public attitudes, awareness
5.2 Awareness of health advice and publicity about hot weather
All regions in England experienced a level 3 heat-health alert from 17-21 June 2017.
Nearly all (95.4%) survey participants said they were in England on some or all of those days.
Those who were in the country during some or all of the June heatwave were asked if they were aware of any hot weather-related health advice and publicity during that period. Those who were aware, were also asked whether they thought the advice or publicity was useful. Heat protection messages are often aimed at vulnerable groups, but are also relevant to all members of the population who can experience adverse effects in hot weather (e.g. due to outdoor physical activity) (Caspersen et al., 2000).
The results for vulnerable groups are shown in Table 5.3 and for other
socio-demographic groups in Table 5.4. Just over half of participants said they were aware of hot weather-related advice or publicity during the June heatwave and, of those who had heard the advice/publicity, the vast majority said what they heard was very or fairly useful. While one vulnerable group – participants aged 75+ – were much more likely to have heard the advice/publicity (64.1%), another vulnerable group – participants aged 18-74 in bad health – were much less likely to have heard it (only 38.3%).
There are not many differences by these other socio-demographic characteristics, and where there are it appears that health advice/publicity during heatwaves is largely reaching the right sorts of people. For example, the advice/publicity was more likely to be heard by participants living in the warmest parts of the country (the South East), where a slightly higher than average proportion had heard the advice. The one group where health advice does not appear to be getting through is among households with children, as these household types were the least likely to have heard the advice (although, as already mentioned, we do not know the age of the children living in these households).
Table 5.3 Whether heard health advice or publicity during June 2017 heatwave, and whether advice was useful for vulnerable groups
Not heard
health advice Heard health
advice Heard advice and found it:
Useful Not useful
All % 48.9 51.1 42.5 8.5
Aged 18-74 % 50.1 49.9 41.6 8.4
Aged 75+ % 35.9 64.1 54.2 9.8
Aged 75+ and living alone % 45.1 54.9 45.2 9.7
Aged 18-74 no LLSI % 50.4 49.6 41.2 8.4
Aged 18-74 with LLSI % 48.2 51.8 44.0 7.9
Aged 18-74 in good/fair health % 48.9 51.1 42.7 8.4
Aged 18-74 in bad health % 61.7 38.3 30.8 7.5
Row %
Table 5.4 Whether heard health advice or publicity during June 2017 heatwave, and whether advice
Heard advice and found it: Bases (unweighted) Useful Not useful
All % 48.9 51.1 42.5 8.5 1786
Gender
Male % 48.7 51.3 40.7 10.6 784
Female % 49.2 50.8 44.2 6.6 1002
Age group
East Midlands % 51.8 48.2 38.7 9.5 190
West Midlands % 48.1 51.9 38.7 13.2 174
East of England % 49.4 50.6 44.2 6.4 218
London % 45.1 54.9 44.4 10.6 178
South East % 42.4 57.6 48.3 9.4 320
Degree or higher % 51.2 48.8 35.6 13.2 708
A level or equivalent % 48.4 51.6 46.9 4.8 386
Other below A level % 46.3 53.7 46.0 7.7 359
Other qualifications % 47.3 52.7 50.6 2.1 141
None % 49.6 50.4 41.8 8.6 191
Row %
Figure 5.3 shows that there was no association between participants hearing health advice/publicity about hot weather and their views towards hot weather. Since the aim of such advice/publicity is to warn people of the risks of hot weather, it would appear that such advice/publicity does not seem to be having a significant impact in this respect. In fact, previous research has found that hearing such advice was associated with more positive feelings towards hot weather (Lefevre et al., 2015), but this relationship was not found in our survey. However, as a cross-sectional survey, it is not possible to assume any causal relationships between hearing advice about hot weather and participants’ attitudes, since we do not know what other influences there have been on people’s attitudes or for how long they have held such attitudes.
Table 5.4 Continued
Not heard health advice
Heard health advice
Heard advice and found it: Bases (unweighted) Useful Not useful
Household type
Single person % 48.4 51.6 42.8 8.8 423
Lone parent % 57.2 42.8 42.8 – 83
2 adults, no children % 43.9 56.1 47.1 9.0 634
2 adults, 1+ children % 57.6 42.4 34.2 8.2 387
3 adults, no children % 41.7 58.3 48.1 10.2 168
3 adults, 1+ children % 62.5 37.5 32.8 4.8 77
Disability
Yes – affects daily life % 49.4 50.6 42.5 8.1 280
Yes – not affect % 42.9 57.1 46.6 10.5 352
None % 50.3 49.7 41.5 8.1 1153
General health
Very good % 47.8 52.2 44.8 8.1 338
Good % 50.0 50.0 41.8 8.2 838
Fair % 44.3 55.7 46.1 9.6 463
Bad/very bad % 59.1 40.9 33.2 7.7 147
Row %
Although the focus groups were held quite a few months after the summer of 2017, participants were asked to reflect on their recollection of hot weather in England during that summer and they were also prompted to think about the specific level 3 heat-health alert in June that year. They were asked about whether they remembered receiving any alerts, publicity or advice about how to best protect themselves
against the heat, and for their opinion on any advice or publicity received. Leaflets and guidance documents produced by the NHS, PHE and Age UK (Public Health England, 2018a, Age UK, 2017) were circulated later in the session to gauge their awareness and thoughts on how useful this information is.
Few participants had specifically remembered the June 2017 heatwave, and those that did, did not consider it to be a ‘heatwave’. According to all those interviewed, heatwaves were generally thought to be hot weather that lasted a long period, though opinion on what was constituted ‘long’ varied between one and several weeks. Still, there was agreement among most participants that there were some very hot days in the summer of 2017, but that they didn’t last long; ‘we haven’t really had a summer’
was a common response.
Only a small number of participants remembered seeing or hearing any specific warnings or advice about heat-health on television, radio or in doctors’ surgeries during the hot weather. One participant thought that they remembered seeing ‘something saying drink more water’ (FG1 P4), though nothing else. Most agreed that they normally became aware of impending hot weather through listening to or watching national or local weather reports on the radio or television, where information is aimed at the general population, communicating specifics on temperature and climate. Another conceded that information and advice may have been available in their GP’s surgery noticeboard, but that people rarely read these, stating that ‘half the time you sit down and read a magazine before you actually go in’ (FG1 P5). Specific advice and guidance, as described in the Age UK leaflet, was felt by a few as lacking as they felt that some people, like themselves, may benefit from this.
Another concern was expressed about how health protection information was, and could be, accessed during heatwaves. Although most participants said that they had reasonably good access to IT and knowledge of websites for information about the
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Figure 5.3 Attitudes towards hot weather, by whether or not heard health advice/publicity:
% strongly agree/agree
Love hot weather Time in sun Risk to my health Risk to health of others Climate change
Heard advice Not heard
dangers of hot weather to health (e.g. NHS 111), they felt that many of their peers lacked this form of access either because of cost or reluctance to engage. One expressed the view that reliance on ICT to provide health promoting and protecting messages actively excludes older people who largely rely on television and radio:
‘Sometimes on television you’d get, at the end of a programme, “and if you want to get further information log on to our website” and the times I’ve said to [my husband] ‘how many people haven’t got computers’ – they might want to see what this is all about but they, they’re not online.’ (FG1 P5)
‘…then they give you a telephone number you can’t take down because you haven’t got a pen in your hand, you know – it’s all these sort of things against…
well it’s against the elderly.’ (FG2 P4)