Extreme heat impacts on daily life and adaptive behaviours captured through lived experience

So far, there has been little evidence of the impact of extreme heat on behaviour and wellbeing in daily life, beyond gross health metrics like hospital admissions and mortality. Data are needed to better understand the relative impact of a changing climate across life course strata and ultimately inform effective adaptation strategies. Using the UK September 2023 heatwave as a case study, we surveyed 3,242 participants from the Avon Longitudinal Study of Parents and Children (ALSPAC) about their lived experience of extreme heat. Responses evidenced perceived adverse impacts on sleep quality (67% of participants), productivity at home (41%), appetite (29%), and productivity at work (25%). Beneficial impacts were perceived for mood (39% of participants) and physical health (20%). Demographic (age and gender), and socio-economic variables (employment status and housing type), were associated with differences in the reported heat effects for lived experience of sleep quality, productivity at home and mood. Participants who were female, ≤34 years of age, and unemployed / not working, perceived 'a lot worse' impacts on sleep quality in greater numbers than other sub-groups (age: 25% ≤ 34 versus 10% ≥ 65; gender: 21% female versus 10% male; employment status: 37% unemployed / not working versus 19% employed). These groups, as well as people living in flats, also perceived 'a lot and slightly worse' impacts on productivity at home and mood, more often than other sub-groups. Despite the majority (82%) of participants reporting awareness of the UK Health Security Agency (UKHSA) and Met Office amber Heat-Health Alert, only 34% reported taking adaptive measures. Understanding physiological and socio-economic drivers behind the experience of extreme heat is crucial for building resilience. Established cohort studies can be usefully employed to rapidly measuring impact and variation in response