Extreme heat kills more people in many countries than any other weather hazard, yet it rarely commands the attention given to storms or floods. That is changing: heat-health action plans, once a specialist idea, are becoming a routine responsibility of city governments, with named officials, trigger temperatures and rehearsed responses.
What a heat plan actually does
A typical plan links weather forecasts to a ladder of actions. At the first threshold, public messaging begins and care homes are reminded of protocols. Higher thresholds trigger cooling centres, extended pool and library hours, checks on people living alone, and changes to outdoor work schedules.
The evidence behind these measures comes from bitter experience. Cities that introduced plans after deadly heatwaves have documented substantially smaller rises in mortality during later events of similar intensity, suggesting the systems work when they are maintained rather than left on a shelf.
The people most at risk
Heat danger concentrates: older people, infants, outdoor workers, athletes, and those with heart, lung or kidney conditions or on certain medications. Social isolation multiplies the risk, which is why effective plans are as much about neighbourhood networks as about air conditioning.
Housing quality is the other great divider. A well-insulated flat with shutters behaves very differently in a heatwave from a top-floor room under a dark roof, and long-term heat policy is increasingly about retrofitting the worst stock first.
Preparing before the thermometer agrees
The hardest part of heat planning is that the dangerous days are forecast with confidence only a few days ahead, while the assets that matter, trained staff, stocked cooling centres, agreements with care providers, must exist before the season starts. Good plans therefore work to a calendar, not just a forecast.
Exercise is part of it. Some cities now run heat drills the way others rehearse flood response, walking through the decisions of a five-day extreme event in a morning. The drills reliably surface mundane problems: a cooling centre whose keys sit with one person, a call list that is two years out of date.
Communication research adds a subtlety: warnings work best when they are specific about actions and timing rather than general about danger. Telling people to check on neighbours on Thursday evening, when nights will not cool, saves more lives than telling them summer is getting hotter.
The wider context
Urban heat is where climate change becomes most personal. Global average temperature rises sound abstract; the temperature of a particular bedroom in a particular heatwave is not. Because cities amplify heat through their surfaces and waste energy, the urban experience of a warming climate runs several degrees ahead of the surrounding countryside.
Adaptation spending is beginning to reflect that. Insurers, public health agencies and city treasuries all have financial reasons to care about shade, ventilation and resilient housing stock, and cost-benefit analyses increasingly find that cooling measures pay for themselves in avoided illness and lost working hours. The obstacle is rarely the science; it is the competition for land, money and attention against every other urban priority.
Naming the heat
Some cities now appoint chief heat officers and give severe heatwaves names, borrowing from storm practice to raise public salience. The experiments are debated, but the underlying insight is sound: an invisible hazard needs deliberate communication to compete for attention.
Employers are being pulled into the frame as well, with guidance and in some places legal duties around water, rest and shade for outdoor work, and adjusted hours during the most dangerous periods.
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Further reading: World Health Organization and NOAA.
Heat planning lacks drama, which is precisely its challenge and its strength. Done well, it becomes as unremarkable as gritting roads in winter, a quiet system that saves lives every summer without making headlines.

