Australian summer heat has been a source of national pride for generations. Australians understand heat, we cope with hot summers relishing opportunities to indulge in national pastimes such as cricket, barbeques and hanging out at the beach. However, across large areas of eastern Australia, the 2018-2019 summer challenged ideas of a ‘hot summer’ with extraordinary weeks of record-breaking high temperatures. As this year’s summer approaches rural and regional communities across Australia should consider their community health response to the increasing temperatures that are forecast.
The human body can cope with temperatures into the mid-30s (core temperature). Above this temperature cooling is required to maintain health of the person. Dehydration, heat stroke, renal impairment, cardiac failure and even death are all risks from periods of increased temperature without adequate cooling. There are other effects of increased temperatures, particularly the loss of nocturnal cooling. Increased irritability, poor sleep, personal and domestic violence, poor concentration and loss of productivity are all associated with increased temperatures and extreme heat.
The climate is changing and with this comes higher temperatures and more frequent extreme temperature variations, particularly heat. The Australian climate is particularly vulnerable to climate change, particularly because our temperatures are already high during summer periods. Temperature increase related to climate change is regional, and some parts of Australia have seen significant increases in the rate of extreme temperature events. Small incremental increases in the global temperature (1 degree) in practice means significant rise in hot days over summer for most parts of Australia. And along with this a growing health challenge.
So how can we prepare and adapt to our summers with climate change and hotter periods? Across Australia the policy responses from government have varied. Many states approach the risk through their emergency response mechanism, much like they respond to fires and floods. It is unclear whether this is an adequate approach to the likely increasing duration, frequency and intensity of protracted heat events. The Victorian Government has produced a useful ‘Heat Health Plan’ for Victoria, which offers some great practical advice for communities contending with extreme heat events.
First, it’s important to recognise that extreme heat is not defined by a particular temperature, but encompasses temperature, humidity and overnight cooling. Communicating risk from heat is a key element of the Victorian strategy, sharing information about heat and how the community might best respond. The Victorian plan lays out the importance of communities planning prior to summer and cooperating with resources during a heat event. Non-essential activities should be limited during protracted heat events including school. This is particularly relevant and important for health services: to prepare and coordinate, discuss and plan for protracted periods of high temperatures and how the communities and workforce might be affected. It may be appropriate for health services to cancel or defer non-essential, elective surgeries or procedures during protracted heat events.
NSW Health does not have a heat health plan. The NSW government has seen the development of heat strategies as the responsibility of local government and in 2016 produced Minimising the impacts of extreme heat: A guide for local governments. Many local governments have (understandably) struggled with the development of these strategies. Across parts of Australia the local heat response plan is limited. Regional communities need to consider their vulnerable populations, reduced mobility and pre-existing health conditions magnifying the risks of heat events. Understanding local resources is also key, particularly for parts of Australia where the dual challenge of water shortages and hot weather will constitute a major health threat.
The coming Australian summer may be hotter than we’ve ever experienced. Heat is a serious health challenge and loss of life can be expected with a very hot summer. Community preparation can mitigate the tremendous health risks posed by protracted hot weather. Across regional and rural Australia conversations and planning should start today. It would be great to see all levels of Australian government invest in this challenge now, however without this the best response lies in our capacity to work together at a local level. Health workers can play a major role in coordinating the local response and saving lives.