Heat Risk Perception and Vulnerability in Puerto Rico: Insights for Climate Adaptation in the Caribbean

Brenda Guzman-Colon, Zack Guido, Claudia P. Amaya-Ardila, Laura T. Cabrera-Rivera and Pablo A. Méndez-Lázaro ()
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Brenda Guzman-Colon: Department of Environmental Health, Graduate School of Public Health, University of Puerto Rico-Medical Sciences Campus, San Juan 00936-5067, Puerto Rico
Zack Guido: Arizona Institute for Resilience, University of Arizona, Tucson, AZ 85721, USA
Claudia P. Amaya-Ardila: Department of Biostatistics, Graduate School of Public Health, University of Puerto Rico-Medical Sciences Campus, San Juan 00936-5067, Puerto Rico
Laura T. Cabrera-Rivera: Department of Environmental Health, Graduate School of Public Health, University of Puerto Rico-Medical Sciences Campus, San Juan 00936-5067, Puerto Rico
Pablo A. Méndez-Lázaro: Department of Environmental Health, Graduate School of Public Health, University of Puerto Rico-Medical Sciences Campus, San Juan 00936-5067, Puerto Rico

IJERPH, 2025, vol. 22, issue 8, 1-23

Abstract: Extreme heat poses growing health risks in tropical regions, yet public perception of this threat remains understudied in the Caribbean. This study examines how residents in Puerto Rico perceived heat-related health risks and how these perceptions relate to vulnerability and protective behaviors during the extreme heat events of the summer of 2020. We conducted a cross-sectional telephone survey of 500 adults across metropolitan and non-metropolitan areas of Puerto Rico, using stratified probability sampling. The questionnaire assessed heat risk perception, sociodemographic characteristics, health status, prior heat exposure, and heat-related behaviors. While most participants expressed concern about climate change and high temperatures, fewer than half perceived heat as a high level of personal health risk. Higher levels of risk perception were significantly associated with being male, aged 50–64, unemployed, and in fair health, having multiple chronic conditions, and prior experience with heat-related symptoms. Those with symptoms were nearly five times more likely to report high levels of risk perception (OR = 4.94, 95% CI: 2.93–8.34). In contrast, older adults (65+), despite their higher level of vulnerability, reported lower levels of risk perception and fewer symptoms. Nighttime heat exposure was widespread and strongly associated with heat-related symptoms. Common coping strategies included the use of fans and air conditioning, though economic constraints and infrastructure instability limited access. The findings highlight the disparity between actual and perceived vulnerability, particularly among older adults. Public health strategies should focus on risk communication tailored to vulnerable groups and address barriers to heat adaptation. Strengthening heat resilience in Puerto Rico requires improved infrastructure, equitable access to cooling, and targeted outreach.

Keywords: heat risk perception; social vulnerability; climate adaptation; community resilience; Caribbean (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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