Men who live alone are most likely to die during heatwaves

A New Yorker sunbathes by the East River during the 2012 heat wave. Image: Getty.

Cities around the globe felt record-breaking, red-hot temperatures this July: in the United States, Scotland, Ireland, Norway, Algeria, Georgia, Armenia, Russia, Oman and China, the thermometer reached all-time highs.

In the Canadian province of Quebec, a weeklong heatwave was linked to 74 deaths, making it the province’s second deadliest period of extreme heat since the summer of 2010.

At the peak of the heatwave, on Tuesday, 3 July 3, Montréal recorded its highest temperature in history (36.6 C) and posted its most extreme midnight combination of heat and humidity. The stifling temperatures continued for most of the week.

Quebecers felt the heat. By Wednesday of that week, Montréal ambulance services were so busy that people with mild symptoms of heat illness were asked to seek help elsewhere. By Saturday, the city morgue was so crowded they had no choice but to move bodies to funeral homes for storage.

We thought Montréal was prepared. The city pioneered an extreme heat plan in 1994, before any other Canadian city. The plan involves frequent visits to home-care patients, monitoring signs of heat illness, opening air-conditioned shelters, extending pool hours and conducting mass media communication campaigns to warn about the heat.

After 2010’s heatwave, the city ramped up efforts to contact individuals with underlying health conditions that make them particularly vulnerable to the heat. The city’s plan has worked until now, reducing mortality by 2.52 deaths per day during hot periods.

So what went wrong this summer?

Most were men, living alone

When Montréal cooled off on Sunday 7 July, journalists and commentators looked for answers. The media first drew comparisons with cities in other provinces, Toronto and Ottawa in particular, where no deaths were recorded in similar temperatures.

Public health officials noted that Ontario takes longer to attribute deaths to heat, so these deaths may be reported later. But, almost a month after the heatwave, the Ontario death toll has stayed at zero. Others suggested that ownership of air conditioning is part of the picture: 85 per cent of Toronto residents have access to it, compared to 42 per cent of Quebec households.

A new report from Quebec’s public health authority tells a different story.

Men living alone, especially those with underlying physical or mental health conditions and substance-abuse issues, counted for the majority of deaths. Almost all who died were over 60 years old. And the majority of deaths happened in densely built-up parts of the city — neighbourhoods where heat-trapping concrete and sparse vegetation elevated the temperatures by around 5C to 10C.

It’s true that most people who died had no air conditioning, but these social factors also crucially determined who lived and who died.


The fatal risk of isolation

Living alone in itself does not necessarily mean being disconnected, but older people are at a higher risk of becoming isolated if they live by themselves. This isolation can become fatal during a heatwave.

As sociologist Eric Klinenberg found in his analysis of the 1995 Chicago heatwave, older people living alone were at the highest risk of dying in the heat, especially if they had weak ties to their surrounding community, were distrustful of their neighbours or lived in neighbourhoods marked by disinvestment.

Montréal’s heat plan focuses on outreach: city staff getting in touch with people whose bodies are the most vulnerable to breaking down in the heat. Once they make contact, city staff take people to cool places or provide access to medical attention. But these strategies rely on social interaction and connection. Family, friends or even neighbours need to be available and willing to check up on the most vulnerable.

Even when firefighters comb neighbourhoods door-to-door, as they did in July, they cannot visit every single vulnerable person, and there’s no guarantee that older people alone in their apartments will answer the knocks. This is especially true for individuals with reduced mobility or lack of trust in their neighbours or city services.

The popularity of living alone and deadly heat

The province has more people living alone than ever before. It’s possible that in the face of this demographic shift, more Quebecers are at risk of losing the social ties that are vital in times of disaster.

The latest Canadian census uncovered that, for the first time in history, individuals living alone are the most common type of household — more than couples living together, or people living with roommates or with parents.

Single-person households are geographically concentrated. In the heatwave, we saw an overlap between where people are more likely to live alone and where people died from the heat. A total of 42 of the top 50 places in Canada where most people live alone are located in southern Quebec, where the heatwave killed 74 people.

It’s not possible to determine the exact role of Quebec’s demographic shift in explaining the high number of heat deaths. But this pattern points to the need for a close look into the social causes.

We also need new public health practices that target the growing number of people living alone, who we know to be the most vulnerable.

Dr. David Kaiser, senior doctor in Montréal’s health department, echoed the challenge: “Despite what we put in place in the last four, five days, some of the most vulnerable people are not being reached, and that is the central focus of the work we have to do.”

We need more effective ways to identify who is at risk, how to get in touch, and how to get them help.

The world is trending hotter

Editor and Montréal resident Fariha Naqvi-Mohamed wrote in the Montréal Gazette that resisting heatwaves is a community effort. The city must battle the heat together under city sprinklers, having fun in public pools and sharing popsicles.

The key question remains: how do we bring the people who feel socially isolated into the public spaces where we can look out for each other, and build the ties that people can rely upon in times of disaster?

While climate scientists are careful to not attribute single weather events to climate change, the world is trending hotter and the heatwaves are consistent with our expectations for more extreme temperatures more frequently.

The ConversationIn the face of mounting evidence of the severity of the impacts and the vulnerability of our communities, even in wealthy societies, it’s important that we now view climate change view as a serious public health threat and act accordingly.

Malcolm Araos, PhD Student, New York University

This article was originally published on The Conversation. Read the original article.

 
 
 
 

Everybody hates the Midlands, and other lessons from YouGov’s latest spurious polling

Dorset, which people like, for some reason. Image: Getty.

Just because you’re paranoid, the old joke runs, doesn’t mean they’re not out to get you. By the same token: just because I’m an egomaniac, doesn’t mean that YouGov isn’t commissioning polls of upwards of 50,000 people aimed at me, personally.

Seriously, that particular pollster has form for this: almost exactly a year ago, it published the results of a poll about London’s tube network that I’m about 98 per cent certain* was inspired by an argument Stephen Bush and I had been having on Twitter, at least partly on the grounds that it was the sort of thing that muggins here would almost certainly write up. 

And, I did write it up – or, to put it another way, I fell for it. So when, 364 days later, the same pollster produces not one but two polls, ranking Britain’s cities and counties respectively, it’s hard to escape the suspicion that CityMetric and YouGuv are now locked in a co-dependent and potentially abusive relationship.

But never mind that now. What do the polls tell us?

Let’s start with the counties

Everybody loves the West Country

YouGov invited 42,000 people to tell it whether or not they liked England’s 47 ceremonial counties for some reason. The top five, which got good reviews from between 86 and 92 per cent of respondents, were, in order: Dorset, Devon, Cornwall, North Yorkshire and Somerset. That’s England’s four most south westerly counties. And North Yorkshire.

So: almost everyone likes the South West, though whether this is because they associate it with summer holidays or cider or what, the data doesn’t say. Perhaps, given the inclusion of North Yorkshire, people just like countryside. That would seem to be supported by the fact that...


Nobody really likes the metropolitan counties

Greater London was stitched together in 1965. Nine years later, more new counties were created to cover the metropolitan areas of Manchester, Liverpool (Merseyside), Birmingham (the West Midlands), Newcastle (Tyne&Wear), Leeds (West Yorkshire and Sheffield (South Yorkshire). Actually, there were also new counties covering Teesside (Cleveland) and Bristol/Bath (Avon), too, but those have since been scrapped, so let’s ignore them.

Not all of those seven counties still exist in any meaningful governmental sense – but they’re still there for ’ceremonial purposes’, whatever that means. And we now know, thanks to this poll, that – to the first approximation – nobody much likes any of them. The only one to make it into the top half of the ranking is West Yorkshire, which comes 12th (75 per cent approval); South Yorkshire (66 per cent) is next, at 27th. Both of those, it may be significant, have the name of a historic county in their name.

The ones without an ancient identity to fall back on are all clustered near the bottom. Tyne & Wear is 30th out of 47 (64 per cent), Greater London 38th (58 per cent), Merseyside 41st (55 per cent), Greater Manchester 42nd (53 per cent)... Not even half of people like the West Midlands (49 per cent, placing it 44th out of 47). Although it seems to suffer also from the fact that...

Everybody hates the Midlands

Honestly, look at that map:

 

Click to expand.

The three bottom rated counties, are all Midlands ones: Leicestershire, Northamptonshire and Bedfordshire – which, hilariously, with just 40 per cent approval, is a full seven points behind its nearest rival, the single biggest drop on the entire table.

What the hell did Bedfordshire ever do to you, England? Honestly, it makes Essex’s 50 per cent approval rate look pretty cheery.

While we’re talking about irrational differences:

There’s trouble brewing in Sussex

West Sussex ranks 21st, with a 71 per cent approval rating. But East Sussex is 29th, at just 65 per cent.

Honestly, what the fuck? Does the existence of Brighton piss people off that much?

Actually, we know it doesn’t because thanks to YouGov we have polling.

No, Brighton does not piss people off that much

Click to expand.

A respectable 18th out of 57, with a 74 per cent approval rating. I guess it could be dragged up by how much everyone loves Hove, but it doesn’t seem that likely.

London is surprisingly popular

Considering how much of the national debate on these things is dedicated to slagging off the capital – and who can blame people, really, given the state of British politics – I’m a bit surprised that London is not only in the top half but the top third. It ranks 22nd, with an approval rating of 73 per cent, higher than any other major city except Edinburgh.

But what people really want is somewhere pretty with a castle or cathedral

Honestly, look at the top 10:

City % who like the city Rank
York 92% 1
Bath 89% 2
Edinburgh 88% 3
Chester 83% 4
Durham 81% 5
Salisbury 80% 6
Truro 80% 7
Canterbury 79% 8
Wells 79% 9
Cambridge 78% 10

These people don’t want cities, they want Christmas cards.

No really, everyone hates the Midlands

Birmingham is the worst-rated big city, coming 47th with an approval rating of just 40 per cent. Leicester, Coventry and Wolverhampton fare even worse.

What did the Midlands ever do to you, Britain?

The least popular city is Bradford, which shows that people are awful

An approval rating of just 23 per cent. Given that Bradford is lovely, and has the best curries in Britain, I’m going to assume that

a) a lot of people haven’t been there, and

b) a lot of people have dodgy views on race relations.

Official city status is stupid

This isn’t something I learned from the polls exactly, but... Ripon? Ely? St David’s? Wells? These aren’t cities, they’re villages with ideas above their station.

By the same token, some places that very obviously should be cities are nowhere to be seen. Reading and Huddersfield are conspicuous by their absence. Middlesbrough and Teesside are nowhere to be seen.

I’ve ranted about this before – honestly, I don’t care if it’s how the queen likes it, it’s stupid. But what really bugs me is that YouGov haven’t even ranked all the official cities. Where’s Chelmsford, the county town of Essex, which attained the dignity of official city status in 2012? Or Perth, which managed at the same time? Or St Asaph, a Welsh village of 3,355 people? Did St Asaph mean nothing to you, YouGov?

Jonn Elledge is the editor of CityMetric. He is on Twitter as @jonnelledge and on Facebook as JonnElledgeWrites.

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*A YouGov employee I met in a pub later confirmed this, and I make a point of always believing things that people tell me in pubs.