Miqdad Asaria – Heatwaves don’t affect us all equally

Heatwaves not only affect the poor much more than the rich, they also contribute to widening inequality between the classes.

Miqdad Asaria is an Assistant Professor at the Department of Health Policy at LSE and co-director of the MSc in Health Data Science. He is also visiting fellow at the REAL Centre at The Health Foundation and an affiliate of the LSE Data Science Institute.

Cross-posted from LSE Politics blog

Picture by Hong Kong Free Press

Interim estimates suggest that almost 3,000 people died in England due to heat associated causes in May and June of 2026. This number already approaches previous records for total annual heat related deaths in the country in 2022, without considering the further deaths likely to occur as the long hot summer continues. Analysis of heat associated deaths from previous years suggests that these death rates are highest in the elderly (age 85 and over) especially those in care homes and hospitals with the most common recorded causes of death being respiratory and cardiovascular disease.

Alongside these deaths in the elderly, heatwaves also result in a range of negative health outcomes for those most susceptible, particularly those with existing health conditions. The heat and associated lack of sleep worsens symptoms in those with underlying psychiatric conditions ranging from exacerbating depression and anxiety to triggering manic episodes and suicide in people with more severe mental illness. During heatwaves pregnant women are also more susceptible and increasingly likely to experience adverse pregnancy outcomes which more often result in pre-term births and poor neonatal health outcomes.

At the same time the heat places stress on our already fragile health and care system, both in terms of dealing with a surge of patients experiencing the negative impacts of heat exposure as well as through the melt down of infrastructure not built for the heat. This and the lack of cooling results in thousands of operations being cancelled , unsafe working conditions for staff and ultimately worse health outcomes for patients.

Whilst some groups in the population are particularly vulnerable to heat not everyone is equally exposed. Socially marginalised groups are the least able to shield themselves from the worst impacts of heat. This increased exposure, termed the cooled versus cooked divide by Jeff Goodell, permeates across all areas of home and work life and occurs across every key life stage. In reality this divide manifests as a continuous gradient rather than a simple binary; however, examining the extremes will help us to identify key challenges.

How different neighbourhoods fare in heatwaves

Wealthy neighbourhoods with tree lined streets and large amounts of green space are significantly cooler than densely populated built-up areas that amplify the heat in the daytime and retain heat into the night experiencing what is called the urban heat island effect where low-income and ethnic minority families are concentrated. These same neighbourhoods are also exposed to much higher levels of air pollution .

Whilst wealthy families can retreat to their cool homes, private swimming pools and golf courses that remain well watered despite the widespread hosepipe bans , poorer families are told to stay away from the few parched trees in their neighbourhoods as they start to shed branches becoming a danger to those sitting under them . Lacking access to public swimming pools , with over 500 closed due to the last decade and a half of austerity, poor children seek respite from the heat in rivers, lakes and reservoirs risking drowning .

How different housing fare in heatwaves

Housing also plays a major role in exposure to heat. There are many ways that homes can be adapted to stay cool from installing exterior blinds and planting trees to installing sustainable cooling based around air source heat pumps powered by solar panels. However, most of these require substantial upfront investment and entail making changes to the property and hence are only applicable to wealthy owner occupiers.

Low-income and ethnic minority families, who typically live in privately and socially rented housing, are most at risk from poorly designed and inadequately insulated dangerously hot homes that they do not have the means or permission to adapt. Even when poorer families are housed in temporary housing equipped with in-built air conditioning they are often prohibited from using it by their landlords, whilst the homeless have even less respite from the heat which compounds the many challenges they already navigate.

How different schools fare in heatwaves

Children from wealthy families are driven to school in air-conditioned SUVs, whilst poor children navigate sweltering tubes and buses . Once at school, wealthy children can play in their well watered lush green sports fields with private schools having 41 per cent more tree shade than state schools. As temperatures soar outside, rich children retreat to their air-conditioned classrooms (where air conditioning is not already available it is donated by their wealthy parents ). Meanwhile, poorer children are left to suffer in unbearable conditions in ovenlike classrooms surrounded by black asphalt playgrounds and have been reported as crying for their mummies in desperation at their dire predicament.

These hotter conditions unsurprisingly result in poorer cognition and lower test scores and occur at precisely the time of year when national exams are held widening the achievement gap between wealthy and poor children. Eventually, it gets so hot that schools without cooling start to shut down , sending poor children back to their dangerously hot homes located in their densely populated neighbourhoods leaving them to navigate the impacts of the urban heat island effect with their parents who have to rearrange work to manage additional unplanned childcare responsibilities.

How heatwaves affect women differently

As schools close , it is predominantly the mothers of children that forgo work to take on the additional unexpected childcare. For low-income mothers this typically entails losing income and risking being sacked . During heatwaves, women are also subjected to higher levels of sexual abuse outside the home and domestic violence at home. This compounds the already increased susceptibility to the negative impacts of heat on pregnant, menopausal and menstruating women.

How heatwaves affect you differently depending on your work

ork is another dimension starkly highlighting the differential exposure to heat between the comfortable, in their steady careers working in air-conditioned offices easily able to switch to working from home as the need arises, and those working outdoors in construction, agriculture and precarious gig-economy jobs termed the eco-precariat . For these eco-precariat workers, whose work-life is dictated by uncaring algorithms making them race against gamified targets through the midday sun delivering packages to save the wealthy from the discomfort of leaving their air-conditioned homes, there is no escaping the heat without sacrificing their livelihoods.

The UK has no official guidance for maximum workplace temperature. With rising temperatures on public transport, bus drivers have been particularly exposed to the relentless heat threatening to strike if substantial measures are not taken to improve their working conditions. Whilst unionised labour has the possibility to strike, no such protection is afforded to the eco-precariat who are classed as self-employed.

How intersectionality compounds the effects of heatwaves

Many of these inequalities intersect and compound in complex ways , to illustrate this, let’s take the example of a pregnant Bangladeshi woman in overcrowded social-rented housing in Tower Hamlets who is also doing platform delivery work, sitting inside the urban heat island, forbidden by her landlord from adapting her house to protect her from the heat. As her older children’s school closes due to the heatwave she is unable to go out to work and get paid and the heat results in her giving birth prematurely whilst her older children miss school and struggle through their exams after days of poor sleep and an over-heated school exam hall.

What can we do to better adapt to heatwaves

Heatwaves are not only deadly, they also impact all areas of our lives and livelihoods exacerbating the divide between the socially marginalised and the privileged. The response to heatwaves so far in the UK has been largely to leave people to privately adapt themselves whether through installing air conditioning in their homes or sponsoring tree planting in their local neighbourhoods. Air conditioning whilst very effective at cooling homes is expensive to install and run , largely limited to those who own their own homes, and works by exporting heat into the street and emissions into the atmosphere exacerbating both climate change and the urban heat island effect for those who do not have air conditioning. These carbon-intensive, privately hoarded cooling solutions are collectively maladaptive, allowing the wealthy to buy their way out of facing the impacts of climate change whilst simultaneously making the impacts of climate change worse for everyone else.

An alternative and more wholesome approach adapts to these conditions at a societal level, recognising the disparities in exposure and vulnerability to heat. Part of it is regulation: legally mandated maximum temperatures to protect workers, and building regulations and renters rights protections to compel landlords to adapt housing. The rest is investment in public services, embracing the ethos of private sufficiency coupled with public luxury , whilst designing adaptation, where possible, to carry net mitigation co-benefits. That means turning community spaces such as libraries and swimming pools into public cooling centres, shifting cooling from the private to the public sphere; building free, climate-controlled public and active transport to displace polluting private cars; investing in passive retrofitting, shading and communal low-carbon heating and cooling in schools, hospitals, care homes and social housing, following cities such as Paris and Geneva ; and building more parks, lakes and rivers in the neighbourhoods where low-income and ethnic minority families live. This is a chance to revive the ambition that built the public baths , the free library movement and the public parks once opened so that working people in industrial cities could find air and shade, and to reverse a decade and a half of austerity that has closed hundreds of local libraries and public swimming pools. Regulation and passive retrofit can deliver large gains in both equity and carbon at modest cost; the bigger infrastructure would need serious investment, perhaps funded by the wealth taxes now gaining momentum, which would have the additional benefit of curtailing inequality.

Ultimately, adaptation to extreme temperatures can only take us so far. We also need to urgently mitigate our impacts on climate change preventing further warming and tackle the inequality plaguing our societies that drive climate change and hinder any attempt to tackle it.

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