Building on Social Capital and Social Networks to Improve Preparedness

Following Health Canada’s heat projections published in 2011, the Town of Melita worked with Health Canada and other stakeholders to complete heat vulnerability assessments that would provide guidance in the design of a rural Heat Alert and Response System for the community. As a rural municipality, Melita does not experience the urban heat island effect, but projected increases in temperature due to climate change still pose a significant threat to residents of the Town. Melita established a local Heat Alert Response Advisory Committee (HARSAC) consisting of local health and regional disaster management partners, as well as community members and representatives from the local municipality. With Health Canada’s support, the committee conducted vulnerability assessments and table-top exercises, which simulated extreme heat events. These two activities revealed the risks related to extreme heat faced by the small rural community, the characteristics of vulnerable groups, and existing capacities and limitations within the community. Following the assessment, the committee asked local Emergency Medical Services to start including a heat vulnerability assessment for seniors as part of a general health assessment. Mediums such as local newspapers, heat-health fact sheets, brochures, and children’s colouring sheets were used to inform the local population of best practices to reduce health risks from extreme heat events. The Town also worked to introduce more cooling locations, such as the outdoor swimming pool, bowling alley, seniors centre, and the library, as part of the development of the Heat Alert and Response System. An innovative idea was to use the local Handi-Van service as transportation for high-risk individuals to cooling stations during extreme heat events. The engagement of various stakeholders in Heat Alert and Response System activities helped reinforce communication and relationships between the residents and those providing social support services, and enabled the system to be flexible to local conditions.

Understanding and Assessing Impacts

In 2011, Health Canada published a Best Practices Guidebook on Heat Alert and Response Systems, which included a chart of heat projections for specific Canadian cities. Subsequently, Manitoba Health, Seniors, and Active Living (MHSAL) decided to develop a province-wide plan to develop local Heat Alert and Response Systems for both urban areas and rural/remote communities in Manitoba. The Town of Melita was one of two regional health authorities that partnered with MHSAL’s Office of Disaster Management to conduct vulnerability assessments, whose findings would inform the development of Heat Alert and Response Systems. Identifying vulnerable populations was a demanding task for the Town of Melita, since rural communities often lack the data monitor relationships between temperature, mortality, and morbidity. The Town formed a Heat Alert Response Advisory Committee (HARSAC) with the assistance of the local regional health authority (the Assiniboine Regional Health Authority). With the support of Health Canada, Melita conducted a vulnerability assessment in parallel with a table-top exercise that simulated an extreme heat event. These two activities helped the Town identify specific risks related to extreme heat faced by the small rural community. The Town also used the assessment to learn about characteristics of vulnerable groups and existing capacities and limitations within the community. A major limitation particular to rural communities is that they often lack the larger public buildings that urban cities can use as cooling facilities. Instead, Melita was forced to rely on the support of social networks to communicate about and identify and access cooling alternatives. Understanding the importance of improving adaptive capacity to extreme heat events in the face of increasing temperatures, Assiniboine Regional Health Authority and the Town of Melita used information from the assessments to begin development and implementation of a local Heat Alert and Response System for the community.

Identifying Actions

With data on vulnerable populations in the community, the Town of Melita was able to begin identifying objectives and different types of actions for the Heat Alert and Response System. Since seniors were identified as a vulnerable population to extreme heat events, the HARSAC asked local Emergency Medical Services to include a heat vulnerability assessment of all older adults as part of a general health assessment. This heat vulnerability assessment included questions such as whether or not they had a means by which to cool their homes. The results of these assessments would help pinpoint instances of vulnerability to heat throughout the community. This serves as a useful tool for gauging the scope of implementation for the Heat Alert and Response System. Another important action identified in the planning phase was the introduction of education initiatives to better inform the local population of heat-health risks and preventative measures. As part of the development of the Heat Alert and Response System, the potential locations for cooling options within the Melita area were identified. As mentioned earlier, one of the issues facing this small, rural community was that potential cooling facilities were not large enough to welcome large numbers of people during an extreme heat event. To overcome this obstacle, the Town identified multiple cooling alternatives, including the outdoor swimming pool, seniors centre, library, and bowling alley. A discussion was held in relation to local resources that could be used to transport vulnerable individuals to cooling stations during extreme heat events. The local Handi-Van service was one such resource that was identified as a useful transportation tool for those in need. A central theme throughout the development of the Heat Alert and Response System was the importance of drawing upon strong social networks to provide support to those needing transportation or other assistance during times of extreme heat.

Implementation

The Regional Health Authority was able to leverage Melita’s strong social capital and social networks to implement a local Heat Alert and Response System. The Town implemented educational initiatives on reducing health risks from extreme heat events through various sources such as the local newspaper, heat-health fact sheets, brochures, and informal resources such as children’s colouring sheets. Information on heat-health risk was distributed to medical clinics, published on both the MHSAL and Regional Health Authority websites, and communicated through a provincial information line dedicated to providing a wide range of health advice. The information was also provided to the community through public health staff, home care programs and Emergency Medical Services. Health Canada heat tools were also introduced in the assessments for out-patients in the emergency rooms of local health centres. These implemented measures improved the community’s adaptive capacity to extreme heat by enabling the local population to understand the severity of heat-health risks. Improving residents’ knowledge on the issue made the implementation of the Heat Alert and Response System that much more effective in Melita. The Town relied on social networks and important relationships among community members to introduce cooling facilities (swimming pool, bowling alley, library, etc.) and transportation to these locations for vulnerable population members during extreme heat events. Several people volunteered to assist with aspects of the system such as transportation to cooling facilities or water distribution during dangerously hot days. Melita’s Heat Alert and Response System was reflective of local capacities and vulnerabilities, and its implementation was complemented with the implementation of several public engagement and education initiatives.

Outcomes and Monitoring Progress

Melita was able to develop an effective Heat Alert and Response System informed by tangible data from vulnerability assessments and comprehensive analyses of the community’s strengths and limitations. The Town’s strong social capital and social networks along with the willingness of numerous volunteers was fundamental to the execution of adequate responses during events of extreme heat. Another key success factor in the development of the Heat Alert and Response System was the engagement of various stakeholders to form important relationships between residents and those providing social support services. For example, the participation of Emergency Medical Services allowed for a greater understanding of heat-health risks within the community while simultaneously educating the population about these same risks. An important take-away lesson learned during this study was the importance of including air-conditioned or cooling areas in long-term care facilities. The vulnerability assessment revealed the need to provide air-conditioned areas in all long-term care facilities to protect this vulnerable population sector against the risks of extreme heat. A primary challenge that the Town faced was finding ways to communicate heat risk to the general population in a way that provided sufficient time for people to prepare and take necessary precautions to protect their health. The Assiniboine Regional Health Authority developed a region-wide Heat Response Plan, but there are many areas in Manitoba that still lack heat plans, cooling centres, or effective means to communicate to vulnerable people. When asked what advice she would give other rural municipalities, Dr. Toni Morris-Oswald, Disaster Management Specialist for MHSAL, emphasized the importance of working with the local community to develop a Heat Alert and Response System around pre-established social capital and social networks.

Next Steps

The vulnerability assessments conducted in the initial phase of the project continue to inform next steps for Melita’s adaptation to extreme heat. As mentioned earlier, a key takeaway was the importance of providing long-term care facilities with sufficient air-conditioning and cooling areas. Since the implementation of the Heat Alert and Response System the Town of Melita made upgrades to provide air-conditioned areas in the Melita Personal Care Home. Three other capital projects were completed within the next year across the community. The Town is committed to continue investing in such infrastructure upgrades where it is necessary to protect vulnerable populations from the risks of extreme heat. Other next actions for the Town include continued monitoring of the effectiveness of the Heat Alert and Response System. With new technologies and heat assessments introduced to the local health care system, the Town will be equipped with tangible data that can be used to assess the effectiveness of their adaptation efforts. Beyond the scope of Melita, Manitoba’s HARSAC continues to engage the challenge of helping rural communities across the province develop heat plans, introduce cooling centres, and effectively communicate risks to vulnerable people. The committee strives to develop a comprehensive provincial plan in the future.

Resources

Link to Full Case Study

Additional Resources


Understanding and Assessing Impacts

In 2011, Health Canada published a Best Practices Guidebook on Heat Alert and Response Systems, which included a chart of heat projections for specific Canadian cities. Subsequently, Manitoba Health, Seniors, and Active Living (MHSAL) decided to develop a province-wide plan to develop local Heat Alert and Response Systems for both urban areas and rural/remote communities in Manitoba. The Town of Melita was one of two regional health authorities that partnered with MHSAL’s Office of Disaster Management to conduct vulnerability assessments, whose findings would inform the development of Heat Alert and Response Systems. Identifying vulnerable populations was a demanding task for the Town of Melita, since rural communities often lack the data monitor relationships between temperature, mortality, and morbidity. The Town formed a Heat Alert Response Advisory Committee (HARSAC) with the assistance of the local regional health authority (the Assiniboine Regional Health Authority). With the support of Health Canada, Melita conducted a vulnerability assessment in parallel with a table-top exercise that simulated an extreme heat event. These two activities helped the Town identify specific risks related to extreme heat faced by the small rural community. The Town also used the assessment to learn about characteristics of vulnerable groups and existing capacities and limitations within the community. A major limitation particular to rural communities is that they often lack the larger public buildings that urban cities can use as cooling facilities. Instead, Melita was forced to rely on the support of social networks to communicate about and identify and access cooling alternatives. Understanding the importance of improving adaptive capacity to extreme heat events in the face of increasing temperatures, Assiniboine Regional Health Authority and the Town of Melita used information from the assessments to begin development and implementation of a local Heat Alert and Response System for the community.

Identifying Actions

With data on vulnerable populations in the community, the Town of Melita was able to begin identifying objectives and different types of actions for the Heat Alert and Response System. Since seniors were identified as a vulnerable population to extreme heat events, the HARSAC asked local Emergency Medical Services to include a heat vulnerability assessment of all older adults as part of a general health assessment. This heat vulnerability assessment included questions such as whether or not they had a means by which to cool their homes. The results of these assessments would help pinpoint instances of vulnerability to heat throughout the community. This serves as a useful tool for gauging the scope of implementation for the Heat Alert and Response System. Another important action identified in the planning phase was the introduction of education initiatives to better inform the local population of heat-health risks and preventative measures. As part of the development of the Heat Alert and Response System, the potential locations for cooling options within the Melita area were identified. As mentioned earlier, one of the issues facing this small, rural community was that potential cooling facilities were not large enough to welcome large numbers of people during an extreme heat event. To overcome this obstacle, the Town identified multiple cooling alternatives, including the outdoor swimming pool, seniors centre, library, and bowling alley. A discussion was held in relation to local resources that could be used to transport vulnerable individuals to cooling stations during extreme heat events. The local Handi-Van service was one such resource that was identified as a useful transportation tool for those in need. A central theme throughout the development of the Heat Alert and Response System was the importance of drawing upon strong social networks to provide support to those needing transportation or other assistance during times of extreme heat.

Implementation

The Regional Health Authority was able to leverage Melita’s strong social capital and social networks to implement a local Heat Alert and Response System. The Town implemented educational initiatives on reducing health risks from extreme heat events through various sources such as the local newspaper, heat-health fact sheets, brochures, and informal resources such as children’s colouring sheets. Information on heat-health risk was distributed to medical clinics, published on both the MHSAL and Regional Health Authority websites, and communicated through a provincial information line dedicated to providing a wide range of health advice. The information was also provided to the community through public health staff, home care programs and Emergency Medical Services. Health Canada heat tools were also introduced in the assessments for out-patients in the emergency rooms of local health centres. These implemented measures improved the community’s adaptive capacity to extreme heat by enabling the local population to understand the severity of heat-health risks. Improving residents’ knowledge on the issue made the implementation of the Heat Alert and Response System that much more effective in Melita. The Town relied on social networks and important relationships among community members to introduce cooling facilities (swimming pool, bowling alley, library, etc.) and transportation to these locations for vulnerable population members during extreme heat events. Several people volunteered to assist with aspects of the system such as transportation to cooling facilities or water distribution during dangerously hot days. Melita’s Heat Alert and Response System was reflective of local capacities and vulnerabilities, and its implementation was complemented with the implementation of several public engagement and education initiatives.

Outcomes and Monitoring Progress

Melita was able to develop an effective Heat Alert and Response System informed by tangible data from vulnerability assessments and comprehensive analyses of the community’s strengths and limitations. The Town’s strong social capital and social networks along with the willingness of numerous volunteers was fundamental to the execution of adequate responses during events of extreme heat. Another key success factor in the development of the Heat Alert and Response System was the engagement of various stakeholders to form important relationships between residents and those providing social support services. For example, the participation of Emergency Medical Services allowed for a greater understanding of heat-health risks within the community while simultaneously educating the population about these same risks. An important take-away lesson learned during this study was the importance of including air-conditioned or cooling areas in long-term care facilities. The vulnerability assessment revealed the need to provide air-conditioned areas in all long-term care facilities to protect this vulnerable population sector against the risks of extreme heat. A primary challenge that the Town faced was finding ways to communicate heat risk to the general population in a way that provided sufficient time for people to prepare and take necessary precautions to protect their health. The Assiniboine Regional Health Authority developed a region-wide Heat Response Plan, but there are many areas in Manitoba that still lack heat plans, cooling centres, or effective means to communicate to vulnerable people. When asked what advice she would give other rural municipalities, Dr. Toni Morris-Oswald, Disaster Management Specialist for MHSAL, emphasized the importance of working with the local community to develop a Heat Alert and Response System around pre-established social capital and social networks.

Next Steps

The vulnerability assessments conducted in the initial phase of the project continue to inform next steps for Melita’s adaptation to extreme heat. As mentioned earlier, a key takeaway was the importance of providing long-term care facilities with sufficient air-conditioning and cooling areas. Since the implementation of the Heat Alert and Response System the Town of Melita made upgrades to provide air-conditioned areas in the Melita Personal Care Home. Three other capital projects were completed within the next year across the community. The Town is committed to continue investing in such infrastructure upgrades where it is necessary to protect vulnerable populations from the risks of extreme heat. Other next actions for the Town include continued monitoring of the effectiveness of the Heat Alert and Response System. With new technologies and heat assessments introduced to the local health care system, the Town will be equipped with tangible data that can be used to assess the effectiveness of their adaptation efforts. Beyond the scope of Melita, Manitoba’s HARSAC continues to engage the challenge of helping rural communities across the province develop heat plans, introduce cooling centres, and effectively communicate risks to vulnerable people. The committee strives to develop a comprehensive provincial plan in the future.

Resources

Link to Full Case Study

Additional Resources