Examining the Optimal Placement of Cooling Centers to Serve Populations at High Risk of Extreme Heat Exposure in 81 US Cities

Abstract

Objective: Although extreme heat can impact the health of anyone, certain groups are disproportionately affected. In urban settings, cooling centers are intended to reduce heat exposure by providing air-conditioned spaces to the public. We examined the characteristics of populations living near cooling centers and how well they serve areas with high social vulnerability. Methods: We identified 1402 cooling centers in 81 US cities from publicly available sources and analyzed markers of urban heat and social vulnerability in relation to their locations. Within each city, we developed cooling center access areas, defined as the geographic area within a 0.5-mile walk from a center, and compared sociodemographic characteristics of populations living within versus outside the access areas. We analyzed results by city and geographic region to evaluate climate-relevant regional differences. Results: Access to cooling centers differed among cities, ranging from 0.01% (Atlanta, Georgia) to 63.2% (Washington, DC) of the population living within an access area. On average, cooling centers were in areas that had higher levels of social vulnerability, as measured by the number of people living in urban heat islands, annual household income below poverty, racial and ethnic minority status, low educational attainment, and high unemployment rate. However, access areas were less inclusive of adult populations aged ≥65 years than among populations aged <65 years. Conclusion: Given the large percentage of individuals without access to cooling centers and the anticipated increase in frequency and severity of extreme heat events, the current distribution of centers in the urban areas that we examined may be insufficient to protect individuals from the adverse health effects of extreme heat, particularly in the absence of additional measures to reduce risk.

The Authors Respond

“…Evidence suggests that cooling centers in many communities across the United States may be less extensive, less intensely focused on the highest-risk populations, and visited less often than the participating facilities of Maricopa County’s Heat Relief Network. 3,4 We agree with Hondula et al 1 that cooling centers can provide many other benefits and services beyond acute relief from extreme heat. Indeed, there is growing interest in creating community resilience hubs, 5–7 which “address gaps in services or resources in certain communities—both during and between disasters such as hurricanes, pandemics, or floods.” 8 Facilitating awareness of and access to large numbers of cool spaces that serve as informal cooling centers may also effectively complement (and be more highly utilized during heat events than) designated cooling centers.…”

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“…A recent Centers for Disease Control and Prevention report ( Widerynski et al, 2017 ) identified barriers to accessing or using cooling centres include, but are not limited to, knowledge of their location, inability to leave home, limited access to transportation, and negative association of cooling centres for strictly vulnerable populations. Nevertheless, more than 50% of the population in 3 major metropolitans in Canada are within a 15-min walk to a defined cooling centre ( Quick et al, 2022 ), and up to 63% of cooling centres in 81 US cities are within a 0.5-mile radius of ones residence ( Adams et al, 2023 ). No data currently exists to describe the prevalence and accessibility of cooling centres in Slovenia.…”

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“…14 It was referenced by >200 news outlets in discussions about separating autism from profound autism, and it was shared by several large autism-related groups on X (formerly Twitter). 15 Another article, which examined how well cooling centers serve urban areas with high social vulnerability, 16 owes its relatively high Altmetric score (555, as assessed on February 6, 2024) to a heat wave in July 2023. During 2 days, the article was referenced by >60 news outlets in stories related to surviving excessive heat.…”

“…During 2 days, the article was referenced by >60 news outlets in stories related to surviving excessive heat. 17 A third article, which examined the association between the incidence of COVID-19 across levels of social vulnerability and the duration of behavioral policy interventions, 18 received an Altmetric score of 202, largely because of a tweet by CDC’s Office of Health Equity that gained traction. 19…”