Heat stress and coping strategies among older adults in three Sunbelt cities in the United States

Abstract Background Prevailing scientific evidence suggests that extreme heat poses a substantial threat to the health and well-being of older adults in the Sunbelt cities of the United States. However, prior research has not adequately addressed the specific socio-demographic, health-related vulnerabilities, and coping-strategic factors influencing heat stress among older urban populations. Methods Informed by the Socio-Ecological Model, this study adopts a retrospective cohort study design to investigate the predictors and experiences of heat stress among older adults. Data from older adults in Los Angeles, Houston, and Phoenix were analyzed using thematic and multiple binary logistic regression analyses. Results The results reveal that much older adults (aged 80 +) were less likely to experience heat stress compared to their relatively younger counterparts. Also, marital status, income, respiratory diseases, physical activity, taking cool showers, and city of residence were significantly associated with a higher risk of suffering heat stress. The qualitative results uncovered individual-level behavioural adjustment as an effective coping mechanism during extreme heat events. Conclusion These results underscore the complex interplay of behavioral, socio-demographic, and health-related factors influencing heat stress among older adults. The study recommends that urban health strategies prioritize these demographics, enhancing support systems and coping mechanisms to reduce vulnerability to heat stress among older urban populations.