Urban heat stress: novel survey suggests health and fitness as future avenue for research and adaptation strategies

Extreme heat has tremendous adverse effects on human health. Heat stress is expected to further increase due to urbanization, an aging population, and global warming. Previous research has identified correlations between extreme heat and mortality. However, the underlying physical, behavioral, environmental, and social risk factors remain largely unknown and comprehensive quantitative investigation on an individual level is lacking. We conducted a new cross-sectional household questionnaire survey to analyze individual heat impairment (self-assessed and reported symptoms) and a large set of potential risk factors in the city of Berlin, Germany. This unique dataset (n = 474) allows for the investigation of new relationships, especially between health/fitness and urban heat stress. Our analysis found previously undocumented associations, leading us to generate new hypotheses for future research: various health/fitness variables returned the strongest associations with individual heat stress. Our primary hypothesis is that age, the most commonly used risk factor, is outperformed by health/fitness as a dominant risk factor. Related variables seem to more accurately represent humans’ cardiovascular capacity to handle elevated temperature. Among them, active travel was associated with reduced heat stress. We observed statistical associations for heat exposure regarding the individual living space but not for the neighborhood environment. Heat stress research should further investigate individual risk factors of heat stress using quantitative methodologies. It should focus more on health and fitness and systematically explore their role in adaptation strategies. The potential of health and fitness to reduce urban heat stress risk means that encouraging active travel could be an effective adaptation strategy. Through reduced CO2 emissions from urban transport, societies could reap double rewards by addressing two root causes of urban heat stress: population health and global warming