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.

 
 
 
 

British television once sounded like Britain. But then, the ITV mergers happened

The Granada Studios, Quay Street, Manchester. Image: Wikimedia Commons.

This summer, several ITV franchises celebrated half a century of continuous operation. There was a Yorkshire Television themed cake, and a flag bearing the company’s logo was flown over ITV’s Yorkshire base for a time. It was all very jolly – but while a few people beyond Britain’s small community of television historians and old telly nerds engaged with the idea, any excitement was brief.

The main reason for is not, as you might assume, that, in the era of streaming and so forth, ITV is no longer a dominant presence in many people’s cultural lives: even the quickest of glances at the relevant figures would tell you otherwise. No, it’s because the mere existence of ITV’s franchises is now passing out of common memory. They are the trademarks, literally rather than figuratively, of a version of ITV that today exists only nominally.

For most of its history, ITV operated on a federal model. ITV wasn’t a company, it was a concept: ‘Independent Television’, that is, television which was not the BBC.

It was also a network, rather than a channel – a network of multiple regional channels, each of which served a specific area of the UK. Each had their own name and onscreen identity; and each made programmes within their own region. They were ITV – but they were also Yorkshire, Granada, Grampian, Thames, and so on.

So when I was a child growing up the in Midlands in the ‘80s, no one at school ever said “ITV”: they said “Central”, because that’s what the channel called itself on air, or “Channel Three” because that’s where it was on the dial. To visit friends who lived in other regions was to go abroad – to visit strange lands where the third channel was called Anglia, and its logo was a bafflingly long film sequence of a model knight rotating on a record turntable, where all the newsreaders were different and where they didn’t show old horror films on Friday nights.

The ITV regions as of 1982, plus Ireland. Image: Wikimedia Commons.

Of course, there were programmes that were shown across the whole network. Any station, no matter in what part of the country, would be foolish not to transmit Coronation Street during the period where it could persuade nearly half the population to tune in. But even The Street wasn’t networked from the beginning: it started in six of the then eight ITV regions, and rolled out to the other two after a few months when it became clear the series was here to stay.

This was a common occurrence: The Avengers, one of the few ITV series to genuinely break America, began in an even more limited number of regions in the same year, with other areas scrambling to catch up when the programme became a hit.

The idea behind ITV’s structure was that the regions would compete with each other to put programmes on the network, opting in and out of others’ productions as worked best for them. ITV was, after all, an invention of a 1950s Conservative government that was developing a taste for the idea of ‘healthy competition’ even as it accepted the moral and practical case for a mixed economy. The system worked well for decades: in 1971, for example, the success of London Weekend Television’s Upstairs, Downstairs, creatively and commercially, and domestically and internationally, prompted other regions to invest in high end period dramas so as to not look like a poor relation.


Even away from prestige productions there was, inexplicable as it now seems, a genuine sense of local pride when a hit programme came from your region. That Bullseye was made on Broad Street in Birmingham was something that people knew. That 17.6m people watched the 1984 Xmas special, making it one of the ten most watched programmes of the year, made Bully a sort of local hero. In more concrete terms, Bullseye and other Birmingham based programmes provided jobs, and kept that part of the country visible from all others. This was true of all areas, and from all areas.

ITV franchises would often make programmes that were distinctive to, or set in, their region. Another of Central’s late eighties hits was Boon. It might have starred the cockney-sounding Michael Elphick, but it was filmed and set in Birmingham, just as Central’s predecessor ATV’s Public Eye had been at the end of the sixties. In Tales of the Unexpected, one of the poorest and smallest ITV regions, the aforementioned Anglia, made a bona fide international hit, largely filmed in transmission area, too. HTV produced a string of children’s series set in its south west catchment area, including some, such as The Georgian House, that examined the way the area had profited from the slave trade.

There was another element of ‘competition’ in the structure of ITV as originally conceived: the franchises were not for life. Every few years, a franchise round would come along, forcing the incumbent stations to bid to continue its own existence against other local offerings.

The process was no simple auction. Ministers were empowered to reject higher financial bids if they felt a lower bid offered other things that mattered: local employment or investment, programming plans that reflected the identity of the region they were bidding to serve, or simply higher quality programmes.

Yorkshire Television itself owes its existence to just such a franchise round: the one that followed a 1967 decision by regulator IBA that Granada, until then the holder of a pan-northern England licence, was insufficiently local to Yorkshire. For a decade, commissioning and production had been concentrated in Manchester, with little representation of, or benefit for, the other side of the Pennines. IBA’s decision was intended to correct this.

Yorkshire existed in practical terms for almost exactly 40 years. Its achievements included Rising Damp, the only truly great sitcom ever made for ITV.

But in 1997 it was, ironically, bought out by Granada, the company who had had to move aside in order for it to be created. What had changed? The law.

In 1990, another Conservative government, one even keener on competition and rather less convinced of the moral and practical case for a mixed economy, had changed the rules concerning ITV regions. There was still a ‘quality threshold’ of a sort – but there was less discretion for those awarding the franchises. Crucially, the rules had been liberalised, and the various ITV franchises that existed as of 1992 started buying out, merging with and swallowing one another until, in 2004, the last two merged to form ITV plc: a single company and a single channel.

The Yorkshire Television birthday cake. Image: ITV.

Yorkshire Television – or rather ITV Yorkshire as it was renamed in 2006 – is listed at Companies House as a dormant company, although it is still the nominal holder of the ITV licence for much of Northern England. Its distinctive onscreen identity, including the logo, visible on the cake above, disappeared early this century, replaced by generic ITV branding, sometimes with the word Yorkshire hidden underneath it, but often without it. Having once been created because Manchester was too far away, Yorkshire TV is now largely indistinguishable from that offered in London. (It is more by accident of history than anything else that ITV retains any non-London focus at all; one of the last two regions standing was Granada.)

The onscreen identities of the all the other franchises disappeared at roughly the same time. What remained of local production and commissioning followed. Regional variations now only really exist for news and advertising. TV is proud that is can offer advertisers a variety of levels of engagement, from micro regional to national: it just doesn’t bother doing so with programming or workforce any more.

Except for viewers in Scotland. Curiously, STV is an ITV franchise which, for reasons too complicated to go into here, doesn’t suffer from the restrictions/opportunities imposed by upon its English brethren in 1990. It also – like UTV in Northern Ireland, another complex, special case – Its own onscreen identity. Nationalism, as it so often does, is trumping regionalism – although it was not all that long ago that Scotland had multiple ITV regions, in recognising its own lack homogeneity and distinct regions, while respecting its status as a country.


As is often observed by anyone who has thought about it for more than four seconds, the UK is an almost hilariously over-centralised country, with its political, financial, administrative, artistic and political centres all in the same place. Regionalised television helped form a bulwark against the consequences of that centralisation. Regional commissioning and production guaranteed that the UK of ITV looked and sounded like the whole of the UK. The regions could talk about themselves, to themselves and others, via the medium of national television.

The idea of a federal UK crops up with increasing frequency these days; it is almost inconceivable that considerable constitutional tinkering will not be required after the good ship UK hits the iceberg that is Brexit, and that’s assuming that Northern Ireland and Scotland remain within that country at all. If the UK is to become a federation, and many think it will have to, then why shouldn’t its most popular and influential medium?

A new Broadcasting Act is needed. One that breaks up ITV plc and offers its constituent licences out to tender again; one that offers them only on the guarantee that certain conditions, to do with regional employment and production, regional commissioning and investment, are met.

Our current national conversation is undeniably toxic. Maybe increasing the variety of accents in that conversation will help.

Thanks to Dr David Rolinson at the University of Stirling and britishtelevisiondrama.org.uk.