Extreme heat exposure and sensitivity have been a growing concern in urban regions as the effects of extreme heat pose a threat to public health, the water supply, and the infrastructure. Heat-related illnesses demand an immediate Emergency Medical Service (EMS) response since they might result in death or serious disability if not treated quickly. Despite increased concerns about urban heat waves and relevant health issues, a limited amount of research has investigated the effects of heat vulnerability on heat-related illnesses. This study explores the geographical distribution of heat vulnerability in the city of Austin and Travis County areas of Texas and identifies neighborhoods with a high degree of heat vulnerability and restricted EMS accessibility. We conducted negative binomial regressions to investigate the effects of heat vulnerability on heat-related EMS incidents. Heat-related EMS calls have increased in neighborhoods with more impervious surfaces, Hispanics, those receiving social benefits, people living alone, and the elderly. Higher urban capacity, including efficient road networks, water areas, and green spaces, is likely to reduce heat-related EMS incidents. This study provides data-driven evidence to help planners prioritize vulnerable locations and concentrate local efforts on addressing heat-related health concerns.

Anthropogenic climate change has increased the frequency and intensity of fires. Despite their widespread consequences, current research has largely overlooked urban fires and their associated vulnerability. This study seeks to identify patterns of fire vulnerability, map out areas with high fire vulnerability and limited access to fire stations and hospitals, and ultimately determine the factors contributing to increased fire incidents. Principal Component Analysis was used to develop a fire vulnerability index comprising variables capturing health status and socio-environmental factors. Enhanced 2-step floating catchment area (E2SFCA) analysis was conducted to determine relative accessibility to resources such as hospitals and fire stations. Ordinary least squares (OLS) regression and geographically weighted regression (GWR) were utilized to determine factors associated with higher fire incident counts. The results of the fire vulnerability analysis highlight areas of high fire vulnerability in the eastern periphery and the north-central parts of Austin. Moreover, the eastern periphery experiences decreased accessibility to fire stations and hospitals. Finally, the results of the GWR analysis highlight a varied negative relationship between health vulnerability and fire incidents and a positive relationship with socio-environmental vulnerability. The GWR model (R²: 0.332) was able to predict a greater extent of the variance compared to OLS (R²: 0.056). Results of this study underscore that areas with socio-environmental vulnerabilities are likely to face a higher number of fire incidents and have reduced access to hospitals and fire stations. These findings can inform public health officials, city planners, and emergency services departments in developing targeted strategies to mitigate the harm caused by fire incidents.

This paper aims to investigate the following research questions: (1) what are the hourly patterns of heat index and heat-related emergency medical service (EMS) incidents during summertime?; and (2) how do the lagged effects of heat intensity and hourly excess heat (HEH) vary by heat-related symptoms? Using the hourly weather and heat-related EMS call data in Austin-Travis County, Texas, this paper reveals the relationship between heat index patterns on an hourly basis and heat-related health issues and evaluates the immediate health effects of extreme heat events by utilizing a distributed lag non-linear model (DLNM). Delving into the heat index intensity and HEH, our findings suggest that higher heat intensity has immediate, short-term lagged effects on all causes of heat-related EMS incidents, including in cardiovascular, respiratory, neurological, and non-severe cases, while its relative risk (RR) varies by time. HEH also shows a short-term cumulative lagged effect within 5 h in all-cause, cardiovascular, and non-severe symptoms, while there are no statistically significant RRs found for respiratory and neurological cases in the short term. Our findings could be a reference for policymakers when devoting resources, developing extreme heat warning standards, and optimizing local EMS services, providing data-driven evidence for the effective deployment of ambulances.

Climate change, air pollution, and ecological degradation are defining public health and health equity challenges of our time. Efforts to integrate and evaluate climate change curriculum in medical education is still nascent. Herein, the authors presented findings of a longitudinal evaluation of such curriculum at Harvard Medical School (HMS). Authors designed and administered competency-based and course content-specific pre/post surveys to first-year HMS students to evaluate the impact of the climate change, environment, and health curriculum. Survey development used an adapted Delphi process to solicit feedback from experts at HMS, students, and the Office of Medical Education and included seven-point Likert scale questions (dichotomized and analyzed using Fisher’s exact test). Once data saturation was reached, we conducted a thematic analysis to identify key themes and selected illustrative quotes to support each theme. Surveys were administered to the first-year class of 134 HMS students from August 2023 to December 2024. Response rates varied from 21/132 (15.7%) to 119/134 (82.1%). Comparing pre-to post-course responses, competency-based surveys demonstrated statistically significant improvements in 19/20 items (95.0%) and course content-specific surveys showed statistically significant improvements in 20/29 items (69.0%). The vast majority of open-ended responses affirmed the curriculum’s value. This study demonstrated that the curriculum significantly improved medical students’ self-perceived competence in climate-related topics. While statistically significant improvements were observed, results are based on self-reported perceptions and may be subject to response bias due to response rate attrition during the study. No formal validation process was conducted during survey development. As climate and health equity education continues to expand rapidly, often with little standardization, these findings offer insight for other institutions seeking to build measurably impactful curricula, and ultimately prepare medical students to more effectively deliver patient care on a warming planet.