Improving heat risk education and warning messaging: 3 recommendations

As population exposure to extreme heat increases, government agencies are developing heat health warning systems to support the public in taking protective action. The reach and effectiveness of these interventions – especially for those most at-risk – is still a concern. 

To address this concern, we convened four focus groups in 2021, involving 43 participants across San Diego County, California, to hear their recommendations for increasing the reach and effectiveness of heat risk education and warning messaging. Focus group participants included community leaders and advocates as well as representatives of nonprofit and community-based organizations, county and city government agencies, healthcare professionals, schools and universities, and a utility company. The focus group discussions were recorded (with the permission of participants), transcribed, and analyzed to identify common themes. 

Recommendations for raising awareness of heat risks

There were three key recommendations across the four focus groups:

1. Diversify communication channels;
2. Provide content that is specific, comprehensive, and accessible; and
3. Conduct a formally coordinated heat risk education campaign.

All three recommendations align with evidence-based support for successful hazard risk communication. They also highlight the need for input and feedback from heat-susceptible communities in the planning and implementation of interventions meant specifically to support them in taking protective action.

Diversify communication channels

Agencies already involved in heat risk education and warning messaging should explore opportunities to further their reach across diverse populations. One approach is to collaborate with existing networks of community organizations and individuals that have high levels of social capital, cultural competence, and trust with heat-susceptible communities. Examples in San Diego County include nonprofit and community-based organizations, neighborhood schools, healthcare professionals, and community and religious leaders. 

These organizations and individuals can create opportunities for the direct integration of heat risk education into established information and communication programs (e.g., neighborhood schools to parents/families or clinics/community healthcare professionals to outdoor workers). They can also connect the communities they work with to those agencies involved in heat risk education and warning messaging so that they are aware of the information and resources provided, as well as how to access those resources. 

We are currently working with other researchers, community-based organizations, the United States National Weather Service (NWS), and local government partners in San Diego County to apply this recommendation. Specifically, we are creating a heat risk education curriculum for peer-trainers (or community advocates) to integrate into existing outreach to community audiences by teaching them about heat waves and heat-related illnesses – including symptoms, treatment, and methods and resources for prevention. The curriculum will be implemented and evaluated in late 2023. 

In another example, the University of California Los Angeles Labor Occupational Safety and Health Program (LOSH) developed a peer-trainer course on workplace heat risk, for community health workers. The course was based on popular education principles and methodology, and involved extensive interaction and dialogue with participants to ensure that it was relevant to and built on local experience. In total, 159 peer-trainers representing 70 community organizations participated in the course and together provided heat risk education to thousands of potentially at-risk individuals. 

Provide content that is specific, comprehensive, and accessible

Providing content that is specific, comprehensive, and accessible applies both to heat risk education and to warning messaging.

Specific:

• Make clear which populations and/or geographic areas are most susceptible to heat risk and why – otherwise, people are less likely to take action
• Be explicit about the potential health impacts and their symptoms, and who is most at risk – at-risk groups often do not recognize their own vulnerability or heed alerts

Comprehensive:

• Provide clear recommendations for mitigating health impacts at individual, household, and community levels – people must be explicitly advised what to do and why

Accessible:

• Make information available in different languages and formats (e.g., storytelling and short videos) to ensure information equity
• Be culturally competent (e.g., clarify misconceptions and dispel myths) to enhance information uptake

An example of a community providing specific, comprehensive, and accessible information on heat risk comes from Seattle and the King County Public Health Department (Washington, USA). The Public Health Department partnered with the University of Washington Department of Environmental and Occupational Health Sciences to create a “Stay Safe in the Heat” campaign using a comic book to reach people with high risk for heat illnesses. The comic book was translated into 12 languages, including English, Amharic, Arabic, Chinese, French, Korean, Russian, Somali, Spanish, Tagalog, Ukrainian, and Vietnamese. 

Conduct a formally coordinated heat risk education campaign

The ideal campaign structure may vary by location, but one approach is to:

1. Create training opportunities for key community organizations and individuals to become knowledgeable about heat risk and connected with the agencies involved in education and warning messaging to diversify communication channels (see Recommendation 1);
2. Utilize the diversified communication channels to provide heat risk education to heat-susceptible communities (see Recommendations 1 and 2); and
3. Continue (or repeat) the campaign until the public adopts protective action as matter of course.

In some places, such campaigns exist. One example is the “Beat the Heat: don’t forget your drink” campaign in New South Wales (Australia), which delivers brief information sessions and soundbites about heat risk mitigation to the public through radio and television as well as in unpaid community newspaper announcements. A study of the campaign (involving a survey of 328 people) found that 63% of respondents reported hearing or seeing heat warnings, 54% indicated they had modified their behavior, and 25% recalled the slogan (“Beat the heat”). Notably, of the 46% of respondents who indicated they had not changed their behavior, 96% reported their reason for this was because they already routinely took protective action.

Moving forward in a warming world

Implementation and evaluation of these recommendations will take time and an investment of human and financial resources. Agencies involved in heat risk education and warning messaging will need to build trust and form relationships with key community organizations and individuals. They may also need flexibility, openness, and ability to modify current approaches to hazard risk communication (within institutional norms and guidelines). This investment will pay out: as heat extremes and population exposure continue to increase, heat risk awareness will reduce the negative impacts of extreme heat on human health, the economy, and critical infrastructure.

Kristin VanderMolen is an assistant research professor at the Desert Research Institute. She conducts interdisciplinary research on climate impacts and adaptation, including on information and health equity related to extreme heat and wildfire smoke. Her work is focused in the western US. 

Nick Kimutis earned his Master of Public Health, Epidemiology in May of 2023 and a Bachelor of Science in Molecular Microbiology and Immunology in May of 2021. Nick has worked at the Desert Research Institute since November 2017, and for the Western Regional Climate Center since May 2018. Nick has diverse research interests including the intersection of climate and public health. Nick has a loving partner, Brian, and an adorable Rottweiler.

Benjamin Hatchett studies natural hazards as well as past, present, and future weather and climate extremes in mountain and coastal regions.