Building resilience to climate change: pilot evaluation of the impact of India’s first Heat Action Plan on all-cause mortality
Open accessAbstract
Background. Ahmedabad implemented South Asia’s first heat action plan (HAP) after a 2010 heatwave. This study evaluates the HAP’s impact on all-cause mortality in 2014–2015 relative to a 2007–2010 baseline. Methods. We analyzed daily maximum temperature (Tmax)-mortality relationships before and after HAP. We estimated rate ratios (RRs) for daily mortality using distributed lag nonlinear models and mortality incidence rates (IRs) for HAP warning days, comparing pre- and post-HAP periods, and calculated incidence rate ratios (IRRs). We estimated the number of deaths avoided after HAP implementation using pre- and post-HAP IRs. Results. The maximum pre-HAP RR was 2.34 (95%CI 1.98–2.76) at 47°C (lag 0), and the maximum post-HAP RR was 1.25 (1.02–1.53) estimated at 47°C (lag 0). Post-to-pre-HAP nonlagged mortality IRR for Tmax over 40°C was 0.95 (0.73–1.22) and 0.73 (0.29–1.81) for Tmax over 45°C. An estimated 1,190 (95%CI 162–2,218) average annualized deaths were avoided in the post-HAP period. Conclusion. Extreme heat and HAP warnings after implementation were associated with decreased summertime all-cause mortality rates, with largest declines at highest temperatures. Ahmedabad’s plan can serve as a guide for other cities attempting to increase resilience to extreme heat.
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In the aftermath of the catastrophic heatwave in 2010, Ahmedabad became the first South Asian city to implement a Heat Action Plan; the city is now estimated to avoid approximately 1190 heat-related deaths annually.
“In the aftermath of the catastrophic heatwave in 2010, Ahmedabad in India became the first South Asian city to implement a Heat Action Plan (HAP); the city is now estimated to avoid approximately 1190 heat-related deaths annually (Hess et al 2018).”
From Attribution of 2022 early-spring heatwave in India and Pakistan to climate change: lessons in assessing vulnerability and preparedness in reducing impacts (2023) · cites this paper as Hess et al 2018
Adaptation to extreme heat has been shown to be effective in some cases.
“Adaptation to extreme heat has been shown to be effective in some cases (Hess et al 2018).”
From Attribution of 2022 early-spring heatwave in India and Pakistan to climate change: lessons in assessing vulnerability and preparedness in reducing impacts (2023) · cites this paper as Hess et al 2018
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- Authors
- Hess, J. J., LM, S., Knowlton, K., Saha, S., Dutta, P., Ganguly, P., Tiwari, A., Jaiswal, A., Sheffield, P., Sarkar, J., Bhan, S. C., Begda, A., Shah, T., Solanki, B., & Mavalankar, D.
- Affiliations
- University of Washington (US)
- Indian Institute of Public Health, Gandhinagar, Ahmedabad, India
- Natural Resources Defense Council (US)
- Emory University (US)
- Indian Institute of Public Health Gandhinagar (IN)
- Icahn School of Medicine at Mount Sinai (US)
- India Meteorological Department (IN)
- Ahmedabad Municipal Corporation, Ahmedabad, India
- Corresponding author
- Hess, Jeremy J.
- ORCID
- Venue
- Journal of Environmental and Public Health
- Publisher
- Wiley
- Published
- 2018-11-01
- Volume
- 2018
- Pages
- 1-8
- ISSN
- 1687-9805 (ISSN-L)
- 1687-9813
- PMC
- PMC6236972
- OpenAlex
- W2898634854
- Cited by
- 118
- References
- 33
- Citations by year
- 2026: 19 · 2025: 16 · 2024: 16 · 2023: 13 · 2022: 13 · 2021: 31 · 2020: 7 · 2019: 3
- FWCI
- 5.06
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Environmental and Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Institutes of Health (5R21TW009535-02, K23ES024127)
- Climate Development and Knowledge Network (5R21TW009535-02, K23ES024127)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Keywords
- heat action plans, heat-related mortality, all-cause mortality, extreme heat, heat waves, climate change adaptation, heat warnings, temperature-mortality relationship, urban resilience, Ahmedabad
- MeSH terms
- Cities, Humans, India, Mortality, Pilot Projects, Seasons, Extreme Heat, Climate Change
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