Temporal trends in human vulnerability to excessive heat

Over recent decades, studies have examined various morbidity and mortality outcomes associated with heat exposure. This review explores the collective knowledge of the temporal trends of heat on human health, with regard to the hypothesis that humans are less vulnerable to heat events presently than in the past. Using Web of Science and Scopus, the authors identified all peer-reviewed articles that contained keywords on human impact (e.g. mortality, morbidity) and meteorological component (e.g. heat, heatwave). After sorting, a total of 71 articles, both case studies and epidemiological studies, contained explicit assessments of temporal trends in human vulnerability, and thus were used in this review. Most of the studies utilized mortality data, focused on the developed world, and showed a general decrease in heat sensitivity. Factors such as the implementation of a heat warning system, increased awareness, and improved quality of life were cited as contributing factors that led to the decreased impact of heat. Despite the overall recent decreases in heat vulnerability, spatial variability was shown, and differences with respect to health outcomes were also discussed. Several papers noted increases in heat's impact on human health, particularly when unprecedented conditions occurred. Further, many populations, from outdoor workers to rural residents, in addition to the populations in much of the developing world, have been significantly underrepresented in research to date, and temporal changes in their vulnerability should be assessed in future studies. Moreover, continued monitoring and improvement of heat intervention is needed; with projected changes in the frequency, duration, and intensity of heat events combined with shifts in demographics, heat will remain a major public health issue moving forward.