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.

This research evaluates the climatic summertime representation of the diurnal cycle of near-surface temperature using the Weather Research and Forecasting System (WRF) over the rapidly urbanizing and water-vulnerable Phoenix metropolitan area. A suite of monthly, high-resolution (2 km grid spacing) simulations are conducted during the month of July with both a contemporary landscape and a hypothetical presettlement scenario. WRF demonstrates excellent agreement in the representation of the daily to monthly diurnal cycle of near-surface temperatures, including the accurate simulation of maximum daytime temperature timing. Thermal sensitivity to anthropogenic land use and land cover change (LULCC), assessed via replacement of the modern-day landscape with natural shrubland, is small on the regional scale. The WRF-simulated characterization of the diurnal cycle, supported by previous observational analyses, illustrates two distinct and opposing impacts on the urbanized diurnal cycle of the Phoenix metro area, with evening and nighttime warming partially offset by daytime cooling. The simulated nighttime urban heat island (UHI) over this semiarid urban complex is explained by well-known mechanisms (slow release of heat from within the urban fabric stored during daytime and increased emission of longwave radiation from the urban canopy toward the surface). During daylight hours, the limited vegetation and dry semidesert region surrounding metro Phoenix warms at greater rates than the urban complex. Although prior work has suggested that daytime temperatures are lower within the urban complex owing to the addition of residential and agricultural irrigation (i.e., “oasis effect”) we show that modification of Phoenix's surrounding environment to a biome more representative of temperate regions eliminates the daytime urban cooling. Our results indicate that surrounding environmental conditions, including land cover and availability of soil moisture, play a principal role in establishing the nature and evolution of the diurnal cycle of near-surface temperature for the greater Phoenix, Arizona, metropolitan area relative to its rural and undeveloped counterpart.

Evaluation of built environment energy demand is necessary in light of global projections of urban expansion. Of particular concern are rapidly expanding urban areas in environments where consumption requirements for cooling are excessive. Here, we simulate urban air conditioning (AC) electric consumption for several extreme heat events during summertime over a semiarid metropolitan area with the Weather Research and Forecasting (WRF) model coupled to a multilayer building energy scheme. Observed total load values obtained from an electric utility company were split into two parts, one linked to meteorology (i.e., AC consumption) which was compared to WRF simulations, and another to human behavior. WRF-simulated non-dimensional AC consumption profiles compared favorably to diurnal observations in terms of both amplitude and timing. The hourly ratio of AC to total electricity consumption accounted for ~53% of diurnally averaged total electric demand, ranging from ~35% during early morning to ~65% during evening hours. Our work highlights the importance of modeling AC electricity consumption and its role for the sustainable planning of future urban energy needs. Finally, the methodology presented in this article establishes a new energy consumption-modeling framework that can be applied to any urban environment where the use of AC systems is prevalent.

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.

Objectives: To provide novel quantification and advanced measurements of surface temperatures (Ts) in playgrounds, employing multiple scales of data, and provide insight into hot-hazard mitigation techniques and designs for improved environmental and public health.

Methods: We conduct an analysis of Ts in two Metro-Phoenix playgrounds at three scales: neighborhood (1 km resolution), microscale (6.8 m resolution), and touch-scale (1 cm resolution). Data were derived from two sources: airborne remote sensing (neighborhood and microscale) and in situ (playground site) infrared Ts (touch-scale). Metrics of surface-to-air temperature deltas (Ts–a) and scale offsets (errors) are introduced.

Results: Select in situ Ts in direct sunlight are shown to approach or surpass values likely to result in burns to children at touch-scales much finer than Ts resolved by airborne remote sensing. Scale offsets based on neighbourhood and microscale ground observations are 3.8 ◦C and 7.3 ◦C less than the Ts–a at the 1 cm touch-scale, respectively, and 6.6 ◦C and 10.1 ◦C lower than touch-scale playground equipment Ts, respectively. Hence, the coarser scales underestimate high Ts within playgrounds. Both natural (tree) and artificial (shade sail) shade types are associated with significant reductions in Ts.

Conclusions: A scale mismatch exists based on differing methods of urban Ts measurement. The sub-meter touch-scale is the spatial scale at which data must be collected and policies of urban landscape design and health must be executed in order to mitigate high Ts in high-contact environments such as playgrounds. Shade implementation is the most promising mitigation technique to reduce child burns, increase park usability, and mitigate urban heating.

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.

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.