Governing the Climate Adaptation of Care Settings

由于全球气候变化，英国预计将经历更炎热、更干燥的夏季，预计热浪发生的频率、强度和持续时间都将增加。2003年和2018年，仅在英格兰就有2091人和863人因热浪死亡，这意味着未来气温升高可能导致与热有关的死亡率平行上升。英国目前也面临着人口快速老龄化的问题，预计到2035年，75岁及以上的人口将占总人口的13%。老年人更容易受到气候引起的影响，因为他们更有可能患有潜在的慢性健康并发症，使他们更容易受到热应激的影响。室内环境是老年人热暴露的主要调节因素，他们往往大部分时间都在室内度过。不良的建筑设计、缺乏有效的热管理以及护理机构中工作人员和居民之间不同的需求和偏好可能导致室内热暴露增加，对最脆弱的居民的健康产生有害影响。对气候变暖的不适应，比如空调的使用，可能会增加养老院的燃料费用，增加已经捉襟见肘的护理行业的运营成本，增加建筑碳排放，从而破坏政府减少温室气体排放的努力。为期一年的试点项目“护理环境的气候适应能力”和之前由我们的研究小组领导的小规模研究表明，即使在非极端的夏天，英国的养老院也已经过热。在护理环境中适应气候变化的一个关键目标是通过建筑设计引入被动冷却策略来限制这种风险。然而，作为试点项目一部分的初步建模也表明，在2050年代和2080年代，常见的被动冷却策略可能无法充分降低过热风险。需要进一步研究先进的被动冷却策略，结合人类行为和组织变化，以确定英国护理提供的最佳气候适应途径。该项目的主要目的是量化全国护理机构中与气候相关的热风险，加强对人类行为、组织能力和治理的理解，使英国的护理服务能够在气候变化下制定公平的适应途径，以应对不断上升的热压力。在试点项目的基础上，这个新颖的跨学科项目将首次在英国收集50个护理设置面板的纵向温度和湿度数据，以量化夏季过热的反复出现的风险。我们还将通过对居民、一线护理人员、管理人员和政策利益相关者的调查，确定和评估社会、制度和文化障碍和机会，这些障碍和机会支撑着护理和额外护理院中适应气候变暖的治理。在这个小组的子样本中，我们将使用创新的测量技术来收集居民的生理数据，并研究他们与热暴露和健康影响的关系。此外，在英国，我们将首次创建英国护理服务的建筑库存模型，该模型能够预测未来一系列气候变化情景下护理环境中的未来过热风险。这将有助于评估近期、中期和长期未来过热缓解战略和政策在热舒适和健康结果方面的有效性。在整个项目中，我们将继续开发和扩展在试点项目期间创建的利益相关者社区。通过与不同利益相关者网络的持续对话，我们将探索组织能力和结构，以及它们如何影响行动和政策，以便为从业者、企业和政策制定者提供最佳实践指导。

As a result of global climate change, the UK is expected to experience hotter and drier summers, and heatwaves are expected to occur with greater frequency, intensity and duration. In 2003 and 2018, 2,091 and 863 heat-related deaths, respectively, were reported in England alone as a result of heatwaves, meaning future temperature increases could lead to a parallel rise in heat-related mortality. The UK also currently has a rapidly ageing population, with people aged 75 or over expected to account for 13% of the total population by 2035. Older populations are more vulnerable to climate-induced effects as they are more likely to have underlying, chronic health complications, making them more vulnerable to heat stress. The indoor environment is a principle moderator of heat exposure in older populations, who tend to spend the majority of their time indoors. Poor building design, the lack of effective heat management and diverging needs and preferences between staff and residents in care settings may contribute to increased indoor heat exposure with detrimental health impacts falling on the most vulnerable residents. Maladaptation to a warming climate, such as the uptake of air conditioning, could increase fuel bills in care homes, increase operational costs for businesses in the already financially stretched care sector, and increase building carbon emissions, thus undermining government efforts to reduce greenhouse gas emissions. The one-year pilot project 'Climate Resilience of Care Settings' and previous small-scale studies led by our research team have shown that UK care homes are already overheating even under non-extreme summers. A key target for climate adaptation in care settings is to limit such risks by introducing passive cooling strategies via building design. However, preliminary modelling as part of the pilot project also demonstrated that common passive cooling strategies may not adequately mitigate overheating risk in the 2050s and 2080s. Further research into advanced passive cooling strategies, combined with human behaviour and organisational change is required to identify optimum climate adaptation pathways for UK's care provision.The main aim of the project is to quantify climate related heat risks in care settings nationwide and enhance understanding of human behaviour, organisational capacity and governance to enable the UK's care provision to develop equitable adaptation pathways to rising heat stress under climate change. Building on the foundations of the pilot project, this novel, interdisciplinary project will collect, for the first time in the UK, longitudinal temperature and humidity data in a panel of 50 care settings in order to quantify the recurring risk of summertime overheating. We will also identify and assess social, institutional and cultural barriers and opportunities underpinning the governance of adaptation to a warmer climate in care and extra-care homes through surveys with residents, frontline care staff, managers and policy stakeholders. Within sub-samples of this panel, we will use innovative measurement techniques to collect residents' physiological data and study their relation with heat exposure and health impacts. Also for the first time in the UK, we will create a building stock model of the UK's care provision able to predict future overheating risks in care settings under a range of future climate change scenarios. This will help evaluate the effectiveness of near, medium and long term future overheating mitigation strategies and policies on thermal comfort and health outcomes. Throughout the project, we will continue to develop and expand the stakeholder community that was created during the pilot project. Through ongoing dialogue with our diverse network of stakeholders, we will explore organisational capacity and structures, and how these influence action and policy, in order to generate best practice guidance for practitioners, businesses and policymakers.