Health, socioeconomic, and environmental risk factors for heat-related mortality and hospital admission in England

Background Climate change is causing increasingly frequent and intense heat events worldwide. In England, we are already witnessing the impact of extreme heat on population health, with 3,000 excess deaths due to heat in 2022. Our ability to adapt to heat and protect the most vulnerable is impaired by limited understanding of the health, socioeconomic, and environmental risk factors for heat-related adverse outcomes. Aims My research aims to (1) create a dataset linking health, climate, social, and environmental data; (2) identify health, socioeconomic, and environmental risk factors for heat-related mortality and hospital admission, and (3) translate my research into public health interventions. Methods My research will be organised in three work packages: WP1: Linking health, social, environmental, and climate data (Y1-Y2) I will link primary and secondary healthcare data from the NHS for about 57 million people between 2020 and 2024 with socioeconomic data based on the index of multiple deprivation, and occupation from Census 2021; environmental data, including housing and living conditions data from Census 2021, and satellite-derived green space indices; and climate data from the Met Office. Data will be linked by NHS number or residence address within the NHS and Office for National Statistics secure data environments. WP2: Identifying risk factors for heat-related death and hospital admission (Y2-Y4) I will use a case-crossover design and conditional binominal regression to investigate heat-related mortality and hospital admission considering pre-defined thresholds of temperature and humidity. I will conduct subgroup analyses for different health (e.g., chronic diseases, medications), socioeconomic (e.g., occupation, deprivation), and environmental (e.g., accommodation type, proximity to green space) risk factors and their combinations. WP3: Translating my research into public health interventions (Y4-Y5) I will work with my stakeholders to translate my research into practical interventions that protect population health and inform public policy. For instance, I will work with NHS England to enable personalised alerts and advice to be sent via the NHS app to individuals with risk factors for heat-related adverse events; the Met Office and the UK Health Security Agency to update the Adverse Weather Health Plan considering high-risk populations; the Office for National Statistics to develop indicators of health impact to inform national and local climate policy. Impact and dissemination To ensure that my research is implemented, I will reach out to all stakeholders, with whom I have engaged to design my research. My research will benefit the public directly by providing information about risk factors and recommending protective behaviours, and indirectly by helping public health and NHS systems protect the most vulnerable in the population. By enhancing our understanding of health, socioeconomic, and environmental risk factors, my research will help local authorities, voluntary and community sector organisations, and national agencies target their communications and supportive interventions to high-risk individuals. The extensive data linkage developed by my research will enable further research, thus benefiting the scientific community. I will disseminate my findings in scientific publications and conferences and engagement with the public and stakeholders, through newspapers, social media, press releases, workshops, and science festivals.