How a rural community in Manitoba reduces impacts on health from extreme heat

Developing a HARS in a rural region in Manitoba within the Assiniboine Regional Health Authority (ARHA), required that health officials address challenges common to smaller communities and build on existing capacity. Establishing a temperature—mortality relationship was not feasible due to the large geographic area and low population density that limited the amount of data for the analysis.

Despite this, mortality curves of other neighbouring communities, including Winnipeg and Brandon, and historical temperature data for ARHA, provided sufficient evidence to demonstrate heat-health risks and support the development of a HARS. With support from the provincial and regional Medical Officers of Health, multiple partners were engaged to help with this task. This included disaster and emergency management officials, municipal government officials (e.g. mayor, chief administrative officer, local emergency management officers), Meals on Wheels, service providers for seniors, and Manitoba Housing.

An assessment of vulnerability through consultation with community groups helped to develop the ARHA HARS and prioritize community response measures. The assessment revealed that during the heat season, ARHA experienced an influx of visitors (e.g. golfers, campers, children attending camps); therefore, special efforts were needed to reduce the negative health impacts on these individuals as well as permanent residents from extreme heat events. Stakeholder consultations revealed challenges with providing cooling options because of a limited number of easily accessible air-conditioned buildings. In addition, issuing timely alerts was found to be difficult because of weekly media deadlines and limited local media coverage. As a result, response measures were identified to specifically address these challenges, build on existing strengths, and focus on increasing collaboration between the regional health authority and municipal planning staff. The ARHA HARS model focusses on:

• integrating the HARS into the ARHA Disaster Emergency Response Plan to ensure a robust and coordinated response
• ensuring that residents of long-term care facilities have access to air conditioning in common rooms
• establishing an alternate meal plan (cold plates) during alerts in long-term care facilities
• encouraging implementation of alternative work hours for some occupational groups (e.g. construction workers), where staff work evenings or nights to avoid intense heat during the day
• working with Manitoba Health to issue heat alerts and warnings to residents, schools, daycares, recreational groups, volunteer support groups, transient populations (e.g. campers) and sporting events
• developing response plans for Home Care clients which includes an assessment of the client’s home environment and a care management plan for use if they should exhibit signs of heat illness
• contacting municipal departments, as required, to encourage appropriate preparations (e.g. check emergency response equipment such as fans, generators, back-up communications capability)
• using Emergency Medical Services staff to conduct home safety checks through the ARHA Home, Health, and Safety Check Program, thereby providing older adults with information on how to stay cool in hot weather, copies of heat-health fact sheets, and a directory of health-related services available within their local community
• putting volunteers on stand-by to assist at cooling facilities and with drinking water distribution
• arranging for health care staff to support individuals and communities, as required, throughout the region during extreme heat events

Strong community support and participation in the HARS, the use of volunteer networks and the existence of local health practitioners who personally know those at risk have been instrumental in the innovative approach public health officials have taken to reduce impacts from extreme heat.