Red hot American summer: Extreme heat and physical activity of adults

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Lanza, Kevin
Stone, Brian
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This dissertation investigates the relationship between extreme summer heat and outdoor, indoor, and total (i.e., outdoor + indoor) physical activity levels of US adults. With the lack of physical activity across the US, public health practitioners and city planners are making concerted efforts to promote physical activity through formal interventions and the design of spaces, respectively. To inform physical activity interventions, researchers examine which factors associate with physical activity, one of which is temperature. The majority of studies exhibit a significant positive association between temperature and physical activity, yet no studies examine exceptionally hot summer days, which disproportionately impact cities and are set to become more prevalent in the future. This dissertation tests three novel questions: 1) how do hot days associate with outdoor, indoor, and total physical activity; 2) how do hot days influence the effect of built environment factors on outdoor physical activity; and 3) how do heat waves – consecutive hot days – associate with outdoor, indoor, and total physical activity? This work made use of self-reported physical activity and demographic data collected during summer 2016 for a National Science Foundation project (NSF award number: 1520803). The study sample included a spatial and demographic mix of ~50 adults per study city (i.e., Atlanta, Detroit, and Phoenix). Heat was measured as both hot days and heat waves (i.e., two or more consecutive hot days), utilizing air temperature and relative humidity data collected at each city’s major airport. The examined built environment factors (i.e., density, safety, trees, hilliness, connectivity, access to parks, and access to shops + services) were primarily collected from government sources and calculated within an 800m Euclidean distance of each study participant’s home address. Separate two-level growth curve models were run for each research question, version of the dependent variable (i.e., Any Activity and Recommended Activity), and location of physical activity (i.e., outdoor, indoor, and total). Multilevel modeling predicted that 1) hot days do not exhibit a significant association with indoor, outdoor, or total physical activity; 2) hot days do not significantly influence the effect of built environment factors on outdoor physical activity; and 3) heat waves do not exhibit a significant association with outdoor, indoor, or total physical activity. These findings refute the study hypotheses that extreme summer heat would decrease outdoor and total physical activity, while shifting physical activity to indoor, thermally comfortable environments. With high temperatures potentially not serving as a barrier to physical activity, cities should allocate resources to reducing the risk of exertional heat illness, an adverse health event expected to become more frequent with physical activity promotion and climate change.
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