Phoenix Regional Heat and Air Quality Knowledge Repository

Background: Extreme heat is a public health challenge. The scarcity of directly comparable studies on the association of heat with morbidity and mortality and the inconsistent identification of threshold temperatures for severe impacts hampers the development of comprehensive strategies aimed at reducing adverse heat-health events.

Objectives: This quantitative study was designed to link temperature with mortality and morbidity events in Maricopa County, Arizona, USA, with a focus on the summer season.

Methods: Using Poisson regression models that controlled for temporal confounders, we assessed daily temperature–health associations for a suite of mortality and morbidity events, diagnoses, and temperature metrics. Minimum risk temperatures, increasing risk temperatures, and excess risk temperatures were statistically identified to represent different “trigger points” at which heat-health intervention measures might be activated.

Results: We found significant and consistent associations of high environmental temperature with all-cause mortality, cardiovascular mortality, heat-related mortality, and mortality resulting from conditions that are consequences of heat and dehydration. Hospitalizations and emergency department visits due to heat-related conditions and conditions associated with consequences of heat and dehydration were also strongly associated with high temperatures, and there were several times more of those events than there were deaths. For each temperature metric, we observed large contrasts in trigger points (up to 22°C) across multiple health events and diagnoses.

Conclusion: Consideration of multiple health events and diagnoses together with a comprehensive approach to identifying threshold temperatures revealed large differences in trigger points for possible interventions related to heat. Providing an array of heat trigger points applicable for different end-users may improve the public health response to a problem that is projected to worsen in the coming decades.

Maricopa County, Arizona, anchor to the fastest growing megapolitan area in the United States, is located in a hot desert climate where extreme temperatures are associated with elevated risk of mortality. Continued urbanization in the region will impact atmospheric temperatures and, as a result, potentially affect human health. We aimed to quantify the number of excess deaths attributable to heat in Maricopa County based on three future urbanization and adaptation scenarios and multiple exposure variables.

Two scenarios (low and high growth projections) represent the maximum possible uncertainty range associated with urbanization in central Arizona, and a third represents the adaptation of high-albedo cool roof technology. Using a Poisson regression model, we related temperature to mortality using data spanning 1983–2007. Regional climate model simulations based on 2050-projected urbanization scenarios for Maricopa County generated distributions of temperature change, and from these predicted changes future excess heat-related mortality was estimated. Subject to urbanization scenario and exposure variable utilized, projections of heat-related mortality ranged from a decrease of 46 deaths per year (− 95%) to an increase of 339 deaths per year (+ 359%).

Projections based on minimum temperature showed the greatest increase for all expansion and adaptation scenarios and were substantially higher than those for daily mean temperature. Projections based on maximum temperature were largely associated with declining mortality. Low-growth and adaptation scenarios led to the smallest increase in predicted heat-related mortality based on mean temperature projections. Use of only one exposure variable to project future heat-related deaths may therefore be misrepresentative in terms of direction of change and magnitude of effects. Because urbanization-induced impacts can vary across the diurnal cycle, projections of heat-related health outcomes that do not consider place-based, time-varying urban heat island effects are neglecting essential elements for policy relevant decision-making.

We use the Northeast US Urban Climate Archipelago as a case study to explore three key limitations of planning and policy initiatives to mitigate extreme urban heat. These limitations are: (1) a lack of understanding of spatial considerations—for example, how nearby urban areas interact, affecting, and being affected by, implementation of such policies; (2) an emphasis on air temperature reduction that neglects assessments of other important meteorological parameters, such as humidity, mixing heights, and urban wind fields; and (3) too narrow of a temporal focus—either time of day, season, or current vs. future climates. Additionally, the absence of a direct policy/planning linkage between heat mitigation goals and actual human health outcomes, in general, leads to solutions that only indirectly address the underlying problems. These issues are explored through several related atmospheric modeling case studies that reveal the complexities of designing effective urban heat mitigation strategies. We conclude with recommendations regarding how policy-makers can optimize the performance of their urban heat mitigation policies and programs. This optimization starts with a thorough understanding of the actual end-point goals of these policies, and concludes with the careful integration of scientific knowledge into the development of location-specific strategies that recognize and address the limitations discussed herein.

Background:
The evidence that heat waves can result in both increased deaths and illness is substantial, and concern over this issue is rising because of climate change. Adverse health impacts from heat waves can be avoided, and epidemiologic studies have identified specific population and community characteristics that mark vulnerability to heat waves.

Objectives:
We situated vulnerability to heat in geographic space and identified potential areas for intervention and further research.

Methods:
We mapped and analyzed 10 vulnerability factors for heat-related morbidity/mortality in the United States: six demographic characteristics and two household air conditioning variables from the U.S. Census Bureau, vegetation cover from satellite images, and diabetes prevalence from a national survey. We performed a factor analysis of these 10 variables and assigned values of increasing vulnerability for the four resulting factors to each of 39,794 census tracts. We added the four factor scores to obtain a cumulative heat vulnerability index value.

Results:
Four factors explained > 75% of the total variance in the original 10 vulnerability variables: a) social/environmental vulnerability (combined education/poverty/race/green space), b) social isolation, c) air conditioning prevalence, and d) proportion elderly/diabetes. We found substantial spatial variability of heat vulnerability nationally, with generally higher vulnerability in the Northeast and Pacific Coast and the lowest in the Southeast. In urban areas, inner cities showed the highest vulnerability to heat.

Conclusions:
These methods provide a template for making local and regional heat vulnerability maps. After validation using health outcome data, interventions can be targeted at the most vulnerable populations.

Objectives: We estimated neighborhood effects of population characteristics and built and natural environments on deaths due to heat exposure in Maricopa County, Arizona (2000–2008).

Methods: We used 2000 U.S. Census data and remotely sensed vegetation and land surface temperature to construct indicators of neighborhood vulnerability and a geographic information system to map vulnerability and residential addresses of persons who died from heat exposure in 2,081 census block groups. Binary logistic regression and spatial analysis were used to associate deaths with neighborhoods.

Results: Neighborhood scores on three factors—socioeconomic vulnerability, elderly/isolation, and unvegetated area—varied widely throughout the study area. The preferred model (based on fit and parsimony) for predicting the odds of one or more deaths from heat exposure within a census block group included the first two factors and surface temperature in residential neighborhoods, holding population size constant. Spatial analysis identified clusters of neighborhoods with the highest heat vulnerability scores. A large proportion of deaths occurred among people, including homeless persons, who lived in the inner cores of the largest cities and along an industrial corridor.

Conclusions: Place-based indicators of vulnerability complement analyses of person-level heat risk factors. Surface temperature might be used in Maricopa County to identify the most heat-vulnerable neighborhoods, but more attention to the socioecological complexities of climate adaptation is needed.

In this study we characterized the relationship between temperature and mortality in central Arizona desert cities that have an extremely hot climate. Relationships between daily maximum apparent temperature (ATmax) and mortality for eight condition-specific causes and all-cause deaths were modeled for all residents and separately for males and females ages <65 and ≥65 during the months May–October for years 2000–2008. The most robust relationship was between ATmax on day of death and mortality from direct exposure to high environmental heat. For this condition-specific cause of death, the heat thresholds in all gender and age groups (ATmax = 90–97 °F; 32.2‒36.1 °C) were below local median seasonal temperatures in the study period (ATmax = 99.5 °F; 37.5 °C). Heat threshold was defined as ATmax at which the mortality ratio begins an exponential upward trend. Thresholds were identified in younger and older females for cardiac disease/stroke mortality (ATmax = 106 and 108 °F; 41.1 and 42.2 °C) with a one-day lag. Thresholds were also identified for mortality from respiratory diseases in older people (ATmax = 109 °F; 42.8 °C) and for all-cause mortality in females (ATmax = 107 °F; 41.7 °C) and males <65 years (ATmax = 102 °F; 38.9 °C). Heat-related mortality in a region that has already made some adaptations to predictable periods of extremely high temperatures suggests that more extensive and targeted heat-adaptation plans for climate change are needed in cities worldwide.

While previous studies have shown that urban heat islands (UHI) tend to increase residential water use, they have not yet analyzed the feedbacks among vegetation intensity, diurnal temperature variation, water use, and characteristics of the built environment. This study examines these feedback relationships with the help of a path model applied to spatially disaggregated data from Phoenix, Arizona. The empirical evidence from the observations in Phoenix suggests the following: (1) impervious surfaces contribute to increased residential water use by exacerbating UHI; (2) larger lots containing pools and mesic vegetation increase water demand by reducing diurnal temperature difference; and (3) smart design of urban environments needs to go beyond simplistic water body- and vegetation-based solutions for mitigating uncomfortably high temperatures and consider interactions between surface materials, land use, UHI, and water use.

Problem: The prospect that urban heat island (UHI) effects and climate change may increase urban temperatures is a problem for cities that actively promote urban redevelopment and higher densities. One possible UHI mitigation strategy is to plant more trees and other irrigated vegetation to prevent daytime heat storage and facilitate nighttime cooling, but this requires water resources that are limited in a desert city like Phoenix.

Purpose: We investigated the tradeoffs between water use and nighttime cooling inherent in urban form and land use choices.

Methods: We used a Local-Scale Urban Meteorological Parameterization Scheme (LUMPS) model to examine the variation in temperature and evaporation in 10 census tracts in Phoenix's urban core. After validating results with estimates of outdoor water use based on tract-level city water records and satellite imagery, we used the model to simulate the temperature and water use consequences of implementing three different scenarios.

Results and conclusions: We found that increasing irrigated landscaping lowers nighttime temperatures, but this relationship is not linear; the greatest reductions occur in the least vegetated neighborhoods. A ratio of the change in water use to temperature impact reached a threshold beyond which increased outdoor water use did little to ameliorate UHI effects.

Takeaway for practice: There is no one design and landscape plan capable of addressing increasing UHI and climate effects everywhere. Any one strategy will have inconsistent results if applied across all urban landscape features and may lead to an inefficient allocation of scarce water resources.

Research Support: This work was supported by the National Science Foundation (NSF) under Grant SES-0345945 (Decision Center for a Desert City) and by the City of Phoenix Water Services Department. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of NSF.

In an extreme heat event, people can go to air-conditioned public facilities if residential air-conditioning is not available. Residences that heat slowly may also mitigate health effects, particularly in neighborhoods with social vulnerability. We explored the contributions of social vulnerability and these infrastructures to heat mortality in Maricopa County and whether these relationships are sensitive to temperature. Using Poisson regression modeling with heat-related mortality as the outcome, we assessed the interaction of increasing temperature with social vulnerability, access to publicly available air conditioned space, home air conditioning and the thermal properties of residences. As temperatures increase, mortality from heat-related illness increases less in census tracts with more publicly accessible cooled spaces. Mortality from all internal causes of death did not have this association. Building thermal protection was not associated with mortality. Social vulnerability was still associated with mortality after adjusting for the infrastructure variables. To reduce heat-related mortality, the use of public cooled spaces might be expanded to target the most vulnerable.

Creating a Healthier, More Livable and Prosperous Phoenix

Phoenix is poised to become the next great American City. The Tree and Shade Master Plan presents Phoenix’s leaders and residents a roadmap to creating a 21st Century desert city. The urban forest is a keystone to creating a sustainable city because it solves many problems with one single solution. By investing in trees and the urban forest, the city can reduce its carbon footprint, decrease energy costs, reduce storm water runoff, increase biodiversity, address the urban heat island effect, clean the air, and increase property values. In addition, trees can help to create walkable streets and vibrant pedestrian places. More trees will not solve all the problems, but it is known that for every dollar invested in the urban forest results in an impressive return of $2.23 in benefits.

Phoenix has a strong foundation on which to build the future. Phoenix residents value natural resources and have voted repeatedly to invest in the living infrastructure. For instance, the Phoenix Parks and Preserve Initiative was passed twice with over 75 percent voter approval. This modest sales tax has purchased land for the Sonoran Preserve, funded habitat restoration efforts along Rio Salado, built new parks and planted hundreds of new trees. These projects and others like it provide the base for a healthy urban forest. Trees and engineered shade have the potential to be one of the city’s greatest assets and the Tree and Shade Master Plan provides the framework for creating a healthier, more livable and prosperous Phoenix.

The Urban Forest – Trees for People

The urban forest is a critical component of the living infrastructure. It benefits and attracts residents and tourists alike to live, work, shop and play in the city. Phoenix’s urban forest is a diverse ecosystem of soils, vegetation, trees, associated organisms, air, water, wildlife and people. The urban forest is found not only in parks, mountain preserves and native desert areas, but also in neighborhoods, commercial corridors, industrial parks and along streets. The urban forest is made up of a rich mosaic of private and public property that surrounds the city and provides many environmental, economic, and social benefits.

In order for the urban forest to be a profitable investment, Phoenix must do more than just plant trees. The entire lifecycle of the tree must be addressed because the current planting, maintenance, and irrigation practices are preventing many trees from providing their maximum return on investment. The Tree and Shade Master Plan provides a detailed roadmap to address these issues, as well as many others, with realistic and incremental steps. To succeed, this plan requires a long-term investment from the residents and leaders of Phoenix.

Trees are Solution Multipliers

Solution multipliers solve numerous problems simultaneously. Trees are a perfect example of a solution multiplier because when planted and maintained correctly, they can provide many economic, environmental, and social benefits. According to the US Forest Service, trees benefit the community by: providing a cooling effect that reduces energy costs; improving air quality; strengthening quality of place and the local economy; reducing storm water runoff; improving social connections; promoting smart growth and compact development; and creating walkable communities (US Forest Service and Urban & Community Forestry). Trees are high-yield assets; for example, the City of Chicago values its trees at $2.3 billion dollars. Trees have a documented return on investment (ROI) in Arizona of $2.23 for every $1 invested (US Department of Agriculture Forest Service). This demonstrates the important role that trees have within the city's economy. This is why it is critical to manage and invest in the urban forest; the health of the urban forest is closely linked to the economic health of the city.

Maintainable Infrastructure

Phoenix is a desert city that has a history of several decades of drought. In order to achieve a healthy urban forest we must use water wisely. Currently, 60 percent of Phoenix’s water is used outdoors, mainly for landscape irrigation. According to the City of Phoenix’s Water Services Department, Phoenix has an adequate sustainable water supply to meet the State of Arizona’s 100-year assured water supply standard. This includes growth in Phoenix’s system water demand over the next 20 years or more. Nonetheless, to achieve a maintainable urban forest, water must be used more efficiently. This is done with high-efficiency irrigation systems, use of drought-tolerant plant material, strategic placement of shade corridors and continued education. In order for a healthy urban forest to exist, it must be coupled with strong water management.

Implementation

The Urban Forest Infrastructure Team and the Parks and Recreation Department are charged with coordinating and maintaining the Tree and Shade Master Plan. Many City departments will implement the plan as they work to fulfill their own missions. The Tree and Shade Master Plan will not only provide a framework to achieve an average 25 percent tree canopy coverage by 2030 but will also help to achieve many goals and policies from the Green Phoenix Initiative and the voter ratified General Plan.

The plan proposes incremental steps to achieve the 2030 vision and canopy goal. The City of Phoenix is beginning to put a process in place to preserve, maintain, and redevelop the urban forest. This plan intends to increase the quality of life and economic vitality of the city by recommending ways to create a sustainable urban forest for future generations.