title: Assessing heat-adaptive behaviors among older, urban-dwelling adults.
abstract: OBJECTIVE
  Health studies have shown that the elderly are at a greater risk to extreme heat. The frequency and intensity of summer heat waves will continue to increase as a result of climate change. It is important that we understand the environmental and structural factors that increase heat vulnerability, as well as examine the behaviors used by the elderly to adapt to hot indoor temperatures.
  
  
  METHODS
  From June 1 to August 31, 2009, residents in 29 homes in Detroit, MI, kept an hourly log of eight heat-adaptive behaviors: opening windows/doors, turning fans or the air conditioner on, changing clothes, taking a shower, going to the basement, the porch/yard, or leaving the house. Percentages of hourly behavior were calculated, overall and stratified by housing type and percent surface imperviousness. The frequency of behavior use, as a result of indoor and outdoor predetermined temperature intervals was compared to a reference temperature range of 21.1-23.8°C.
  
  
  RESULTS
  The use of all adaptive behaviors, except going to the porch or yard, was significantly associated with indoor temperature. Non-mechanical adaptations such as changing clothes, taking showers, and going outside or to the basement were rarely used. Residents living in high-rises and highly impervious areas reported a higher use of adaptive behaviors. The odds of leaving the house significantly increased as outdoor temperature increased.
  
  
  CONCLUSIONS
  These findings suggest that the full range of heat adaptation measures may be underused by the elderly and public health interventions need to focus on outreach to these populations.
authors.affiliation: University of Michigan School of Public Health, Environmental Health Sciences Department, Ann Arbor, MI 48109, USA. jalonne@umich.edu
authors.forename: Jalonne L
authors.initials: JL
authors.lastname: White-Newsome
authors.forename: Brisa N
authors.initials: BN
authors.lastname: Sánchez
authors.forename: Edith A
authors.initials: EA
authors.lastname: Parker
authors.forename: J Timothy
authors.initials: JT
authors.lastname: Dvonch
authors.forename: Zhenzhen
authors.initials: Z
authors.lastname: Zhang
authors.forename: Marie S
authors.initials: MS
authors.lastname: O'Neill
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged / Q000523:psychology*; D057231:Climate Change; D006358:Hot Temperature; D006801:Humans; D012111:Residence Characteristics; D014505:Urban Population