title: Extreme heat and cultural and linguistic minorities in Australia: perceptions of stakeholders.
abstract: BACKGROUND
  Despite acclimatisation to hot weather, many individuals in Australia are adversely affected by extreme heat each summer, placing added pressure on the health sector. In terms of public health, it is therefore important to identify vulnerable groups, particularly in the face of a warming climate. International evidence points to a disparity in heat-susceptibility in certain minority groups, although it is unknown if this occurs in Australia. With cultural diversity increasing, the aim of this study was to explore how migrants from different cultural backgrounds and climate experiences manage periods of extreme heat in Australia.
  
  
  METHODS
  A qualitative study was undertaken across three Australian cities, involving interviews and focus groups with key informants including stakeholders involved in multicultural service provision and community members. Thematic analysis and a framework approach were used to analyse the data.
  
  
  RESULTS
  Whilst migrants and refugees generally adapt well upon resettlement, there are sociocultural barriers encountered by some that hinder environmental adaptation to periods of extreme heat in Australia. These barriers include socioeconomic disadvantage and poor housing, language barriers to the access of information, isolation, health issues, cultural factors and lack of acclimatisation. Most often mentioned as being at risk were new arrivals, people in new and emerging communities, and older migrants.
  
  
  CONCLUSIONS
  With increasing diversity within populations, it is important that the health sector is aware that during periods of extreme heat there may be disparities in the adaptive capacity of minority groups, underpinned by sociocultural and language-based vulnerabilities in migrants and refugees. These factors need to be considered by policymakers when formulating and disseminating heat health strategies.
authors.forename: Alana
authors.initials: A
authors.lastname: Hansen
authors.forename: Monika
authors.initials: M
authors.lastname: Nitschke
authors.forename: Arthur
authors.initials: A
authors.lastname: Saniotis
authors.forename: Jill
authors.initials: J
authors.lastname: Benson
authors.forename: Yan
authors.initials: Y
authors.lastname: Tan
authors.forename: Val
authors.initials: V
authors.lastname: Smyth
authors.forename: Leigh
authors.initials: L
authors.lastname: Wilson
authors.forename: Gil-Soo
authors.initials: GS
authors.lastname: Han
authors.forename: Lillian
authors.initials: L
authors.lastname: Mwanri
authors.affiliation: Discipline of Public Health, The University of Adelaide, Level 8, Hughes Building, Mail Drop DX650 207, Adelaide, South Australia 5005, Australia. peng.bi@adelaide.edu.au.
authors.forename: Peng
authors.initials: P
authors.lastname: Bi
mesh_terms: D000064:Acclimatization; D001315:Australia; D003144:Communication Barriers; D003469:Culture; D055874:Extreme Heat; D017144:Focus Groups; D054624:Health Status Disparities; D006798:Housing; D006801:Humans; D007802:Language; D008037:Linguistics; D008913:Minority Groups; D010465:Perception; D011634:Public Health; D036301:Qualitative Research; D012036:Refugees; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D014171:Transients and Migrants