Heat Perception and Coping Strategies: A Structured Interview-Based Study of Elderly People in Cologne, Germany
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Areas and Data Collection
2.2. Interview Topics
2.2.1. Demographic and Socioeconomic Characteristics
2.2.2. Perceived Heat Strain
2.2.3. Coping Strategies
2.2.4. Self-Reported Health and Functional Ability
2.3. Statistical Analysis
3. Results
3.1. Demographic, Socio-Economic, and Health-Related Characteristics of Participants
3.2. Perception of Heat Strain and Vulnerability
3.3. Heat Coping Strategies
3.4. Correlation of Coping-Strategies and Perception of Heat Strain, Socio-Economic, and Health-Related Factors
4. Discussion
4.1. Perception of Heat Strain and Vulnerability
4.2. Coping Strategies
4.3. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Number of People in Study Area (%) | Number of Contacted People | Number of People in Sample (%) |
---|---|---|---|
Study Area 1 | |||
Age Class I | 2510 (50.2) | 336 | 40 (58.0) |
Age Class II | 1898 (38.0) | 255 | 25 (36.2) |
Age Class III | 588 (11.8) | 79 | 4 (5.8) |
Study Area 2 | |||
Age Class I | 1007 (44.5) | 298 | 35 (50.7) |
Age Class II | 1034 (45.7) | 306 | 27 (39.1) |
Age Class III | 219 (9.7) | 65 | 7 (10.1) |
Study Area 3 | |||
Age Class I | 2436 (52.1) | 349 | 35 (59.3) |
Age Class II | 1713 (36.6) | 245 | 18 (30.5) |
Age Class III | 527 (11.3) | 76 | 6 (10.2) |
Study Area 4 | |||
Age Class I | 2075 (49.9) | 334 | 32 (52.5) |
Age Class II | 1568 (37.7) | 253 | 25 (41.0) |
Age Class III | 512 (12.3) | 82 | 4 (6.6) |
Variables | Men | Women | Chi-Quadrat | p-Value |
---|---|---|---|---|
n (%) | n (%) | |||
Age: mean (range) | 75 (65–93) | 74 (65–93) | ||
Age classes (n = 258) | n = 127 | n = 131 | ||
I: 65 to 74 years | 61 (48.0) | 81 (61.8) | χ2(2) = 5.846 | 0.054 |
II: 75 to 84 years | 56 (44.1) | 39 (29.8) | ||
III: over 84 years | 10 (7.9) | 11 (8.4) | ||
Living situation (n = 257) | n = 126 | n = 131 | ||
alone | 31 (24.6) | 64 (48.9) | χ2(2) = 16.212 | 0.000 *** |
with one other person | 88 (69.8) | 62 (67.3) | ||
with >2 people | 7 (5.6) | 5 (3.8) | ||
Monthly Household Income (n = 198) | n = 95 | n = 103 | ||
I (<1000 €) | 7 (7.4)) | 9 (8.7) | χ2(4) = 23.727 | 0.000 *** |
II (1000–<2000 €) | 21 (22.1) | 51 (49.5) | ||
III (2000–<3000 €) | 29 (30.5) | 19 (18.4) | ||
IV (≥3000 €) | 38 (40.0) | 24 (23.3) | ||
School leaving certificate (n = 245) | n = 121 | n = 124 | ||
I Academic secondary school | 60 (49.6) | 31 (25.0) | χ2(4) = 21.008 | 0.000 *** |
II Secondary school | 15 (12.4) | 6 (21.0) | ||
III Secondary general school | 46 (38.0) | 60 (48.4) | ||
IV No school certificate | 0 (0.0) | 4 (3.2) | ||
Former Occupation (n = 250) | n = 123 | n = 127 | ||
Self-employed | 13 (10.6) | 8 (6.3) | χ2(5) = 35.353 | 0.000 *** |
Employee or public servant in a managing position | 43 (35.0) | 19 (15.0) | ||
Employee or public servant | ||||
Skilled worker | 43 (35.0) | 71 (55.9) | ||
Worker | 21 (17.1) | 9 (7.1) | ||
Farmer | 3 (2.4) | 13 (10.2) | ||
Housewife/homemaker | 0 (0.0) | 0 (0.0) | ||
0 (0.0) | 7 (5.5) | |||
Academic Education (n = 258) | n = 127 | n = 131 | ||
Yes | 47 (37.0) | 20 (15.3) | χ2(1) = 15.854 | 0.000 *** |
No | 80 (63.0) | 111 (84.7) | ||
Self-reported health status (n = 226) | n = 124 | n = 129 | ||
Very good | 10 (8.10) | 10 (7.8) | χ2(4) = 3.423 | 0.49 |
Good | 58 (46.80) | 48 (37.2) | ||
Fair | 43 (34.70) | 54 (41.9) | ||
poor | 11 (8.90) | 12 (9.3) | ||
Very poor | 2 (1.60) | 5 (3.9) | ||
FA Index (n = 226) | n = 116 | n = 110 | ||
ROBUST | 82 (70.7) | 78 (70.9) | χ2(3) = 1 | 0.972 |
postROBUST | 14 (12.1) | 15 (13.6) | ||
preFRAIL | 11 (9.6) | 9 (8.2) | ||
FRAIL | 9 (7.8) | 8 (7.3) | ||
Social contacts (n = 256) | n = 125 | n = 131 | ||
Once or more a week | 102 (81.6) | 110 (84.0) | χ2(3) = 6.536 | 0.088 |
Two or three times a month | 11 (8.8) | 9 (6.9) | ||
Once per month | 8 (6.4) | 2 (1.5) | ||
Less than once per month | 4 (3.2) | 10 (7.6) |
Variables | Perception of Personal Heat Strain | ||||||
---|---|---|---|---|---|---|---|
No | Little | Moderate | Clearly | Very Much | Mann-Whitney U-Test (W) | ||
(%) | n (%) | n (%) | n (%) | n (%) | Kruskal-Wallis-Test (H) | ||
Gender | |||||||
Female | 8 (6.1) | 15 (11.5) | 60 (45.8) | 24 (18.3) | 24 (18.3) | W = 14294 | p = 0.002 ** |
Male | 14 (11.2) | 28 (22.4) | 50 (40.0) | 27 (21.6) | 6 (4.8) | ||
Age Class | |||||||
I: 65–74 years | 11 (7.8) | 28 (19.9) | 61 (43.3) | 24 (17.0) | 17 (12.1) | H = 1.260 | p = 0.532 |
II: 75–84 years | 8 (8.5) | 13 (13.8) | 39 (41.5) | 22 (23.4) | 12 (12.8) | ||
III: >84 years | 3 (14.3) | 2 (9.5) | 10 (47.6) | 5 (23.8) | 1 (4.8) | ||
Household size | |||||||
single | 10 (10.5) | 10 (10.5) | 37 (38.9) | 20 (21.1) | 11 (11.6) | H = 6.785 | p = 0.034 * |
with one other person | 12 (8.1) | 12 (8.1) | 68 (45.6) | 27 (18.1) | 16 (10.7) | ||
with more than one person | 0 (0.0) | 0 (0.0) | 4 (36.4) | 4 (36.4) | 3 (27.3) | ||
School leaving certificate | |||||||
I Academic secondary school | 11 (12.1) | 17 (18.7) | 39 (42.9) | 18 (19.8) | 6 (6.6) | H = 7.283 | p = 0.063 |
II Secondary school | 5 (12.2) | 6 (14.6) | 20 (48.8) | 9 (22.0) | 1 (2.4) | ||
III Secondary general school | 6 (5.5) | 16 (14.7) | 45 (41.3) | 23 (21.1) | 19 (17.4) | ||
IV No school certificate | 0 (0.0) | 1 (25.0) | 2 (50) | 0 (0.0) | 1 (25.0) | ||
Former Occupation | |||||||
Self-employed | 5 (23.8 | 3 (14.3) | 5 (23.8) | 7 (33.3) | 1 (4.8) | H = 12.340 | p = 0.030 * |
Employee or public servant in a managing position | 4 (6.5) | 19 (30.6) | 24 (38.7) | 12 (19.4) | 3 (4.8) | ||
Employee or public servant | |||||||
Skilled worker | 8 (7.0) | 16 (14.0) | 56 (49.1) | 19 (16.7) | 15 (13.2) | ||
Worker | 3 (10.3) | 2 (6.9) | 10 (34.5) | 9 (31.0) | 5 (17.2) | ||
Farmer | 2 (12.5) | 3 (18.8) | 7 (43.8) | 1 (6.3) | 3 (18.8) | ||
Housewife/homemaker | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | ||
0 (0.0) | 0 (0.0) | 2 (28.6) | 3 (42.9) | 2 (28.6) | |||
Household Income per month | |||||||
I (<1000 €) | 3 (18.8) | 2 (12.5) | 7 (43.8) | 2 (12.5) | 2 (12.5) | H = 12.790 | p = 0.005 ** |
II (1000–<2000 €) | 4 (5.6) | 7 (9.7) | 28 (38.9) | 21 (29.2) | 12 (16.7) | ||
III (2000–<3000 €) | 2 (4.2) | 12 (25.0) | 20 (41.7) | 9 (18.8) | 5 (10.4) | ||
IV (≥3000 €) | 6 (9.7) | 16 (25.8) | 28 (45.2) | 8 (12.9) | 4 (6.5) | ||
Self-reported health status | |||||||
Very good | 5 (25.0) | 6 (30.0) | 9 (45.0) | 0 (0.0) | 0 (0.0) | H = 40.452 | p = 0.000 *** |
Good | 12 (11.4) | 25 (23.8) | 45 (42.9) | 15 (14.3) | 8 (7.6) | ||
Fair | 1 (1.0) | 11 (11.3) | 46 (47.4) | 25 (25.8) | 14 (14.4) | ||
Poor | 2 (8.7) | 0 (0.0) | 6 (26.1) | 10 (43.5) | 5 (21.7) | ||
Very poor | 0 (0.0) | 1 (14.3) | 2 (28.6) | 1 (14.3) | 3 (42.9) | ||
FA Index | |||||||
ROBUST | 15 (9.2) | 34 (20.9) | 76 (46.6) | 23 (14.1) | 15 (9.2) | H = 12.797 | p = 0.005 ** |
postROBUST | 1 (3.0) | 3 (9.1) | 15 (45.5) | 12 (36.4) | 2 (6.1) | ||
preFRAIL | 4 (14.8) | 2 (7.4) | 10 (37.0) | 5 (18.5) | 6 (22.2) | ||
FRAIL | 2 (6.1) | 4 (12.1) | 9 (27.3) | 11 (33.3) | 7 (21.2) | ||
Social contacts | |||||||
Once or more per week | 19 (9.0) | 36 (17.1) | 91 (43.1) | 44 (20.9) | 21 (10.0) | H = 4.809 | p = 0.186 |
Two or three times per month | 2 (10.0) | 4 (20) | 10 (50.0) | 1 (5.0) | 3 (15.0) | ||
Once per month | 0 (0.0) | 1 (10.0) | 5 (50.0) | 3 (30.0) | 1 (10.0) | ||
Less than once per month | 1 (7.1) | 2 (14.3) | 3 (21.4) | 3 (21.4) | 5 (35.7) | ||
Living in house vs. flat | |||||||
Flat | 16 (9.5) | 29 (17.2) | 66 (39.1) | 35 (20.7) | 23 (13.6) | W = 10893.500 | p = 0.592 |
House | 6 (6.9) | 14 (16.1) | 44 (50.6) | 16 (18.4) | 7 (8.0) | ||
Objective heat strain | |||||||
High | 12 (9.3) | 22 (17.1) | 53 (41.1) | 29 (22.5) | 13 (10.1) | W = 16461.0 | p = 0.838 |
Low | 10 (7.9) | 21 (16.5) | 57 (44.9) | 22 (17.3) | 17 (13.4) |
Coping Strategy | n (%) |
---|---|
Body-related strategies | |
Wear less or thinner clothes | 256 (99.2) |
Drink more fluids | 206 (79.8) |
Eat differently | 195 (75.6) |
Shower more frequently | 183 (70.9) |
Cooling arms with water | 78 (30.2) |
Using wet towel | 60 (23.3) |
Cooling feet with water | 59 (19.4) |
Home-protective strategies | |
Open windows for ventilation | 250 (96.9) |
Use thinner bedding | 237 (91.9) |
Close blinds/shutters | 221 (85.7) |
Turn on fan | 122 (47.3) |
Air Conditioning | 10 (3.9) |
Activity-related strategies | |
Less physical activity | 207 (80.2) |
Reschedule activities | 198 (76.7) |
Variables | Body-Related Coping Strategies | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Drink More Fluids | Eat Differently | Shower More Frequently | Cool Arms with Water | Use Wet Towels | Cool Feet with Water | |||||||
Chi2 | p-Value | Chi2 | p-Value | Chi2 | p-Value | Chi2 | p-Value | Chi2 | p-Value | Chi2 | p-Value | |
Gender | χ2(1) = 2.469 | 0.116 | χ2(1) = 2.670 | 0.102 | χ2(1) = 0.326 | 0.568 | χ2(1) = 7.945 | 0.005 * | χ2(1) = 3.711 | 0.054 | χ2(1) = 2.112 | 0.146 |
Age classes | χ2(2) = 4.117 | 0.128 | χ2(2) = 12.096 | 0.002 ** | χ2(2) = 6.979 | 0.031 * | χ2(2) = 2.661 | 0.264 | χ2(2) = 1.670 | 0.434 | χ2(2) = 2.914 | 0.233 |
School Leaving Certificate | χ2(3) = 8.045 | 0.045 * | χ2(3) = 6.866 | 0.760 | χ2(3) = 3.216 | 0.360 | χ2(3) = 2.078 | 0.556 | χ2(3) = 4.783 | 0.188 | χ2(3) = 0.942 | 0.815 |
Former Occupation | χ2(5) = 9.200 | 0.101 | χ2(5) = 7.2740 | 0.201 | χ2(5) = 4.115 | 0.533 | χ2(5) = 6.577 | 0.254 | χ2(5) = 4.233 | 0.516 | χ2(5) = 10.563 | 0.061 |
Household Income per month | χ2(3) = 6.753 | 0.080 | χ2(3) = 2.631 | 0.452 | χ2(3) = 4.773 | 0.189 | χ2(3) = 8.989 | 0.029 * | χ2(3) = 8.042 | 0.045 * | χ2(3) = 5.387 | 0.146 |
Health Status | χ2(4) = 9.41 | 0.919 | χ2(4) = 3.761 | 0.439 | χ2(4) = 6.959 | 0.138 | χ2(4) = 16.319 | 0.003 ** | χ2(4) = 9.210 | 0.056 | χ2(4) = 5.339 | 0.254 |
Lucas Functional Index | χ2(3) = 4.014 | 0.260 | χ2(3) = 6.565 | 0.087 | χ2(3) = 13.145 | 0.004 ** | χ2(3) = 3.284 | 0.350 | χ2(3) = 3.497 | 0.321 | χ2(3) = 0.924 | 0.820 |
GP Consultation | χ2(1) = 0.354 | 0.553 | χ2(1) = 0.642 | 0.423 | χ2(1) = 1.700 | 0.192 | χ2(1) = 0.921 | 0.337 | χ2(1) = 0.021 | 0.884 | χ2(1) = 1.943 | 0.163 |
Social Contacts | χ2(3) = 7.243 | 0.065 | χ2(3) = 0.522 | 0.907 | χ2(3) = 3.340 | 0.342 | χ2(3) = 3.025 | 0.388 | χ2(3) = 2.540 | 0.468 | χ2(3) = 0.948 | 0.814 |
Household size | χ2(2) = 8.086 | 0.018 * | χ2(2) = 4.531 | 0.104 | χ2(2) = 3.271 | 0.195 | χ2(2) = 2.318 | 0.314 | χ2(2) = 1.547 | 0.461 | χ2(2) = 0.688 | 0.709 |
Objective Heat Strain (area) | χ2(1) = 0.507 | 0.477 | χ2(1) = 0.228 | 0.633 | χ2(1) = 0.047 | 0.828 | χ2(1) = 0.036 | 0.850 | χ2(1) = 5.241 | 0.022 * | χ2(1) = 0.065 | 0.800 |
House or Flat | χ2(1) = 4.069 | 0.044 * | χ2(1) = 0.985 | 0.321 | χ2(1) = 0.489 | 0.484 | χ2(1) = 1.734 | 0.188 | χ2(1) = 6.924 | 0.009 | χ2(1) = 0.000 | 0.986 |
Variables | Home-Protective Coping Strategies | |||||||
---|---|---|---|---|---|---|---|---|
Open Windows | Close Blinds/Shutters | Turn on Fan | Air Conditioning | |||||
Chi2- | p-Value | Chi2 | p-Value | Chi-Quadrat | p-Value | Chi2 | p-Value | |
Gender | χ2(1) = 1.445 | 0.229 | χ2(1) = 0.303 | 0.582 | χ2(1) = 0.969 | 0.325 | χ2(1) = 0.483 | 0.487 |
Age classes | χ2(2) = 3.991 | 0.136 | χ2(2) = 0.352 | 0.839 | χ2(2) = 0.978 | 0.613 | χ2(2) = 0.121 | 0.941 |
School Leaving Certificate | χ2(3) = 2.660 | 0.447 | χ2(3) = 0.542 | 0.910 | χ2(3) = 2.039 | 0.564 | χ2(3) = 3.563 | 0.313 |
Former Occupation | χ2(5) = 5.162 | 0.396 | χ2(5) = 6.465 | 0.264 | χ2(5) = 8.567 | 0.128 | χ2(5) = 8.000 | 0.156 |
Monthly Household Income | χ2(3) = 3.871 | 0.276 | χ2(3) = 3.610 | 0.307 | χ2(3) = 0.879 | 0.831 | χ2(3) = 10.067 | 0.018 * |
Health Status | χ2(4) = 5.856 | 0.210 | χ2(4) = 14.393 | 0.006 * | χ2(4) = 6.458 | 0.167 | χ2(4) = 2.395 | 0.663 |
Lucas Functional Index | χ2(3) = 1.316 | 0.725 | χ2(3) = 0.864 | 0.834 | χ2(3) = 2.808 | 0.422 | χ2(3) = 2.158 | 0.540 |
GP Consultation | χ2(1) = 0.710 | 0.399 | χ2(1) = 2.039 | 0.153 | χ2(1) = 0.830 | 0.362 | χ2(1) = 0.014 | 0.906 |
Social Contacts | χ2(3) = 26.456 | 0.000 *** | χ2(3) = 0.685 | 0.877 | χ2(3) = 2.618 | 0.454 | χ2(3) = 1.675 | 0.642 |
Household size | χ2(2) = 0.403 | 0.818 | χ2(2) = 1.634 | 0.442 | χ2(2) = 4.221 | 0.121 | χ2(2) = 7.525 | 0.023 * |
Objective Heat Strain (area) | χ2(1) = 0.155 | 0.694 | χ2(1) = 0.0.239 | 0.625 | χ2(1) = 0.014 | 0.906 | χ2(1) = 6.788 | 0.009 |
House or Flat | χ2(1) = 0.103 | 0.749 | χ2(1) = 1.931 | 0.165 | χ2(1) = 1.472 | 0.225 | χ2(1) = 5.963 | 0.015 * |
Variables | Activity-Related Coping Strategies | |||
---|---|---|---|---|
Reduce Physical Activity | Reschedule Activities | |||
Chi2- | p-Value | Chi2- | p-Value | |
Gender | χ2(1) = 1.677 | 0.195 | χ2(1) = 0.974 | 0.324 |
Age classes | χ2(2) = 0.612 | 0.736 | χ2(2) = 3.756 | 0.153 |
School Leaving Certificate | χ2(3) = 1.975 | 0.578 | χ2(3) = 0.992 | 0.803 |
Former Occupation | χ2(5) = 4.412 | 0.492 | χ2(5) = 2.017 | 0.847 |
Household Income per month | χ2(3) = 2.912 | 0.405 | χ2(3) = 5.130 | 0.162 |
Health Status | χ2(4) = 7.905 | 0.095 | χ2(4) = 1.857 | 0.762 |
Lucas Functional Index | χ2(3) = 6.555 | 0.088 | χ2(3) = 6.320 | 0.097 |
GP Consultation | χ2(1) = 0.054 | 0.816 | χ2(1) = 0.255 | 0.614 |
Social Contacts | χ2(3) = 0.726 | 0.867 | χ2(3) = 0.336 | 0.953 |
Household size | χ2(2) = 0.422 | 0.810 | χ2(2) = 2.273 | 0.321 |
Objective Heat Strain (area) | χ2(1) = 0.173 | 0.678 | χ2(1) = 0.732 | 0.392 |
House or Flat | χ2(1) = 0.380 | 0.537 | χ2(1) = 1.543 | 0.214 |
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Kemen, J.; Schäffer-Gemein, S.; Grünewald, J.; Kistemann, T. Heat Perception and Coping Strategies: A Structured Interview-Based Study of Elderly People in Cologne, Germany. Int. J. Environ. Res. Public Health 2021, 18, 7495. https://doi.org/10.3390/ijerph18147495
Kemen J, Schäffer-Gemein S, Grünewald J, Kistemann T. Heat Perception and Coping Strategies: A Structured Interview-Based Study of Elderly People in Cologne, Germany. International Journal of Environmental Research and Public Health. 2021; 18(14):7495. https://doi.org/10.3390/ijerph18147495
Chicago/Turabian StyleKemen, Juliane, Silvia Schäffer-Gemein, Johanna Grünewald, and Thomas Kistemann. 2021. "Heat Perception and Coping Strategies: A Structured Interview-Based Study of Elderly People in Cologne, Germany" International Journal of Environmental Research and Public Health 18, no. 14: 7495. https://doi.org/10.3390/ijerph18147495