Duke Experts on How to Survive Severe Heat

What policymakers and state residents need to know

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“North Carolina is a leader in creating a county-level heat action plan toolkit that is grounded in evidence, informed by community engagement and customizable for diverse geographic and social contexts,” said Ashley Ward, director of the Heat Policy Innovation Hub. “Providing concrete guidance to counties on how to plan, prepare and respond to extreme heat is critical to protect our communities, particularly those most vulnerable. I hope other states will follow North Carolina’s lead.”

The adaptability of the plan template relies on modeling created by Jordan Clark, senior policy associate at the Nicholas Institute, working closely with the State Climate Office. Clark used historical data for emergency department visits in the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) to develop regional thresholds for extreme heat. Those thresholds act as triggers for counties to initiate their heat action plans and for the North Carolina Climate and Health Team to issue alerts from its new Heat Health Alert System.

The work hasn’t stopped with the release of the toolkit. Clark and the hub’s partners are further refining the modeling with updated NC DETECT data, and they are incorporating seasonal variation into the thresholds.

The hub also played a key role in community engagement efforts. Representatives from each of the four lead organizations convened a workshop in July 2023 with state agency officials and local leaders from a climatologically and demographically diverse group of 10 counties. Participants helped the organizers better understand how counties would develop and deploy their plans and identified gaps in resources and knowledge.

Ahead of the toolkit’s release, Ward joined state and local experts for an introductory webinar on the health risks posed by extreme heat. Topics covered in the webinar included the state's changing temperatures, evidence-based strategies for preventing heat-related illnesses, how communities are already preparing and how the state government can help.

“In North Carolina we're extremely fortunate to have so many strong university and state efforts devoted to addressing our greatest climate challenges, like dangerous extreme heat,” said Kathie Dello, director of the North Carolina State Climate Office. “This partnership with Duke, the State Climate Office at NC State, and state agencies like NCORR and NCDHHS demonstrates our state's strength in developing data-driven, solutions-oriented products to ensure that North Carolinians thrive in a changing climate.”

The Heat Policy Innovation Hub brings together scientists and communities to develop and deploy innovative policy solutions that reduce the impacts of extreme heat on human health and well-being. The toolkit is just one example of how the hub is partnering with federal, state and local agencies to plan and prepare for extreme heat.

In April 2023, the Federal Emergency Management Agency (FEMA) issued policy guidance that for the first time required state emergency managers to consider climate change and equity in disaster planning. Ward and Clark wrote a supplemental report that offered recommendations for state emergency managers to adequately evaluate the threat of extreme heat as they update their federally mandated hazard mitigation plans.

Ahead of the 2023–2024 school year, Clark published a comprehensive strategy for high school athletic associations to ensure the health and well-being of student-athletes as they train and compete in high temperatures. The policy brief targets improvements in measuring heat stress, activity modification guidelines and emergency action plans that can be implemented across sports and venues.

“As we see all too often, heat-related illnesses are preventable—with the right knowledge, preparation and planning,” Ward said. “Duke’s Heat Policy Innovation Hub is eager to build purposeful partnerships with the public and private sectors to develop practical policy solutions that safeguard communities against the health impacts of extreme heat.”

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