The City of Phoenix (Arizona, USA) developed a Tree and Shade Master Plan and a Cool Roofs initiative to ameliorate extreme heat during the summer months in their arid city. This study investigates the impact of the City's heat mitigation strategies on daytime microclimate for a pre-monsoon summer day under current climate conditions and two climate change scenarios. We assessed the cooling effect of trees and cool roofs in a Phoenix residential neighborhood using the microclimate model ENVI-met. First, using xeric landscaping as a base, we created eight tree planting scenarios (from 0% canopy cover to 30% canopy cover) for the neighborhood to characterize the relationship between canopy cover and daytime cooling benefit of trees. In a second set of simulations, we ran ENVI-met for nine combined tree planting and landscaping scenarios (mesic, oasis, and xeric) with regular roofs and cool roofs under current climate conditions and two climate change projections. For each of the 54 scenarios, we compared average neighborhood mid-afternoon air temperatures and assessed the benefits of each heat mitigation measure under current and projected climate conditions. Findings suggest that the relationship between percent canopy cover and air temperature reduction is linear, with 0.14 °C cooling per percent increase in tree cover for the neighborhood under investigation. An increase in tree canopy cover from the current 10% to a targeted 25% resulted in an average daytime cooling benefit of up to 2.0 °C in residential neighborhoods at the local scale. Cool roofs reduced neighborhood air temperatures by 0.3 °C when implemented on residential homes. The results from this city-specific mitigation project will inform messaging campaigns aimed at engaging the city decision makers, industry, and the public in the green building and urban forestry initiatives.

Human exposure to excessively warm weather, especially in cities, is an increasingly important public health problem. This study examined heat-related health inequalities within one city in order to understand the relationships between the microclimates of urban neighborhoods, population characteristics, thermal environments that regulate microclimates, and the resources people possess to cope with climatic conditions. A simulation model was used to estimate an outdoor human thermal comfort index (HTCI) as a function of local climate variables collected in 8 diverse city neighborhoods during the summer of 2003 in Phoenix, USA. HTCI is an indicator of heat stress, a condition that can cause illness and death. There were statistically significant differences in temperatures and HTCI between the neighborhoods during the entire summer, which increased during a heat wave period. Lower socioeconomic and ethnic minority groups were more likely to live in warmer neighborhoods with greater exposure to heat stress. High settlement density, sparse vegetation, and having no open space in the neighborhood were significantly correlated with higher temperatures and HTCI. People in warmer neighborhoods were more vulnerable to heat exposure because they had fewer social and material resources to cope with extreme heat. Urban heat island reduction policies should specifically target vulnerable residential areas and take into account equitable distribution and preservation of environmental resources.

Rapid urbanization of the planet is occurring at an unprecedented pace, primarily in arid and semi-arid hot climates [Golden, J.S., 2004. The built environment induced urban heat island effect in rapidly urbanizing arid regions – a sustainable urban engineering complexity. Environ. Sci. J. Integr. Environ. Res. 1 (4), 321–349]. This growth has manifested itself as a cause of various impacts including elevated urban temperatures in comparison to rural sites known as the Urban Heat Island (UHI) effect [Oke, T.R., 1982. The energetic basis of the urban heat island. Q. J. R. Meteor. Soc. 108, 1–24]. Related are the increased demands for electric power as a result of population growth and increased need for mechanical cooling due to the UHI. In the United States, the Environmental Protection Agency has developed a three-prong approach of (1) cool pavements, (2) urban forestry and (3) cool roofs to mitigate the UHI. Researchers undertook an examination of micro scale benefits of the utilization of photovoltaic panels to reduce the thermal impacts to surface temperatures of pavements in comparison to urban forestry. The results of the research indicate that photovoltaic panels provide a greater thermal reduction benefit during the diurnal cycle in comparison to urban forestry while also providing the additional benefits of supporting peak energy demand, conserving water resources and utilizing a renewable energy source.

Maricopa County experiences extreme heat, which has adverse effects on community health and has been recognized as a serious public health issue. Therefore, the Maricopa County Department of Public Health (MCDPH) has conducted surveillance activities to assess morbidity and mortality due to extreme heat for the past 10 years. In 2016, MCDPH was interested in expanding their scope to include other climate-sensitive public health hazards. Subsequently, a network of stakeholders with an interest in the health effects of climate-sensitive hazards was established as the Bridging Climate Change and Public Health (BCCPH) stakeholder group. A smaller Strategic Planning Workgroup of key stakeholders from the BCCPH group was then convened over three sessions to work on a strategic plan for the group, which culminated in this document.

Practical Vision
The driving discussion question to identify the Strategic Planning Workgroup’s practical vision was, “What do we want to see in place in the next 3-5 years as a result of our actions?” The goal of this question was to help the group develop concrete outcomes that the BCCPH workgroup would like to achieve through activities included in the strategic plan. The following goals were identified:
 A healthy community infrastructure design
 Reframed messaging for multiple stakeholder needs
 A coordinated multi-scale education effort
 Improved health strategies and outcomes
 A diverse network of partnerships for climate change adaptation and mitigation planning and development
 New funding opportunities
 Policy and research strategies, and private sector engagement.

Underlying Contradictions
The driving discussion question to identify underlying contradictions was, “What is blocking us from moving towards our practical vision?” The following challenges were identified:
 People act out of self-interest vs. common good
 Siloed effects lead to poor coordination
 Political partisanship delays unified action
 Conflicting information leads to biases
 Culture and convenience impacts action
 Vulnerable populations not represented, and normalization of climate change related negative effects

Strategic Directions
During the BCCPH Strategic Planning Workgroup meetings, participants identified five strategic directions for addressing environmental concerns affecting the health and well-being of the community. These strategic directions are in agreement with the climate and health adaptation strategies outlined in the Arizona Climate and Health Adaptation Plan. The strategic directions for Maricopa County are:
 Fostering Environmental Action for a Healthier Community
 Coordinating Research and Collaborative Efforts to Catalyze Change
 Developing a Strategic and Targeted Communication Plan
 Promoting Community Awareness and Public Education about Climate and Health
 Celebrating Success and Champions

This established model is applied here to show the relative effects of four common mitigation strategies: increasing the overall (1) emissivity, (2) percentage of vegetated area, (3) thermal conductivity, and (4) albedo of the urban environment in a series of percentage increases by 5, 10, 15, and 20% from baseline values.

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.

The urban heat island effect is especially significant in semi-arid climates, generating a myriad of problems for large urban areas. Green space can mitigate warming, providing cooling benefits important to reducing energy consumption and improving human health. The arrangement of green space to reap the full potential of cooling benefits is a challenge, especially considering the diurnal variations of urban heat island effects. Surprisingly, methods that support the strategic placement of green space in the context of urban heat island are lacking. Integrating geographic information systems, remote sensing, spatial statistics and spatial optimization, we developed a framework to identify the best locations and configuration of new green space with respect to cooling benefits. The developed multi-objective model is applied to evaluate the diurnal cooling trade-offs in Phoenix, Arizona. As a result of optimal green space placement, significant cooling potentials can be achieved. A reduction of land surface temperature of approximately 1–2 °C locally and 0.5 °C regionally can be achieved by the addition of new green space. 96% of potential day and night cooling benefits can be achieved through simultaneous consideration. The results also demonstrate that clustered green space enhances local cooling because of the agglomeration effect; whereas, dispersed patterns lead to greater overall regional cooling. The optimization based framework can effectively inform planning decisions with regard to green space allocation to best ameliorate excessive heat.