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.

Conversion of natural to urban land forms imparts influence on local and regional hydroclimate via modification of the surface energy and water balance, and consideration of such effects due to rapidly expanding megapolitan areas is necessary in light of the growing global share of urban inhabitants. Based on a suite of ensemble-based, multi-year simulations using the Weather Research and Forecasting (WRF) model, we quantify seasonally varying hydroclimatic impacts of the most rapidly expanding megapolitan area in the US: Arizona's Sun Corridor, centered upon the Greater Phoenix metropolitan area. Using a scenario-based urban expansion approach that accounts for the full range of Sun Corridor growth uncertainty through 2050, we show that built environment induced warming for the maximum development scenario is greatest during the summer season (regionally averaged warming over AZ exceeds 1 °C).

Warming remains significant during the spring and fall seasons (regionally averaged warming over AZ approaches 0.9 °C during both seasons), and is least during the winter season (regionally averaged warming over AZ of 0.5 °C). Impacts from a minimum expansion scenario are reduced, with regionally averaged warming ranging between 0.1 and 0.3 °C for all seasons except winter, when no warming impacts are diagnosed. Integration of highly reflective cool roofs within the built environment, increasingly recognized as a cost-effective option intended to offset the warming influence of urban complexes, reduces urban-induced warming considerably. However, impacts on the hydrologic cycle are aggravated via enhanced evapotranspiration reduction, leading to a 4% total accumulated precipitation decrease relative to the non-adaptive maximum expansion scenario. Our results highlight potentially unintended consequences of this adaptation approach within rapidly expanding megapolitan areas, and emphasize the need for undeniably sustainable development paths that account for hydrologic impacts in addition to continued focus on mean temperature effects.

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.

Engineered pavements cover a large fraction of cities and offer significant potential for urban heat island mitigation. Though rapidly increasing research efforts have been devoted to the study of pavement materials, thermal interactions between buildings and the ambient environment are mostly neglected. In this study, numerical models featuring a realistic representation of building-environment thermal interactions, were applied to quantify the effect of pavements on the urban thermal environment at multiple scales. It was found that performance of pavements inside the canyon was largely determined by the canyon geometry. In a high-density residential area, modifying pavements had insignificant effect on the wall temperature and building energy consumption. At a regional scale, various pavement types were also found to have a limited cooling effect on land surface temperature and 2-m air temperature for metropolitan Phoenix. In the context of global climate change, the effect of pavement was evaluated in terms of the equivalent CO2 emission. Equivalent CO2 emission offset by reflective pavements in urban canyons was only about 13.9e46.6% of that without building canopies, depending on the canyon geometry. This study revealed the importance of building-environment thermal interactions in determining thermal conditions inside the urban canopy.

Preventing heat-associated morbidity and mortality is a public health priority in Maricopa County, Arizona (United States). The objective of this project was to evaluate Maricopa County cooling centers and gain insight into their capacity to provide relief for the public during extreme heat events. During the summer of 2014, 53 cooling centers were evaluated to assess facility and visitor characteristics. Maricopa County staff collected data by directly observing daily operations and by surveying managers and visitors. The cooling centers in Maricopa County were often housed within community, senior, or religious centers, which offered various services for at least 1500 individuals daily. Many visitors were unemployed and/or homeless. Many learned about a cooling center by word of mouth or by having seen the cooling center’s location. The cooling centers provide a valuable service and reach some of the region’s most vulnerable populations. This project is among the first to systematically evaluate cooling centers from a public health perspective and provides helpful insight to community leaders who are implementing or improving their own network of cooling centers.

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.

Urban Heat Island (UHI) is considered as one of the major problems in the 21st century posed to human beings as a result of urbanization and industrialization of human civilization. The large amount of heat generated from urban structures, as they consume and re-radiate solar radiations, and from the anthropogenic heat sources are the main causes of UHI. The two heat sources increase the temperatures of an urban area as compared to its surroundings, which is known as Urban Heat Island Intensity (UHII). The problem is even worse in cities or metropolises with large population and extensive economic activities. The estimated three billion people living in the urban areas in the world are directly exposed to the problem, which will be increased significantly in the near future. Due to the severity of the problem, vast research effort has been dedicated and a wide range of literature is available for the subject. The literature available in this area includes the latest research approaches, concepts, methodologies, latest investigation tools and mitigation measures. This study was carried out to review and summarize this research area through an investigation of the most important feature of UHI. It was concluded that the heat re-radiated by the urban structures plays the most important role which should be investigated in details to study urban heating especially the UHI. It was also concluded that the future research should be focused on design and planning parameters for reducing the effects of urban heat island and ultimately living in a better environment.

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.

The leading source of weather-related deaths in the United States is heat, and future projections show that the frequency, duration, and intensity of heat events will increase in the Southwest. Presently, there is a dearth of knowledge about how infrastructure may perform during heat waves or could contribute to social vulnerability. To understand how buildings perform in heat and potentially stress people, indoor air temperature changes when air conditioning is inaccessible are modeled for building archetypes in Los Angeles, California, and Phoenix, Arizona, when air conditioning is inaccessible is estimated.

An energy simulation model is used to estimate how quickly indoor air temperature changes when building archetypes are exposed to extreme heat. Building age and geometry (which together determine the building envelope material composition) are found to be the strongest indicators of thermal envelope performance. Older neighborhoods in Los Angeles and Phoenix (often more centrally located in the metropolitan areas) are found to contain the buildings whose interiors warm the fastest, raising particular concern because these regions are also forecast to experience temperature increases. To combat infrastructure vulnerability and provide heat refuge for residents, incentives should be adopted to strategically retrofit buildings where both socially vulnerable populations reside and increasing temperatures are forecast.

Urban Heat Island (UHI) has significant impacts on the buildings energy consumption and outdoor air quality (OAQ). Various approaches, including observation and simulation techniques, have been proposed to understand the causes of UHI formation and to find the corresponding mitigation strategies. However, the causes of UHI are not the same in different climates or city features. Thus, general conclusion cannot be made based on limited monitoring data.

With recent progress in computational tools, simulation methods have been used to study UHI. These approaches, however, are also not able to cover all the phenomena that simultaneously contribute to the formation of UHI. The shortcomings are mostly attributed to the weakness of the theories and computational cost.

This paper presents a review of the techniques used to study UHI. The abilities and limitations of each approach for the investigation of UHI mitigation and prediction are discussed. Treatment of important parameters including latent, sensible, storage, and anthropogenic heat in addition to treatment of radiation, effect of trees and pond, and boundary condition to simulate UHI is also presented. Finally, this paper discusses the application of integration approach as a future opportunity.