The heat is on: Understanding public responses to heat-health alerts in England

Climate change is increasing the frequency and severity of heatwaves, posing growing health risks in temperate countries such as the United Kingdom. Despite rising awareness, behavioural adaptation remains limited, and the factors shaping individual responses are not well understood. This study applies the Health Belief Model to examine how adults in England respond to extreme heat and heat-health alerts, and to identify the cognitive and socio-demographic factors associated with engagement in heat-risk communication. A nationally representative online survey conducted in August 2025 ( n = 1097) revealed substantial gaps in both exposure and response. Nearly one-third of respondents (30%) reported not encountering heat-health alerts, particularly among older adults, low-income groups, and those with limited education. While willingness to adapt during heatwaves was high (91%), only 41% reported taking protective action when heat-health alerts were issued, indicating a clear intention-behaviour gap. Among those who recalled seeing alerts (69.7%), 59.3% took action, with responses increasing with alert severity (72% following red alerts compared with 25% for yellow alerts). Behavioural response was significantly associated with perceived severity, perceived benefits, perceived barriers, and self-efficacy. These findings have important implications for policy and practice. Improving heat-risk communication requires expanding reach among under-exposed groups and adopting behaviourally informed approaches that emphasise personal vulnerability, the seriousness of risk, and clear, feasible protective actions. Grounding communication in behavioural insights can help ensure messages resonate with intended audiences and are transferable to other climate-related hazards. • Applies the Health Belief Model to examine heat risk perceptions and behavioural responses in England. • High willingness to adapt is not matched by protective behaviour, indicating an intention-behaviour gap. • Gaps in alert reach and comprehension limit behavioural response. • Socio-demographic factors shape heat risk perceptions and behavioural responses. • Behavioural responses are associated with perceived severity, benefits, barriers, and self-efficacy.