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There is an urgent need for strategies to reduce the negative impacts of a warming climate on human health. Cooling urban neighborhoods by planting trees and vegetation and increasing albedo of roofs, pavements, and walls can mitigate urban heat. We used synoptic climatology to examine how different tree cover and albedo scenarios would affect heat-related morbidity in Los Angeles, CA, USA, as measured by emergency room (ER) visits. We classified daily meteorological data for historical summer heat events into discrete air mass types. We analyzed those classifications against historical ER visit data to determine both heat-related and excess morbidity. We used the Weather Research and Forecasting model to examine the impacts of varied tree cover and albedo scenarios on meteorological outcomes and used these results with standardized morbidity data algorithms to estimate potential reductions in ER visits. We tested three urban modification scenarios of low, medium, and high increases of tree cover and albedo and compared these against baseline conditions. We found that avoiding 25% to 50% of ER visits during heat events would be a common outcome if the urban environment had more tree cover and higher albedo, with the greatest benefits occurring under heat events that are moderate and those that are particularly hot and dry. We conducted these analyses at the county level and compared results to a heat-vulnerable, working-class Los Angeles community with a high concentration of people of color, and found that reductions in the rate of ER visits would be even greater at the community level compared to the county.

Major urban centers are warming due to a combination of global and local phenomena. City governments are increasingly adopting strategies to mitigate the causes and impacts of extreme heat on their populations. Among these strategies are high solar-reflectance (cool) surfaces installed on building roofs and walls. Use of cool surfaces is a cost-effective and simple strategy that replaces conventional darker surfaces with surfaces that have a high reflectance to shortwave (solar) energy. This report reviews the recent history of cool-surface deployment efforts. This includes peer-reviewed literature, conference proceedings, and grey literature to identify challenges and barriers to wide-scale deployment of cool surfaces. We have also researched heat action plans and programs from cities and different codes and standards, as well as available incentive and rebate programs. The review identifies challenges, barriers, and opportunities associated with large-scale deployment of cool surfaces and categorize them broadly as being related to product development & performance or policies & mandates. It provides a foundation upon which we intend to build a roadmap for rapidly accelerating future deployments of cool surfaces. This roadmap will address identified challenges and incorporate lessons learned from historical efforts to generate a practical and actionable plan.

Solar-reflective building envelope surfaces, such as cool roofs and walls, can be especially helpful in disadvantaged communities that often have poorly insulated older homes, aging or absent air conditioning units, steep utility bills, polluted air, and high vulnerability and exposure to extreme heat. With support from the U.S. Department of Energy, our project seeks to dramatically increase the climate-appropriate deployment of cool surfaces across the United States with an emphasis on their application to disadvantaged communities.First, we sought to identify cool-surface deployment barriers, opportunities, and models by (a) reviewing the history of cool-surface deployment activities, (b) interviewing cool-surface stakeholders, (c) researching successful energy-efficiency/green building deployment models; and (d) interviewing the actors who have implemented these models. Second, we conducted a workshop to engage stakeholders in development of a deployment plan. Third, we asked several U.S. federal agencies (a) how cool surfaces and cool surface stakeholders could support their missions and (b) how agency activities could support cool-surface deployment. Fourth, we identified a set of transformative ideas that form the core of the deployment plan.Transformative ideas include but are not limited to initiatives to (a) launch an educational campaign to make the general public and building professionals aware of how cool roofs and walls exclude unwanted solar heat; (b) create a “Cool Roof Prize” stimulating the development of affordable, high-performance cool asphalt roofing shingles; (c) conduct high-profile, large-scale demonstration programs that bring cool surfaces to disadvantaged heat-vulnerable communities; and (d) support local, regional, and state climate action (heat mitigation) plans with cool surfaces.

There is a pressing need for strategies to prevent the heat-health impacts of climate change. Cooling urban areas through adding trees and vegetation and increasing solar reflectance of roofs and pavements with higher albedo surface materials are recommended strategies for mitigating the urban heat island. We quantified how various tree cover and albedo scenarios would impact heat-related mortality, temperature, humidity, and oppressive air masses in Los Angeles, California, and quantified the number of years that climate change-induced warming could be delayed in Los Angeles if interventions were implemented. Using synoptic climatology, we used meteorological data for historical summer heat waves, classifying days into discrete air mass types. We analyzed those data against historical mortality data to determine excess heat-related mortality. We then used the Weather Research and Forecasting model to explore the effects that tree cover and albedo scenarios would have, correlating the resultant meteorological data with standardized mortality data algorithms to quantify potential reductions in mortality. We found that roughly one in four lives currently lost during heat waves could be saved. We also found that climate change-induced warming could be delayed approximately 40-70 years under business-as-usual and moderate mitigation scenarios, respectively.

BackgroundDespite the substantial role indoor exposure has played in heat wave-related mortality, few epidemiological studies have examined the health effects of exposure to indoor heat. As a result, knowledge gaps regarding indoor heat-health thresholds, vulnerability, and adaptive capacity persist.ObjectiveWe evaluated the role of indoor heat exposure on mortality and morbidity among the elderly (≥65 years of age) in Houston, Texas.MethodsMortality and emergency hospital admission data were obtained through the Texas Department of State Health Services. Summer indoor heat exposure was modeled at the U.S. Census block group (CBG) level using building energy models, outdoor weather data, and building characteristic data. Indoor heat-health associations were examined using time-stratified case-crossover models, controlling for temporal trends and meteorology, and matching on CBG of residence, year, month, and weekday of the adverse health event. Separate models were fitted for three indoor exposure metrics, for individual lag days 0-6, and for 3-d moving averages (lag 0-2). Effect measure modification was explored via stratification on individual- and area-level vulnerability factors.ResultsWe estimated positive associations between short-term changes in indoor heat exposure and cause-specific mortality and morbidity [e.g., circulatory deaths, odds ratio per 5°C increase=1.16 (95% CI: 1.03, 1.30)]. Associations were generally positive for earlier lag periods and weaker across later lag periods. Stratified analyses suggest stronger associations between indoor heat and emergency hospital admissions among African Americans compared with Whites.DiscussionFindings suggest excess mortality among certain elderly populations in Houston who are likely exposed to high indoor heat. We developed a novel methodology to estimate indoor heat exposure that can be adapted to other U.S.LocationsIn locations with high air conditioning prevalence, simplified modeling approaches may adequately account for indoor heat exposure in vulnerable neighborhoods. Accounting for indoor heat exposure may improve the estimation of the total impact of heat on health. https://doi.org/10.1289/EHP6340.

Background Vulnerable populations across the United States are frequently exposed to extreme heat, which is becoming more intense due to a combination of climate change and urban-induced warming. Extreme heat can be particularly detrimental to the health and well-being of older citizens when it is combined with ozone. Although population-based studies have demonstrated associations between ozone, extreme heat, and human health, few studies focused on the role of social and behavioral factors that increase indoor risk and exposure among older adults. Methods We conducted a household survey that aimed to understand how older adults are affected by extreme heat and ozone pollution inside and outside of their homes across Houston, Phoenix, and Los Angeles. We examine contributing factors to the risk of self-reported health effects using a generalized linear mixed-effects regression model of telephone survey data of 909 older adults in 2017. Results We found an increased occurrence of self-reported symptoms for extreme heat with preexisting respiratory health conditions and a lack of air conditioning access; self-reported ozone symptoms were more likely with preexisting respiratory health conditions. The risk of heat-related symptoms was slightly higher in Los Angeles than Houston and Phoenix. We found several demographic, housing, and behavioral characteristics that influenced the risk of heat- and ozone-related symptoms. Conclusions The increased risk among older adults based on specific social and behavioral factors identified in this study can inform public health policy and help cities tailor their heat and ozone response plans to the specific needs of this vulnerable population. [ABSTRACT FROM AUTHOR]