Reducing the health effects of hot weather and heat extremes: from personal cooling strategies to green cities.

Heat extremes (ie, heatwaves) already have a serious impact on human health, with ageing, poverty, and chronic illnesses as aggravating factors. As the global community seeks to contend with even hotter weather in the future as a consequence of global climate change, there is a pressing need to better understand the most effective prevention and response measures that can be implemented, particularly in low-resource settings. In this Series paper, we describe how a future reliance on air conditioning is unsustainable and further marginalises the communities most vulnerable to the heat. We then show that a more holistic understanding of the thermal environment at the landscape and urban, building, and individual scales supports the identification of numerous sustainable opportunities to keep people cooler. We summarise the benefits (eg, effectiveness) and limitations of each identified cooling strategy, and recommend optimal interventions for settings such as aged care homes, slums, workplaces, mass gatherings, refugee camps, and playing sport. The integration of this information into well communicated heat action plans with robust surveillance and monitoring is essential for reducing the adverse health consequences of current and future extreme heat.
Competing Interests: Declaration of interests OJ reports grants from Tennis Australia, Cricket Australia, National Health and Medical Research Council, Multiple Sclerosis Australia, and Wellcome Trust, outside the submitted work. AC reports grants from the New South Wales Department of Planning, Industry, and Environment and National Health and Medical Research Council during the conduct of the study. JV reports Speaker Honorariums from Northern Arizona University, Climate 2020: Seven Generations for Arizona (Flagstaff, AZ, USA) in November, 2019 and Aquarium of the Pacific, The Effects of Earth's Health on Human Health (Long Beach, CA, USA) in March, 2020. All other authors have no competing interests.
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