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和更干燥的夏季，热浪预计将以更高的频率、强度和持续时间发生。2003年和2018年，仅在英国就有2091人和863人因热浪而死亡，这意味着未来气温的上升可能会导致与高温相关的死亡率平行上升。英国目前的人口老龄化速度也很快，预计到2035年，75岁或以上的人口将占总人口的13%。老年人口更容易受到气候诱导的影响，因为他们更有可能出现潜在的慢性健康并发症，使他们更容易受到热应激的影响。在老年人中，室内环境是热暴露的主要调节因素，他们倾向于将大部分时间花在室内。糟糕的建筑设计、缺乏有效的热管理以及护理环境中工作人员和居民之间的需求和偏好不同，可能会增加室内热暴露，对最脆弱的居民造成有害的健康影响。对气候变暖的不适应，如安装空调，可能会增加疗养院的燃料账单，增加本已财政紧张的护理部门的企业运营成本，并增加建筑物碳排放，从而破坏政府减少温室气体排放的努力。由我们的研究团队领导的为期一年的试点项目“关怀环境的气候弹性”和之前的小规模研究表明，即使在非极端的夏天，英国的养老院也已经过热了。护理环境中气候适应的一个关键目标是通过建筑设计引入被动降温策略来限制此类风险。然而，作为试点项目的一部分的初步模拟也表明，普通的被动冷却战略可能不足以缓解本世纪50年代和80年代的过热风险。需要结合人类行为和组织变化对先进的被动降温策略进行进一步研究，以确定英国护理机构适应气候的最佳途径。该项目的主要目标是量化全国护理机构中与气候相关的热风险，并加强对人类行为、组织能力和治理的理解，使英国的护理机构能够制定公平的适应途径，以应对气候变化下不断上升的高温压力。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个护理环境中的纵向温度和湿度数据，以量化夏季过热的复发风险。我们亦会透过向院友、前线护理人员、管理人员和政策持份者进行调查，找出和评估社会、制度和文化上的障碍和机会，以支持安老院舍的管治，以适应护理院舍更温暖的气候。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，并研究它们与热暴露和健康影响的关系。此外，我们还将在英国首次创建英国护理服务的建筑库存模型，该模型能够在一系列未来气候变化情景下预测护理环境中未来的过热风险。这将有助于评估关于热舒适性和健康结果的近期、中期和长期未来过热缓解战略和政策的有效性。在整个项目中，我们将继续发展和扩大在试点项目期间创建的利益相关者社区。通过与我们不同利益攸关方网络的持续对话，我们将探索组织能力和结构，以及这些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.