title: A cross-sectional, randomized cluster sample survey of household vulnerability to extreme heat among slum dwellers in ahmedabad, india.
abstract: Extreme heat is a significant public health concern in India; extreme heat hazards are projected to increase in frequency and severity with climate change. Few of the factors driving population heat vulnerability are documented, though poverty is a presumed risk factor. To facilitate public health preparedness, an assessment of factors affecting vulnerability among slum dwellers was conducted in summer 2011 in Ahmedabad, Gujarat, India. Indicators of heat exposure, susceptibility to heat illness, and adaptive capacity, all of which feed into heat vulnerability, was assessed through a cross-sectional household survey using randomized multistage cluster sampling. Associations between heat-related morbidity and vulnerability factors were identified using multivariate logistic regression with generalized estimating equations to account for clustering effects. Age, preexisting medical conditions, work location, and access to health information and resources were associated with self-reported heat illness. Several of these variables were unique to this study. As sociodemographics, occupational heat exposure, and access to resources were shown to increase vulnerability, future interventions (e.g., health education) might target specific populations among Ahmedabad urban slum dwellers to reduce vulnerability to extreme heat. Surveillance and evaluations of future interventions may also be worthwhile.
authors.affiliation: Department of Environmental Health, Emory University School of Public Health, Atlanta, GA 30322, USA. kathy.tran@alum.emory.edu
authors.forename: Kathy V
authors.initials: KV
authors.lastname: Tran
authors.forename: Gulrez S
authors.initials: GS
authors.lastname: Azhar
authors.forename: Rajesh
authors.initials: R
authors.lastname: Nair
authors.forename: Kim
authors.initials: K
authors.lastname: Knowlton
authors.forename: Anjali
authors.initials: A
authors.lastname: Jaiswal
authors.forename: Perry
authors.initials: P
authors.lastname: Sheffield
authors.forename: Dileep
authors.initials: D
authors.lastname: Mavalankar
authors.forename: Jeremy
authors.initials: J
authors.lastname: Hess
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D004198:Disease Susceptibility; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis*; D055874:Extreme Heat / Q000009:adverse effects*; D005191:Family Characteristics; D005260:Female; D018882:Heat Stress Disorders / Q000453:epidemiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011204:Poverty Areas; D015995:Prevalence; D055815:Young Adult