Participatory Approach to Developing a Heat Alert and Response System

Beginning in 2009, Health Canada (HC) partnered with the New Brunswick Department of Health and the City of Fredericton to pilot a multi-year initiative to develop a community-based Heat Alert and Response system. Fredericton, a city in New Brunswick that was identified to be vulnerable to the risks of increasing temperatures due to climate change was among four Canadian municipalities selected to create an alert system for residents. HC conducted a temperature-mortality analysis for the City of Fredericton, which found a sharp increase in mortality when temperatures exceeded 30 degrees Celsius. Climate projections indicated that the number of hot days in Fredericton would double by the mid-century, making it evident that adaptive measures were needed. The New Brunswick Department of Health quickly moved to create The Heat Alert and Response System Advisory Committee (HARSAC) that would work with various stakeholders and organizations to identify best practices to communicate and share information at the onset of an extreme heat event. In constructing a Heat Alert and Response System through stakeholder engagement, the committee took on a two-fold approach. The approach centered on capitalizing on the extensive networking capacities of the committee’s members and building on existing alert and response structures to reduce the challenges associated with making a new system. Based on input from key stakeholders, the alert triggers were modified from using a series of adjectives to a plain-language tier of ‘Heat Alert’, ‘High Heat Alert’, and ‘Extreme Heat Alert’. To support the roll-out of Fredericton’s Heat Alert and Response System, two bilingual websites were launched that informed the public of heat-health risks. Other public engagement methods included the distribution of materials to at-risk populations and one-on-one training for individuals about heat-health risks. The HARS program in Fredericton was able to capitalize on the robust and well-established Fredericton Emergency Measures Organization (EMO) for the municipality. Through this group the City was able to determine which stakeholders would benefit the most from being involved in the HARSAC as well as which organizations should be targeted for the educational materials. The involvement of several stakeholders in the planning process and the leverage of already established networks of community-based organizations drove the success of the program which is still in place over a decade later.

Understanding and Assessing Impacts

The City of Fredericton, New Brunswick, historically experienced a higher number of hot days than elsewhere in the Maritimes. Climate projections indicated that the number of hot days in Fredericton were expected to double by 2050, coupled with an increase in warmer nights. This made extreme heat as a public health risk an emerging issue for Fredericton that was largely unaddressed. As part of the development of the Heat Alert and Response System, Fredericton partnered with Health Canada and the New Brunswick Department of Health to assess vulnerabilities in the local community. Health Canada led a temperature-mortality analysis for the City, which revealed that when the daily maximum temperature exceeded 30 degrees Celsius, there was a sharp spike in mortality. The study made it clear that without further adaptation, heat-related health risks in Fredericton would continue to increase with a changing climate. Before the Heat Alert and Response System pilot project, the City of Fredericton would rely on a press release from New Brunswick Health, derived from Environment Canada weather warnings, to inform the public of an extreme heat event. This system not only lacked clarity, but it failed to engage the local community and introduce adaptive measures that were desperately needed in the wake of increasing temperatures posing more frequent and severe heat-health risks for the population of Fredericton. Health Canada and New Brunswick Health’s climate projections and initial analysis of the issue identified the need and laid the foundation for the development of a Heat Alert and Response System in Fredericton.

Identifying Actions

After understanding the risks associated with climate change resulting in an increase of extreme heat events, the New Brunswick Department of Health took a leadership role and quickly moved to develop partnerships with municipal authorities and local stakeholders in Fredericton. A program coordinator was selected to increase public awareness of heat-related health risks and behaviours through the production of information materials that would promote protective behaviours before and during an extreme heat event. A Heat Alert and Response System Advisory Committee (HARSAC) was formed to lead the planning phase of the project. The multi-stakeholder advisory committee included representatives from 12 organizations representing a broad range of government departments and private organizations. The committee’s primary purpose was to use its member’s networks to increase support from various agencies and organizations for at-risk populations. This, in turn, helped the City of Fredericton identify best practices to communicate and share information between agencies in advance of an extreme heat event. New Brunswick Health’s approach to building the Heat Alert and Response System through stakeholder engagement was two-fold. First, the advisory committee was structured to consist of a small core of stakeholders with extensive networking capabilities. Members from respected organizations within the community would serve as credible sources of information to ensure the adaptation measures were supported by stakeholders and effective at reaching vulnerable people. Second, the committee built on existing alert and response structures such as the City of Fredericton’s EMO to reduce the challenges inherent with building a completely new system. This multi-year approach of proactive engagement with stakeholders enabled all partners to draw on their experience in responding to other types of emergencies and apply those lessons to the development of the Heat Alert and Response System.

Implementation

Prior to the implementation of the Heat Alert and Response System pilot, a press release from New Brunswick Health, derived from Environment Canada weather warnings, was the only source of communication to inform Fredericton residents of an extreme heat event. This notification system was based on a tiered range of Humidex values and used the terms ‘advisory’, ‘warning’, and ‘alert’ to describe the three levels of severity. The Heat Alert and Response System introduced new wording to reflect the increasing intensity of risk in a more clear, simplified manner. Based on key input from stakeholders, the triggers were modified to a plain-language tier of ‘Heat Alert’, ‘High Heat Alert’ and ‘Extreme Heat Alert’. A corresponding numbering system of level 1, 2, and 3 was also implemented with the Heat Alert and Response System to further convey levels of risk. To support the roll-out of the City of Fredericton Heat Alert and Response System, two bilingual websites were launched that were specifically designed and built for the heat season. Stakeholders from HARSAC supplemented the awareness campaign by providing one-on-one training to their clients about heat-health risks and by distributing materials to vulnerable populations in their network. The City of Fredericton also included a heat-health information brochure in its Spring municipal water utility bills. The Heat Alert and Response System made significant improvements to the City’s existing alert and response structures to improve their state of adaptive capacity to extreme heat. It was important for these improvements to be implemented in tandem with extensive public outreach initiatives to ensure vulnerable populations in Fredericton were aware of protocols and crucial resources during events of extreme heat.

Outcomes and Monitoring Progress

The Heat Alert and Response System pilot project succeeded at improving Fredericton’s response to extreme heat events by clarifying the notification process and connecting people in need with available resources before and during extreme heat events. The City collected feedback after the first heat season, which indicated that the numbering system (Levels 1, 2, and 3) had been easily adopted and used by Heat Alert and Response stakeholders, the media, and the public. Karen White, Director of Healthy Environments Branch, said that “six years later, the Heat Alert and Response System program in Fredericton is doing well. The pilot program was successful because it started out small and leveraged the already established excellent network of community based non-government organizations thus avoiding the need to ‘reinvent the wheel’. By drawing from existing structures and expertise of staff in departments at both the municipal and provincial level, Fredericton avoided the challenges of building a whole new system. This enabled the Heat Alert and Response System to be relevant, clearly understood by the public, and completed in a timely fashion. The essentiality of stakeholder engagement (establishing and maintaining good relationships with all interested parties from the earliest stages of the project) in the development and implementation of a community-based Heat Alert and Response System was one of the most important learning outcomes of this project.” Ms. White also added, “Health Canada provided a wealth of materials and evidence-based information that were an immense help in moving the project in the right direction.” Partnering with important organizations such as Health Canada and New Brunswick Health allowed the City of Fredericton to incorporate data-driven adaptation actions that made the Heat Alert and Response System the success it was.

Next Steps

Since the Heat Alert and Response System was only a pilot project, the City of Fredericton is able to continue gathering feedback from key stakeholders and the general public to improve the system. As mentioned by Ms. White, Director of Healthy Environments Branch, the pilot program started out small and grew as it developed. After the introduction of the Heat Alert and Response System in Fredericton, the Office of the Chief Medical Officer of Health has used its coordinating role to disseminate education and promotional messages to all health regions in New Brunswick. By working first at the local level and delivering a proven product, New Brunswick is in a strong position to leverage the successes and takeaways in Fredericton to improve adaptive capacity to extreme heat province-wide.

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