Socio-economic, infrastructural and health-related risk factors associated with adverse heat-health effects reportedly experienced during hot weather in South Africa

Introduction: poor urban communities are likely to bear the brunt of climate change impacts on health and well-being. The City of Johannesburg, South Africa, is predicted to experience an average increase in ambient temperature of 4°C by 2100. Focusing on the urban environment, this study aimed to determine socio-economic, infrastructural and health-related risk factors for heat-related adverse health effects. Methods: this was a cross-sectional study. Data of interest were collected using a pretested and validated questionnaire administered to parents of children attending schools participating in a school heat study. Information related to demographic, socio-economic and household-level determinants of health, which has an impact on the individual prevalence of adverse heat-health effects associated with hot weather, was collected for 136 households and 580 individuals. Results: sweating (n = 208 individuals; 35%), headache and nausea (n = 111; 19%) and weakness, fatigue and dizziness (n = 87; 15%) were the most common heat-health effects reportedly experienced by individuals (n = 580) during hot weather. Individuals who suffered from hypertension (OR = 2.32, 95% CI: 1.34-4.05, p = 0.003) and individuals older than 60 years (OR = 1.81, 95% CI: 1.27-1.99, p < 0.001) compared to other age groups were more likely to experience 'any heat-health effects'. Living in government-sponsored detached housing and in houses with asbestos roofs were associated with an increase in reported experience of 'any heat-health effects' compared to living in other housing types. Conclusion: heat-health awareness campaigns should target people suffering from pre-existing diseases and the elderly, as these groups are especially vulnerable to heat. Focus should also be given to appropriate roofing and insulation in government-sponsored housing since summertime temperatures are projected to increase.