Examining the magnitude and perception of summertime overheating in London care homes

This paper brings together objective and subjective data on indoor temperature and thermal comfort to examine the magnitude and perception of summertime overheating in two London-based care homes occupying modern and older buildings. Continuous monitoring of indoor and outdoor temperature, relative humidity and CO2 levels was conducted in summer 2019 along with thermal comfort surveys and semi-structured interviews with older residents and staff of the care settings. Indoor temperatures were found to be high (>30 °C) with bedroom temperatures often higher at night than daytime across both care settings. Limited opening due to window restrictors constrained night-time ventilation. Overheating was prevalent with four out of the five monitored bedrooms failing all four overheating metrics investigated. While 35-42% of staff responses perceived indoor temperatures to be uncomfortably hot, only 13-19% of resident responses were found to do so, indicating that elderly residents tend to be relatively insensitive to heat, leaving them open to overheating without realising it. Residents and staff in the modern care setting were less satisfied with their thermal conditions. As hybrid buildings, care settings need to keep both residents and staff comfortable and healthy during hot weather through night-time ventilation, management of heating and supportive institutional practices

Mortality benefit of building adaptations to protect care home residents against heat risks in the context of uncertainty over loss of life expectancy from heat

We explore methodological issues core to the cost-benefit evaluation of building adaptations designed to protect against heat risks to residents of care homes in England in the context of the uncertainties relating to the loss of life expectancy in heat death. We used building physics modelling to quantify the impact of external window shading on indoor temperatures. We calculated associated heat mortality and loss of life expectancy under three sets of assumptions of life-shortening based on: (Method 1) an England & Wales (E&W) life-table, (Method 2) E&W life-table scaled to match observed average survival of care home residents and (Method 3) assuming that those dying of heat have a life expectancy of six months. External window shading was estimated to reduce mean indoor temperatures by 0.9 °C in a �warm� summer and 0.6 °C in an �average� summer. In a care home of 50 residents, the heat deaths and years of life lost (YLL) averted by such shading were estimated by the three life-expectancy assumptions (Methods 1, 2, 3) to be: 0.07, 0.47 and 0.28 heat deaths and 0.29, 0.76 and 0.14 YLL for the warm year and 0.05, 0.31 and 0.19 heat deaths and 0.20, 0.51 and 0.10 YLL for the average year. Over a 20-year time horizon and assuming an annual discount rate of 3.5%, the monetized benefit of reduced YLL would be around £90,000, £230,000 and £44,000 with the three life-expectancy assumptions. Although this range represents appreciable uncertainty, it appears that modest cost adaptations to heat risk may be justified in conventional cost-benefit terms even under conservative assumptions about life expectancy

Relationship-building around a policy decision-support tool for urban health.

Contemporary challenges linked to public health and climate change demand more effective decision-making and urban planning practices, in particular by taking greater account of evidence. In order to do this, trust-building relationships between scientists and urban practitioners through collaborative research programmes is required. Based on a policy-relevant research project, Complex Urban Systems for Sustainability and Health (CUSSH), this project aims to support the transformation of cities to meet environmental imperatives and to improve health with a quantitative health impact assessment. A case study in Rennes, France, focuses on the role of a policy decision-support tool in the production and use of knowledge to support evidence-informed decision-making. Although the primary objective of informing decision-making through evidence-based science is not fulfilled, the use of a decision-making support tool can lay the foundations for relationship-building. It can serve as a support for boundary-spanning activities, which are recognised for their effectiveness in linking science to action. This case study illustrates that the path of knowledge transfer from science to policy can be challenging, and the usefulness of using models may not be where it was thought to have been

Twenty questions about design behavior for sustainability, report of the International Expert Panel on behavioral science for design

How behavioral scientists, engineers, and architects can work together to advance how we all understand and practice design—in order to enhance sustainability in the built environment, and beyond.https://www.nature.com/documents/design_behavior_for_sustainability.pdfPublished versio

The CUSSH programme: learning how to support cities' transformational change towards health and sustainability.

The Complex Urban Systems for Sustainability and Health (CUSSH) project is a global research programme on the complex systemic connections between urban development and health. Through transdisciplinary methods it will develop critical evidence on how to achieve the far-reaching transformation of cities needed to address vital environmental imperatives for planetary health in the 21st century. CUSSH's core components include: (i) a review of evidence on the effects of climate actions (both mitigation and adaptation) and factors influencing their implementation in urban settings; (ii) the development and application of methods for tracking the progress of cities towards sustainability and health goals; (iii) the development and application of models to assess the impact on population health, health inequalities, socio-economic development and environmental parameters of urban development strategies, in order to support policy decisions; (iv) iterative in-depth engagements with stakeholders in partner cities in low-, middle- and high-income settings, using systems-based participatory methods, to test and support the implementation of the transformative changes needed to meet local and global health and sustainability objectives; (v) a programme of public engagement and capacity building. Through these steps, the programme will provide transferable evidence on how to accelerate actions essential to achieving population-level health and global climate goals through, amongst others, changing cities' energy provision, transport infrastructure, green infrastructure, air quality, waste management and housing

Developing a programme theory for a transdisciplinary research collaboration: Complex Urban Systems for Sustainability and Health

Background: Environmental improvement is a priority for urban sustainability and health and achieving it requires transformative change in cities. An approach to achieving such change is to bring together researchers, decision-makers, and public groups in the creation of research and use of scientific evidence. Methods: This article describes the development of a programme theory for Complex Urban Systems for Sustainability and Health (CUSSH), a four-year Wellcome-funded research collaboration which aims to improve capacity to guide transformational health and environmental changes in cities. Results: Drawing on ideas about complex systems, programme evaluation, and transdisciplinary learning, we describe how the programme is understood to “work” in terms of its anticipated processes and resulting changes. The programme theory describes a chain of outputs that ultimately leads to improvement in city sustainability and health (described in an ‘action model’), and the kinds of changes that we expect CUSSH should lead to in people, processes, policies, practices, and research (described in a ‘change model’). Conclusions: Our paper adds to a growing body of research on the process of developing a comprehensive understanding of a transdisciplinary, multiagency, multi-context programme. The programme theory was developed collaboratively over two years. It involved a participatory process to ensure that a broad range of perspectives were included, to contribute to shared understanding across a multidisciplinary team. Examining our approach allowed an appreciation of the benefits and challenges of developing a programme theory for a complex, transdisciplinary research collaboration. Benefits included the development of teamworking and shared understanding and the use of programme theory in guiding evaluation. Challenges included changing membership within a large group, reaching agreement on what the theory would be ‘about’, and the inherent unpredictability of complex initiatives

Improving indoor thermal comfort, air quality and the health of older adults through environmental policies in London

In this work we evaluate the potential of selected environmental strategies in reducing air pollution and summertime indoor overheating. Associated changes in mortality rates are also calculated for older adults in London. Reducing these risks for vulnerable groups is an immediate priority and given that seniors spend most of their time indoors, our focus is on strategies that prioritize the transformation of residential environments for indoor thermal comfort and air quality improvements. For each strategy, we develop specific scenarios related to building adaptations and test potential reductions on indoor overheating and pollutant exposures from outdoor sources (PM2.5), as well as on senior mortality through the CRAFT tool (Cities Rapid Assessment Framework for Transformation). We then pick the scenarios with highest impacts on mortality, aiming to formulate effective policy recommendations for Greater London. Preliminary results suggest that environmental policies related to the installation of shading could have the highest reduction in heat and pollution-related senior mortality, followed by moderate effects due to building insulation retrofits and the greening of roofs. With an increasing ageing population in the UK and beyond, our work highlights the need for city-level policies to address building modifications, considering the importance of indoor spaces for older adults.publishedVersionPeer reviewe

Understanding Urban Green Space Usage through Systems Thinking: A Case Study in Thamesmead, London

Urban green spaces provide environmental, economic, societal and health benefits to cities. However, policy and planning interventions aiming to improve usage have often led to unintended consequences, including, in some circumstances, an actual decline in usage. Previous research has identified factors influencing the use of urban green space, more often with a focus on the ‘quality’ and physical features of the space, rather than on the broader social factors. This study aims to unpack the complexity of factors that influence the use of urban green space through the application of Systems Thinking. A qualitative mixed-method approach integrating System Dynamics with rapid ethnography was adopted to elicit the views of local residents in Thamesmead, London. A thematic analysis of interviews was undertaken to systematically map the causal relations between factors, which were compared to wider stakeholders’ views. Our findings highlight the relevance of dynamics and social influences on the use of green space, which include social interactions and stewardship, health conditions, availability of services and amenities. These are factors that are underexplored in the literature and, sometimes, overlooked in urban green space policy by decision-makers. We infer that attendance of urban green spaces requires time, which may be occupied in other practices determined by local conditions and needs. Expanding the spatial and temporal boundaries of investigation, wider than debates on ‘quality’, should, in our view, increase the chances of identifying critical influences and foster an increased use of green space

Governing the Climate Adaptation of Care Settings Dataset, 2022

The dataset consists of air temperatures recorded longitudinally and reported at hourly intervals using Hobo MX1101, Hobo MX1102A and Hobo MX2301 devices. The monitoring period covered 1st May 2022 to 30th September 2022 inclusive – the full non-heating season in England. The devices were deployed in 30 care homes across England: eleven in Greater London, nine in the north of England as far north as Newcastle-upon-Tyne, six in the Midlands, and four in the south of England including on the Isle of Wight. The locations monitored consisted of 22 offices (staff-only areas such as manager’s offices, administrator offices, nurse stations), 30 lounges (communal areas such as lounges, dining rooms and lounge/diners), and 30 bedrooms (single rooms, with a range of occupancy – some vacant, some occupied only at night, others occupied 24/7 depending on resident needs). In addition, outdoor temperatures were monitored at each of the 30 care homes