New York City's climate change and public health program: Progress and lessons learned

Background: As part of the CDC's Climate-Ready States and Cities Initiative, NYC has been conducting health risk assessments of several priority climate hazards. Our heat risk assessment exemplifies how climate adaptation research can strengthen current programs and inform future planning.

Methods: Future heat-attributable mortality per 1°F increase in temperature was calculated using the U.S. EPA's Benefits Mapping and Analysis Program (BenMAP) with local temperature and mortality data. A random sample telephone survey and follow-up focus groups were conducted to understand heat-health awareness and behaviors.

Results: Approximately 100-250 excess deaths could occur each year in NYC as a result of increasing daily warm season temperatures into the 2020s. During summer 2011, 77% (95% CI: 73, 80) of New Yorkers heard or saw an extreme heat weather warning, mainly on TV. Among the 24%, (22, 28) of adults with elevated health risk, 34% (28, 41) did not have air conditioning (AC) or never/rarely used it on very hot days. Of this group, 48% (37, 59) stay home during hot weather. Reasons for not using AC during hot weather include dislike of AC (24%, 14, 39), not feeling hot (16%, 7, 31), preferring a fan (15%, 7, 31), and wanting to conserve energy (15%, 7, 31). Even though most heat deaths occur in overheated homes without air conditioning, seniors in our focus groups did not find this to be a strong “take-home” message in recent media segments.

Conclusions: Warming temperatures will add to the burden of heat-related mortality in NYC. Challenges to current and future heat programs include gaps in risk perception, and barriers in accessing and using AC. Results from our health risk assessment are being used to improve risk communication strategies for vulnerable New Yorkers and identify cooling needs.