Beat the Heat: Impacts of Heat on Health in Boston and Strategies to Address Them
The goal of this stepped wedge trial is to assess the practical effects of air conditioners on hot weather impacts among older adults. The main questions it aims to answer are: How does the presence of an air conditioning unit affect heat stress, heat strain, mental health, and healthcare utilization among older adults who did not previously have access to air conditioning? How, and in what conditioners, do older adults use air conditioning once it is installed in their home? Researchers will compare participants in arms with (A) and without (B) air conditioning units in the first summer season; this will allow them to assess the effect of air conditioners. In the second summer season, both arms will have air conditioning units, but those in the year two distribution arm (B) will receive an electricity subsidy, while those in the year one AC distribution arm (A) will not, allowing researchers to assess the effect of an electricity subsidy. Participants will be randomized to receive an air conditioner and financial support for electricity costs in either the first summer season or the second summer season of the study. * Heat stress, heat strain, mental health, and healthcare utilization will be assessed via participant survey. * Air conditioner utilization will be assessed via continuous load monitoring devices. * Indoor air temperature will be assessed via continuous data loggers.
• reside in Roxbury, Dorchester, East Boston or Mattapan MA
• age 55-95 years old
• speak English or Spanish
• do not have air conditioning in the home
• living with at least one of the following conditions: chronic CVD (hypertension, hyperlipidemia, diabetes, history of stroke or myocardial infarction, atrial fibrillation, or heart failure), chronic pulmonary disease (asthma, COPD/emphysema, interstitial lung disease), chronic neurologic disease (stroke, Parkinson's disease, or other chronic neurologic conditions), chronic mental health conditions (including anxiety disorder, major depression, bipolar disorder), and/or history of hospitalization (defined as spending at least one night in the hospital) for any reason within the past three years.