title: Survey of county-level heat preparedness and response to the 2011 summer heat in 30 U.S. States.
abstract: BACKGROUND
  Adapting to extreme heat is becoming more critical as our climate changes. Previous research reveals that very few communities in the United States have programs to sufficiently prevent health problems during hot weather.
  
  
  OBJECTIVE
  Our goal was to examine county-level local heat preparedness and response in 30 U.S. states following the unusually hot summer of 2011.
  
  
  METHODS
  Using a multimodal survey approach, we invited local health and emergency response departments from 586 counties to participate in the largest survey to date of heat preparedness and response in the United States. County-level responses were pooled into national and regional-level summaries. Logistic regressions modeled associations between heat planning/response and county characteristics, including population, poverty rates, typical summer weather, and 2011 summer weather.
  
  
  RESULTS
  Of 586 counties, 190 (32%) responded to the survey. Only 40% of these counties had existing heat plans. The most common heat responses were communication about heat, outreach, and collaborations with other organizations. Both heat preparedness and heat response were, on average, more extensive in counties with higher populations, lower poverty rates, and lower percentages of older people. Heat response was generally more extensive in counties with heat plans.
  
  
  CONCLUSIONS
  Most responding counties were underprepared for extreme heat in 2011 and lacked a formal response plan. Because counties with heat plans were more likely to act to prevent adverse heat impacts to residents, local health departments should consider adopting such plans, especially because increased extreme heat is anticipated with further climate change.
authors.affiliation: Union of Concerned Scientists, Washington, DC, USA.
authors.forename: Jalonne L
authors.initials: JL
authors.lastname: White-Newsome
authors.forename: Brenda
authors.initials: B
authors.lastname: Ekwurzel
authors.forename: Mia
authors.initials: M
authors.lastname: Baer-Schultz
authors.forename: Kristie L
authors.initials: KL
authors.lastname: Ebi
authors.forename: Marie S
authors.initials: MS
authors.lastname: O'Neill
authors.forename: G Brooke
authors.initials: GB
authors.lastname: Anderson
mesh_terms: D057231:Climate Change; D003625:Data Collection; D004189:Disaster Planning / Q000706:statistics & numerical data*; D055874:Extreme Heat; D006801:Humans; D009111:Local Government; D011203:Poverty; D011634:Public Health; D014481:United States