Heatwaves and the older Australia population: A mixed methods study.

Abstract

Introduction In Australia heatwaves are increasing in duration, frequency and intensity. This phenomenon parallels an ageing population. The aged are at risk of increased mortality and morbidity in very hot weather, however risk perception studies suggest older people deny they at risk. This research investigated the relationship between heat-related mortality and morbidity in NSW, Australia and the factors that place older people at risk of heat-related illness.

Method This research consists of two literature reviews and three discrete studies using both qualitative and quantitative methods in a rural population in NSW Australia.

Results Review of the Australian literature highlighted the differences in methods used, heatwave definitions and populations studied in Australian heat-related research. There was a relationship between heat-related mortality and morbidity on days classified as either severe (> 95th percentile of expected temperature) or extreme (> 99th percentile). Direct and indirect effects of heatwaves contributed to deaths and increased hospitalisations on both severe and extreme days.

Less than half of the aged care facilities(ACFs) included in our sample had a heatwave response plan. Only one third of ACFs in NSW were fully air-conditioned, 65% had partial or no air-conditioning. Few ACF staff had participated in staff in-service training on caring for older people in extreme conditions.

Older rural residents with a self-perceived sense of ‘wellness’ do not consider themselves at risk in hot weather, even if they have multiple co-morbidities, or are aged; factors that independently place them at increased risk of heat-related morbidity and mortality.

Conclusions This research found that high daily temperatures have both direct and indirect effects on the health of the adult population. Those aged >75 years are most affected however people with chronic conditions and/or circulatory disorders are vulnerable to heat-related morbidity and mortality at any age. There was a general complacency about, and low perception of, heat-related health risk in the Australian population and a low level of preparedness for extreme heat events in the aged care sector, both in the knowledge of how to care for the vulnerable aged in very hot weather and in organisational planning for periods of extreme heat.