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.

Urban heat is a growing problem that impacts public health, water and energy use, and the economy and affects population subgroups differently. Exposure and sensitivity, two key factors in determining vulnerability, have been widely researched. This dissertation focuses on the adaptive capacity component of heat vulnerability at the individual, household, and community scale. Using a mixed methods approach and metropolitan Phoenix as a test site, I explored how vulnerable communities understand and adapt to increasing extreme urban heat to uncover adaptive capacity that is not being operationalized well through current heat vulnerability frameworks. Twenty-three open-ended interviews were conducted where residents were encouraged to tell their stories about past and present extreme heat adaptive capacity behaviors. A community-based participatory research project consisting of three workshops and demonstration projects was piloted in three underserved neighborhoods to address urban heat on a local scale and collaboratively create community heat action plans. Last, a practitioner stakeholder meeting was held to discuss how the heat action plans will be integrated into other community efforts. Using data from the interviews, workshops, and stakeholder meeting, social capital was examined in the context of urban heat. Although social capital has been measured in a multitude of ways to gauge social relationships, trust, and reciprocity within a community, it is situational and reflects a position within the formal and informal aspects of any issue. Three narratives emerged from the interviews illuminating differentiated capacities to cope with urban heat: heat is an inconvenience, heat is a manageable problem, and heat is a catastrophe. For each of these narratives, generic adaptive capacity is impacted differently by specific heat adaptive capacity. The heat action plan workshops generated hyper-local heat solutions that reflected the neighborhoods’ different identities. Community-based organizations were instrumental in the success of this program. Social capital indicators were developed specific to urban heat that rely on heavily on family and personal relationships, attitudes and beliefs, perceived support, network size and community engagement. This research highlights how extreme heat vulnerability may need to be rethought to capture adaptive capacity nuances and the dynamic structure of who is vulnerable under what circumstances.

Exertional heat stroke continues to be one of the leading causes of illness and death in sport in the United States, with an athlete’s experienced microclimate varying by venue design and location. A limited number of studies have attempted to determine the relationship between observed wet bulb globe temperature (WBGT) and WBGT derived from regional weather station data. Moreover, only one study has quantified the relationship between regionally modeled and on-site measured WBGT over different athletic surfaces (natural grass, rubber track, and concrete tennis court). The current research expands on previous studies to examine how different athletic surfaces influence the thermal environment in the Phoenix Metropolitan Area using a combination of fieldwork, modeling, and statistical analysis. Meteorological data were collected from 0700–1900hr across 6 days in June and 5 days in August 2019 in Tempe, Arizona at various Sun Devil Athletics facilities. This research also explored the influence of surface temperatures on WBGT and the changes projected under a future warmer climate. Results indicate that based on American College of Sports Medicine guidelines practice would not be cancelled in June (WBGT≥32.3°C); however, in August, ~33% of practice time was lost across multiple surfaces. The second-tier recommendations (WBGT≥30.1°C) to limit intense exercise were reached an average of 7 hours each day for all surfaces in August. Further, WBGT was calculated using data from four Arizona Meteorological Network (AZMET) weather stations to provide regional WBGT values for comparison. The on-site (field/court) WBGT values were consistently higher than regional values and significantly different (p<0.05). Thus, using regionally-modeled WBGT data to guide activity or clothing modification for heat safety may lead to misclassification and unsafe conditions. Surface temperature measurements indicate a maximum temperature (170°F) occurring around solar noon, yet WBGT reached its highest level mid-afternoon and on the artificial turf surface (2–5PM). Climate projections show that WBGT values are expected to rise, further restricting the amount of practice and games than can take place outdoors during the afternoon. The findings from this study can be used to inform athletic trainers and coaches about the thermal environment through WBGT values on-field.

Environmental hazards and disaster researchers have demonstrated strong associations between sociodemographic indicators, such as age and socio-economic status (SES), and hazard exposures and health outcomes for individuals and in certain communities. At the same time, behavioral health and risk communications research has examined how individual psychology influences adaptive strategies and behaviors in the face of hazards. However, at present, we do not understand the explanatory mechanisms that explain relationships between larger scale social structure, individual psychology, and specific behaviors that may attenuate or amplify risk. Extreme heat presents growing risks in a rapidly warming and urbanizing world. This dissertation examines the social and behavioral mechanisms that may explain inequitable health outcomes from exposure to concurrent extreme heat and electrical power failure in Phoenix, AZ and extreme heat in Detroit, MI. Exploratory analysis of 163 surveys in Phoenix, AZ showed that age, gender, and respondent’s racialized group identity did not relate to thermal discomfort and self-reported heat illness, which were only predicted by SES (StdB = -0.52, p < 0.01). Of the explanatory mechanisms tested in the study, only relative air conditioning intensity and thermal discomfort explained self-reported heat illness. Thermal discomfort was tested as both a mechanism and outcome measure. Content analysis of 40 semi-structured interviews in Phoenix, AZ revealed that social vulnerability was associated with an increase in perceived hazard severity (StdB = 0.44, p < 0.01), a decrease in perceived adaptation efficacy (StdB = -0.38, p = 0.02), and an indirect increase (through adaptive efficacy) in maladaptive intentions (StdB = 0.18, p = 0.01). Structural equation modeling of 244 surveys in Phoenix, AZ and Detroit, MI revealed that relationships between previous heat illness experience, perceived heat risk, and adaptive intentions were significantly moderated by adaptive capacity: high adaptive capacity households were more likely to undertake adaptive behaviors, and those decisions were more heavily influenced by risk perceptions and previous experiences. However, high adaptive capacity households had lower risk perceptions and fewer heat illness experiences than low adaptive capacity households. A better understanding of the mechanisms that produce social vulnerability can facilitate more salient risk messaging and more targeted public health interventions. For example, public health risk messaging that provides information on the efficacy of specific adaptations may be more likely to motivate self-protective action, and ultimately protect populations.

The City of Phoenix Street Transportation Department partnered with the Rob and Melani Walton Sustainability Solutions Service at Arizona State University (ASU) and researchers from various ASU schools to evaluate the effectiveness, performance, and community perception of the new pavement coating. The data collection and analysis occurred across multiple neighborhoods and at varying times across days and/or months over the course of one year (July 15, 2020–July 14, 2021), allowing the team to study the impacts of the surface treatment under various weather conditions.