Urban Heat and Health

Physi­cians and phys­i­ol­o­gists under­stand the human body’s respons­es to extreme heat bet­ter than archi­tects or oth­er pro­fes­sion­als do. As heat waves increase in inten­si­ty and fre­quen­cy, how­ev­er, gain­ing an under­stand­ing of these respons­es and the con­di­tions that cause them is becom­ing more crit­i­cal for the AEC com­mu­ni­ty. Aware­ness of these bod­i­ly process­es empow­ers us to bet­ter help our com­mu­ni­ties thrive despite ris­ing tem­per­a­tures; it under­lies and jus­ti­fies the adap­tive mit­i­ga­tion mea­sures tak­en on col­lec­tive lev­els. Emer­gency physi­cian Elan Levy gave the large­ly non­med­ical audi­ence a prac­ti­cal overview on the top­ic: when air tem­per­a­tures exceed core body tem­per­a­ture and/or humid­i­ty pre­vents sweat from evap­o­rat­ing, par­tic­u­lar­ly in some­one who is unac­cli­ma­tized to hot con­di­tions or influ­enced by age, med­ica­tions, or dis­ease, a cas­cade of dys­func­tions impairs the car­dio­vas­cu­lar, res­pi­ra­to­ry, and cen­tral ner­vous sys­tems. The result is heat stroke, either exer­tion­al or non-exer­tion­al; the lat­ter is “clas­si­cal” heat stroke, and involves dehy­dra­tion.


Dr. Elan Levy, Attend­ing Physi­cian of the Lenox Hill Hos­pi­tal Emer­gency Depart­ment, elab­o­rates on caus­es of heat stroke.

Heat waves as severe as the 2003 Parisian event, which Richard Keller pro­filed in depth, result in mor­tal­i­ty that is dis­pro­por­tion­ate to expec­ta­tions. We should be able to improve our pre­dic­tions, how­ev­er; vul­ner­a­bil­i­ty to hyper­ther­mia is not ran­dom. That said, it is also not sim­ple: along with the intu­itive asso­ci­a­tions with old age, infir­mi­ty, and pover­ty, heat vul­ner­a­bil­i­ty also varies with aspects of build­ing and dis­trict design, social sup­port net­works, and demo­graph­ics. For exam­ple, high-rise build­ings with frag­ment­ed social cohe­sion pat­terns cor­re­late with high health risks. “One of the key chal­lenges of heat waves is that they real­ly do tar­get the peo­ple who are most dif­fi­cult to reach,” not­ed mod­er­a­tor Eric Kli­nen­berg, who called for neigh­bor­hood designs that are more con­ducive to the social net­works that safe­guard vul­ner­a­ble pop­u­la­tions, some­times even more so than phys­i­cal infra­struc­ture. Kli­nen­berg, who stud­ied the 1995 Chica­go heat wave in depth, extrap­o­lat­ed from Chicago’s three-day event and the longer 2003 Euro­pean heat wave that a com­pa­ra­ble event in any Amer­i­can city would strain its hos­pi­tals and oth­er sys­tems to the break­ing point. In 1995, half of Chicago’s hos­pi­tals went on bypass sta­tus, reject­ing and redi­rect­ing fur­ther emer­gency patients. Pow­er-grid fail­ures, such as those expe­ri­enced dur­ing Sandy, would inca­pac­i­tate our cur­rent ele­va­tors and water pumps, turn­ing high-rise res­i­dences into death­traps.

Vul­ner­a­bil­i­ty to hyper­ther­mia is nei­ther ran­dom nor sim­ple: along with the intu­itive asso­ci­a­tions with old age, infir­mi­ty, and pover­ty, heat vul­ner­a­bil­i­ty also varies with aspects of build­ing and dis­trict design, social sup­port net­works, and demo­graph­ics.

For­tu­nate­ly, analy­sis of past mor­tal­i­ty pat­terns and infra­struc­tur­al fail­ures can inform future deci­sions about com­mu­ni­ties’ design and char­ac­ter. Soci­ol­o­gist and film­mak­er Sab­ri­na McCormick, hav­ing observed the state of heat-relat­ed research and prepa­ra­tion in sev­er­al U.S. cities, not­ed that most adap­ta­tion pro­grams are in the ear­ly stages of devel­op­ment. Though New York City is “ahead of the curve” in some ways, our pub­lic cool­ing cen­ter approach­es face per­cep­tu­al obsta­cles, she has found, and the need for bet­ter heat edu­ca­tion match­es that of oth­er cities. New York City offi­cials Tom Mat­te and Melis­sa Umberg­er, of the respec­tive Depart­ments of Health and Emer­gency Man­age­ment, elab­o­rat­ed on some of the city’s efforts to com­bat heat-relat­ed ill­ness­es, as well as ther­mal exac­er­ba­tion of chron­ic dis­or­ders, specif­i­cal­ly cit­ing eas­i­er access to cool­ing for high-risk pop­u­la­tions and mul­ti-faceted infor­ma­tion­al cam­paigns as top pri­or­i­ties.

NYC Emergency Management’s Melissa Umberger emphasizes partnerships as being essential to progress.

NYC Emer­gency Management’s Melis­sa Umberg­er empha­sizes part­ner­ships as being essen­tial to progress.

Post-Sandy New York, Mat­te under­scored, is indeed plan­ning for future sce­nar­ios with post-emer­gency can­vass­ing oper­a­tions, among oth­er care­ful­ly thought out mea­sures. When con­sid­er­ing the ten­den­cy for heat waves to wors­en mul­ti­sys­tem stress­es – Keller cit­ed the com­bi­na­tion of heat, pro­longed drought, for­est fires, and pow­er out­ages in 2003, result­ing in €4 bil­lion in agri­cul­tur­al loss­es in Europe – those mea­sures become even more urgent pri­or­i­ties. “We’re about to invest a lot of col­lec­tive resources over the next decades in cli­mate secu­ri­ty,” Kli­nen­berg sum­ma­rized. He then warned: “If we do cli­mate secu­ri­ty the way we did home­land secu­ri­ty, we’re in big trou­ble.”

Click here to read addi­tion­al insights by Keller, Mat­te, Umberg­er, McCormick, and Levy.