Parts of Australia are currently facing extreme heat^[1], with high temperatures set to continue over the coming days.

Though it’s unclear exactly what the upcoming summer will bring, climate change means Australian summers^[2] are getting hotter. Even this year in August we saw temperatures around 40°C^[3] in parts of the country.

Heatwaves aren’t just uncomfortable – they can be deadly^[4]. Health emergencies related to extreme heat place significant strain on our health-care systems, with data showing increased ambulance callouts^[5] and hospital presentations^[6] during these periods.

Although heatwaves can affect everyone, older adults are particularly at risk. But our new research^[7] has found older Queenslanders don’t necessarily believe heat poses a risk to their health. And this affects how they respond to emergency warnings.

Older people and the heat

Ageing brings physiological changes, including reduced ability to regulate body temperature^[8], which can put older people at increased risk of issues such as heat exhaustion and heat stroke.

Heat exposure can also worsen the symptoms^[9] of existing conditions, such as heart disease, lung disease or kidney disease, which are more common in older people.

The risk is even more pronounced^[10] for older people who live in poor quality housing, are economically disadvantaged, or are socially isolated.

A report from the Australian Institute of Health and Welfare^[11] shows that, of 2,150 hospitalisations due to extreme heat between 2019 and 2022, 37% were among people aged 65 and older (who make up around 16% of the population^[12]).

So there’s an urgent need to prioritise the health of older Australians as the country braces for more intense and prolonged heatwaves^[13] in the future.

When the weather is hot, older people are at greater risk of health complications. Kleber Cordeiro/Shutterstock^[14]

Early warning systems

As we’ve learned more about the risks of heatwaves, there’s been an increased focus on developing population-based early warning systems. These systems play a crucial role in encouraging people to adopt heat-protective behaviours such as staying hydrated, avoiding strenuous physical activity when temperatures are high, and wearing loose or light clothing.

Queensland is one of the world’s most vulnerable regions^[15] to heatwaves. Since 2015, heatwave warnings have been part of the state’s heatwave subplan^[16], which sets out strategies for managing and mitigating the impacts of extreme heat events.

These warnings involve alerts about upcoming high temperatures, and advice on staying cool. They come as notifications through the Bureau of Meterology’s weather app or via media outlets or social media. However, it’s not clear whether these warnings are reaching those most at risk.

As part of a broader project^[17] on extreme heat and older people, we surveyed 547 Queenslanders^[18] aged 65 and over to understand their perceptions of heat risks and to determine if heatwave warnings were reaching them.

We also wanted to know what factors influence how they receive and respond to these warnings, with a view to understanding how we can improve heatwave warnings for this group.

What we found

Only 25% of respondents were aware of the potential consequences of heatwaves on their health. The majority of participants (80%) perceived themselves to be at lower risk compared to others of their age group. This aligns with previous heat-health research^[19] which has similarly found^[20] older adults often don’t perceive heat^[21] as a personal risk.

While most of the sample (87%) reported having one or more chronic health conditions, 30% were unaware having a chronic health condition increased their vulnerability to heatwaves.

Several cultural and personal factors may explain why older people don’t think heat poses a danger to them. In Australia, heat is typically seen as a normal and even positive^[22] part of life. Heat risk messages are often less urgent than warnings for other natural disasters.

Previous research has also shown older people tend not to think heat poses a risk to their health. Miguel AF/Shutterstock^[23]

We also found nearly half of respondents had not heard a heatwave warning. Of those who had, roughly half took actions to keep themselves cool.

What stood out from our analysis was that participants’ awareness and actions in response to heatwave warnings were significantly influenced by their knowledge and perceptions of heat risks. Factors such as age, gender and education were not so important.

Respondents who believed they were at risk were almost twice as likely to hear the warnings, and 3.6 times more likely to take heat protective actions.

This aligns with other research^[24] that highlights the correlation between heat-health risk perception^[25] and the efficacy of heatwave warnings.

One limitation of our research is that we conducted the survey in 2022 during and following a La Nina period^[26], where temperatures are usually lower. So there may have been fewer heatwave warnings throughout the season, potentially reducing participants’ perceptions of heat health risks.

What needs to change?

With another hot summer likely ahead, we need to rethink how we communicate about heatwaves. These are more than just hot days. We need to recognise heatwaves as a serious health risk, especially for older people, and effectively communicate that risk to the public.

This might include using primary health-care professionals such as GPs, nurses and pharmacists to share heat-health information with older patients and their family members, or developing personalised heat action plans for the summer period.

Text message alerts from the Bureau of Meteorology, along with app notifications, could be a good idea considering some older adults may not have a smartphone or be open to using apps.

To improve heatwave communication, we also need to explore the barriers and facilitators^[27] to heat protective behaviours^[28]. This includes considering structural factors (such as housing design), environmental factors (for example, access to shade and cool refuges), individual factors (such as financial constraints or health conditions) and social factors (such as access to family and community support).

Strengthening communication around heatwaves and health will not only protect individual wellbeing but enhance community resilience as extreme heat continues to affect our lives.

References

1. ^{^} extreme heat (www.theguardian.com)
2. ^{^} Australian summers (www.climatecouncil.org.au)
3. ^{^} temperatures around 40°C (theconversation.com)
4. ^{^} can be deadly (www.aihw.gov.au)
5. ^{^} ambulance callouts (pubmed.ncbi.nlm.nih.gov)
6. ^{^} hospital presentations (www.aihw.gov.au)
7. ^{^} new research (journals.sagepub.com)
8. ^{^} regulate body temperature (www.sciencedirect.com)
9. ^{^} worsen the symptoms (www.health.nsw.gov.au)
10. ^{^} even more pronounced (www.racgp.org.au)
11. ^{^} Australian Institute of Health and Welfare (www.aihw.gov.au)
12. ^{^} around 16% of the population (www.aihw.gov.au)
13. ^{^} more intense and prolonged heatwaves (www.mja.com.au)
14. ^{^} Kleber Cordeiro/Shutterstock (www.shutterstock.com)
15. ^{^} most vulnerable regions (www.nature.com)
16. ^{^} heatwave subplan (www.health.qld.gov.au)
17. ^{^} broader project (www.griffith.edu.au)
18. ^{^} 547 Queenslanders (journals.sagepub.com)
19. ^{^} previous heat-health research (link.springer.com)
20. ^{^} has similarly found (www.sciencedirect.com)
21. ^{^} don’t perceive heat (www.tandfonline.com)
22. ^{^} normal and even positive (knowledge.aidr.org.au)
23. ^{^} Miguel AF/Shutterstock (www.shutterstock.com)
24. ^{^} other research (www.sciencedirect.com)
25. ^{^} heat-health risk perception (www.mdpi.com)
26. ^{^} a La Nina period (agupubs.onlinelibrary.wiley.com)
27. ^{^} barriers and facilitators (doi.org)
28. ^{^} heat protective behaviours (doi.org)