Effectiveness of public health interventions in reducing morbidity and mortality during heat episodes: a structured review.

Increasing concern over the impact of hot weather on health has fostered the development of public health interventions to reduce heat-related health impacts. However, evidence of the effectiveness of such interventions is rarely cited for justification. Our objective was to review peer-reviewed and grey literature evaluating interventions aimed at reducing morbidity and/or mortality in populations during hot weather episodes. Among studies considering public risk perceptions, most respondents were aware when an extreme heat episode was occurring but did not necessarily change their practices, primarily due to a lack of self-perception as vulnerable and confusion about the appropriate actions to be taken. Among studies of health outcomes during and following heat episodes, studies were suggestive of positive impacts in reducing morbidity and mortality. While the limited evaluative work to date suggests a positive impact of public health interventions, concern persists about whether the most vulnerable groups, like the elderly and homeless, are being adequately reached.