHSA), Porton Down, United Kingdom
- Behavioural Science and Evaluation, Health Protection Research Unit (BSE HPRU), London, United Kingdom
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Mukhopadhyay B, Weitz CA. Heat Exposure, Heat-Related Symptoms and Coping Strategies among Elderly Residents of Urban Slums and Rural Vilages in West Bengal, India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12446. [PMID: 36231746 PMCID: PMC9564637 DOI: 10.3390/ijerph191912446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
The impact of heat stress among the elderly in India-particularly the elderly poor-has received little or no attention. Consequently, their susceptibility to heat-related illnesses is virtually unknown, as are the strategies they use to avoid, or deal with, the heat. This study examined perceptions of comfort, heat-related symptoms, and coping behaviors of 130 elderly residents of Kolkata slums and 180 elderly residents of rural villages south of Kolkata during a 90-day period when the average 24-h heat indexes were between 38.6 °C and 41.8 °C. Elderly participants in this study reported being comfortable under relatively warm conditions-probably explained by acclimatization to the high level of experienced heat stress. The prevalence of most heat-related symptoms was significantly greater among elderly women, who also were more likely to report multiple symptoms and more severe symptoms. Elderly women in the rural villages were exposed to significantly hotter conditions during the day than elderly men, making it likely that gender differences in symptom frequency, number and severity were related to gender differences in heat stress. Elderly men and elderly village residents made use of a greater array of heat-coping behaviors and exhibited fewer heat-related symptoms than elderly women and elderly slum residents. Overall, heat measurements and heat-related symptoms were less likely to be significant predictors of most coping strategies than personal characteristics, building structures and location. This suggests that heat-coping behaviors during hot weather were the result of complex, culturally influenced decisions based on many different considerations besides just heat stress.
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Affiliation(s)
- Barun Mukhopadhyay
- Biological Anthropology Unit, Indian Statistical Institute, Kolkata 700 108, India
- Indian Anthropological Society, Kolkata 700 019, India
| | - Charles A. Weitz
- Department of Anthropology, Temple University, Philadelphia, PA 19122, USA
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