Throughout the summer, Europe and Spain experienced consecutive heat waves with record temperatures, reaching global average temperatures of more than 1.5 degrees above pre-industrial levels last July. This should be an important wake-up call to the urgency of implementing adaptation measures that minimize the health impacts of high temperatures.
Counting the deaths attributed to the effects of high temperatures, usually in terms of increased mortality, is essential as a public health surveillance tool. However, this should not remain the only research goal. As well as the health effects of air pollution, the impact of extreme heat on mortality is well established. We believe it is time to focus research on other goals that lead to effective public health improvements.
Measures to reduce emissions (mitigation) are extremely relevant in terms of the impact of climate change on health, but are not sufficient to keep the planet’s average temperature below the safety thresholds proposed in the Paris Agreement. Therefore, adaptation and risk management are the basic tools to work on to reduce population vulnerability to high temperatures.
Renovating houses and creating green spaces. From the perspective of adaptation processes, local factors are crucial to reduce the impact on morbidity and mortality. It is important to understand why the populations of some places adapt better to heatwaves than others, what variables affect and change as much as possible those who are able to do so.
It is well known that climatically rehabilitating homes and making them more adaptable to high temperatures reduces the effects of heat waves. In addition, the existence of green and blue zones in cities represents a great opportunity to reduce the health effects of heat.
The aim is to focus research on which urban and social factors can improve life in cities and how these can be implemented for renaturation.
We need to improve prevention plans. Another key factor in our country when it comes to reducing the mortality impact of heat waves is the high temperature prevention plans, both at the state and at the provincial or municipal level, which need to be further improved.
For this it is necessary to reduce the geographical resolution. That is, descending from the provincial scale to the scale of isoclimatic areas (geographical areas with similar behavior of meteorological variables). In addition, implementation at this scale, which goes beyond administrative boundaries, requires setting the threshold temperatures for heatwave mortality. The aim is to determine the effects on health at the local level as well. It is not effective not to consider local factors when analyzing impacts when, as the World Health Organization (WHO) reminds us, these factors are of vital importance.
In addition, there is a need to improve knowledge of the meteorological conditions that generate heat waves. Depending on the origin, exposure risks and effects vary. For example, heat waves originating in the Sahara are associated with a significant increase in particulate matter, the impact of which on morbidity and mortality is sometimes greater than that of the temperature itself Typically lead to increases in tropospheric ozone concentrations, with significant associated health implications.
Therefore, there is a need to study the design of prevention plans that protect health and take into account air pollution and heat waves, but also take into account the co-occurrence of wildfires, exacerbation of droughts and vector-borne diseases (such as mosquitoes and ticks). and deepen knowledge of waterborne and foodborne diseases. All of these are risk factors that increase in times of high temperatures.
Field workers are also at risk. In addition, knowledge about the groups of people who are particularly at risk from heat waves, which traditionally focuses on the elderly and the chronically ill, is to be expanded and the research transferred to other population groups. For example, we are talking about field workers and people with disabilities, who may be affected differently in high-temperature situations. Pregnant women are also a particularly vulnerable group during heat waves.
There is a need to identify which diseases are particularly aggravated by heat and are therefore likely to increase hospital admissions and mortality. It is known that the most important of these are chronic, respiratory and circulatory, neurological, renal and even endocrine and metabolic, and even study the greater impact of heat in different age groups (especially preventive measures for the school-age population). .
Nonetheless, there is a need to deepen this analysis and define action protocols at the care level that allow for optimization of risk and resource management in order to minimize the impact on health, including mental health.
How important it is to convey it to the population. Finally, there is a need to examine how this information can be communicated to the population in order to standardize and make alerts and notifications effective, and to train professionals to respond to these risks. Environmental education, health education, training of social and health workers, community health networks, health literacy of patients, families and carers, and the media all play a crucial role.
In other words, there are many lines of action that need further work and research to pave the way for positive adaptation to high temperatures, because although not intuitively recognised, the impact of heatwaves is measured in terms of attributable risks to mortality measured in Spain, decreased in 2004-2013 compared to 1983-2003. This decline has a lot to do with various factors, such as the implementation of public health prevention plans, as well as socio-economic, health and infrastructure improvements, especially in the city and at home. However, the most important thing is the appropriate communication of information about the risks involved and translating this into positive health action.
Cristina Linares She is Co-Director of the Reference Unit on Climate Change, Health and the Urban Environment at the Carlos III Health Institute.
Jesus of the bear He is co-coordinator of the Aragonese Institute of Health Sciences IACS Global Health Itinerary.
Julio Diaz He is Co-Director of the Reference Unit on Climate Change, Health and the Urban Environment at the Carlos III Health Institute.
This article was originally published in Science Media Centre.
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