public attitudes, awareness
5.6 Health effects of hot weather
Participants were asked whether, at any time during summer 2017 (not just during the June heatwave), they had experienced any of the following health symptoms/
conditions as a result of hot weather or heat:
• Dehydration/intense thirst
• Sunburn
• Heat rash/red and dry skin
• Headaches
• A need to contact a GP or NHS 111, call an ambulance or go to hospital or A&E
• Other condition
• (No health symptoms/conditions)
Just over half (52.9%) of participants said they had experienced one or more of these health conditions as a result of hot weather in summer 2017. Most of these participants tended to experience more than one condition, with headaches (25.7%), irritability (21.4%), dehydration/intense thirst (20.2%) and sunburn (18.1%) being the most common. However, the health problems tended not to be severe enough to Table 5.15 Continued
Single adult 66.7 51.8 8.9 40.6 3.2 23.0 12.0 87.1 78.0 445
Lone parent 54.9 35.2 0.9 21.8 0.8 19.2 25.5 80.0 74.1 84
2 adults,
no children 79.9 55.2 11.1 56.1 0.9 17.9 5.6 86.9 74.6 681
2 adults,
1+ children 77.3 55.7 10.6 50.2 4.8 16.6 6.1 86.9 69.4 400
3 adults,
no children 73.7 40.9 14.1 51.0 5.6 23.6 8.9 84.3 69.9 175
3 adults,
1+ children 89.0 64.2 11.6 50.6 8.9 20.5 2.2 83.4 66.4 79
Disability Yes – affects
daily life 64.1 51.4 8.0 40.0 5.3 22.2 12.8 77.6 70.0 292
Yes – not
affect 81.2 57.5 10.7 53.8 1.0 14.7 6.1 87.5 74.9 367
None 76.8 51.4 11.2 50.8 3.6 20.0 7.1 85.9 72.2 1217
General health
Very good 78.5 55.8 10.8 56.0 2.9 19.2 6.1 92.5 77.3 362
Good 77.6 47.6 10.8 52.7 4.0 20.3 7.9 85.4 74.9 884
Fair 74.5 57.0 10.9 44.1 2.4 18.0 8.0 82.6 68.0 483
Bad/very bad 61.1 57.7 8.3 36.0 3.8 20.1 10.5 73.4 61.4 149
require medical treatment, as only 1.4% of participants had had to contact the health services as a result of hot weather. Still, at the population level, 1.4% of all adults living in England translates into a considerable number of people requiring medical attention as a result of hot weather. With an adult population (aged 16+) of approximately 47,000,000, this equates to over 600,000 extra contacts with health services.
A number of other conditions were mentioned by participants including: fatigue/
exhaustion/lethargy (15 participants); breathing problems, including asthma (10); problems sleeping (8); extreme sweating (4); and various other problems mentioned by only one or two participants. In the focus groups, participants mainly said they often found it difficult to sleep at night during hot periods, often because they did not open their windows at night (often for security reasons) or use fans at night (often for reasons of cost).
Table 5.16 shows these symptoms for our vulnerable groups. Whereas participants aged 75+ were less likely to report any of these symptoms, those aged 18-74 with a LLSI or in bad health were more likely to report having at least one of these symptoms (about two in three reported at least one symptom). In particular, they were more likely to report dizziness, cramps, irritability and, for those in bad health only, headaches and heat rash.
The significantly lower reporting of these symptoms by participants aged 75+ seems unexpected, given that older participants are more likely to have a LLSI and to be in worse health. However, as Figure 5.13 shows, for eight of the symptoms (plus none), there was an inverse relationship with age, with the youngest participants most likely to report one or more symptoms (67.2% for the 18-24 age group), while the oldest participants were the least likely to report any (only 31.7% of those aged 75+ reported one or more symptoms). Younger participants were more likely than average to report dehydration, sunburn and headaches. Participants aged 75+ were, however, the most likely to report contacting the NHS: 6.7% did, compared with the average of 1.4%.
Of course, it is important to keep in mind that these are self-reports and are not clinically Table 5.16 Hot weather related health symptoms in summer 2017 for vulnerable groups
good/fair health 20.5 19.0 13.2 26.5 7.0 2.3 5.1 5.8 20.5 0.8 46.6
Aged 18-74 in
bad health 27.2 21.6 25.8 38.2 27.4 5.8 21.2 11.7 34.9 2.1 32.4
diagnosed symptoms due to hot weather. However, it is perhaps not all that surprising that young people suffered more effects from hot weather given that they were much less likely to take action to protect themselves from the heat, as previously shown in Table 5.12: i.e. during the June 2017 heatwave, younger participants were much less likely to stay out of the sun between 11am and 3pm, to stay in the shade, to limit physical activity, to close curtains on windows in sunlight, and to avoid alcohol. This relationship between symptoms and protective actions taken is examined further below.
Figure 5.13 Hot weather related health symptoms in summer 2017, by age group
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Sunburn
Heat rash
Headaches
Dizziness
Cramps
18-24 25-34 35-44 45-54 55-64 65-74 75+
High temperature
Irritability
None Dehydration
The clear association with participants’ general health, as shown in Figure 5.14, is as expected. The likelihood of reporting one or more symptoms was much higher for participants in bad health than for those in very good health (64.7% compared with 36.6%). Participants in bad health were much more likely to report symptoms of dehydration, headaches, dizziness and irritability.
Figure 5.14 Hot weather-related health symptoms in summer 2017, by self-reported general health
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Sunburn Heat rash Headaches Dizziness Nausea
Very good Good Fair Bad/very bad Cramps
High temperature Irritability None Dehydration
Table 5.17 shows these symptoms by a number of other socio-demographic characteristics. There are only a few other differences of note (besides age, having a LLSI or being in bad health which are described above). One difference, possibly due to the urban heat effect, is that participants living in London were the most likely to mention one or more of these symptoms (63.7%), with headaches (33.3%) and irritability (31.1%) being the highest of the regions. There were also differences by ethnicity, with Asian participants being the most likely to mention one or more symptoms (70.1%), in particular dehydration (32.9%) and headaches (49.1%).
The likelihood of experiencing some symptoms was related to the types of actions participants did or did not take to protect themselves from the heat. For example, looking at responses for actions taken during the June 2017 heatwave, 21.7% of those who said they rarely/never stayed out of the sun between 11am and 3pm reported experiencing sunburn compared with 13.9% of those who always/often Table 5.17 Hot weather-related health symptoms in summer 2017, by socio-demographics
Mixed/Other 22.0 20.1 27.4 38.9 12.4 2.0 12.0 8.1 32.0 5.7 36.1
Region
North East 14.3 16.6 18.5 26.9 2.4 1.7 2.8 11.8 27.4 – 47.1
North West 17.0 22.8 11.9 23.6 8.5 1.2 6.2 9.0 12.2 0.2 48.4
Yorkshire &
The Humber 51.5 84.4 66.8 49.2 57.4 43.0 49.4 37.7 86.4 59.2 2.9
East Midlands 44.4 88.3 58.8 51.6 56.3 38.0 45.1 33.6 88.2 47.3 1.0
West Midlands 51.5 84.4 66.8 49.2 57.4 43.0 49.4 37.7 86.4 59.2 2.9
East of England 44.4 88.3 58.8 51.6 56.3 38.0 45.1 33.6 88.2 47.3 1.0
London 24.0 21.3 22.0 33.3 13.1 3.7 8.9 5.7 31.1 0.5 36.3
daily life 26.3 18.6 19.9 26.6 19.4 4.9 17.9 8.6 33.9 1.4 40.2
Yes – not affect 21.3 15.7 10.7 19.2 11.2 5.1 5.6 8.0 17.8 3.2 53.0
None 18.5 18.6 13.5 27.1 6.3 1.9 4.0 5.5 19.3 0.9 47.3
Bases are similar to those in Table 5.7.
stayed out of the sun. However, the association between action taken and symptoms experienced was not always as expected: e.g. among those who said they rarely/
never drank cool fluids, only 4.1% experienced dehydration compared with 20.9% of those who always/often drank fluids; and among who said they rarely/never avoided alcohol 15.2% experienced headaches compared with 30.9% of those who always/
often avoided alcohol. These counter-intuitive associations could be explained in a number of ways, e.g. perhaps people who think they never or rarely suffer from dehydration will not report it as a symptom, but they also may not feel the need to drink fluids in hot weather. By contrast, people who do experience problems of dehydration are likely to drink lots of fluids to try to counteract it.
Participants who reported being able to keep their living space and bedroom cool were significantly less likely to report having any of the heat-related health symptoms (Figure 5.15). However, this association was not found for any of the other housing characteristics asked about.
The provision of hot weather-related publicity/advice does not appear to be associated with the likelihood of people experiencing hot weather-related health problems. Participants who had heard the publicity were just as likely as those who did not hear it to report health problems (52.9% for both groups). Participants who said they had changed their behaviour as a result of hearing the advice were significantly more likely to report hot weather-related health symptoms (61.8%) than those who had heard the advice but did not change their behaviour (46.3%).
Of course, it might be the case that people who consider themselves at risk of developing health problems resulting from hot weather are more likely to change their behaviour than those who do not perceive themselves to be at risk.
There was, however, a clear association between experiencing hot weather-related symptoms and participants’ attitudes towards the health risks of hot weather to themselves, as shown in Figure 5.16. While two-thirds (63.8%) of those who agreed that hot weather was a risk to their health reported 1 or more symptoms during summer 2017, this was much higher than for those who said hot weather was not a risk to their health. However, even among the latter, nearly half (46.2%) of participants reported 1 or more hot weather-related symptoms.
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Figure 5.15 Percent experiencing 1 or more hot weather-related symptoms in summer 2017, by whether can keep living space and bedroom cool
Keep living space cool Keep bedroom cool
Yes No