Scotland County health educator champions heat-health

Heat-related illness is a growing concern in North Carolina. According to climate models, there is an expected annual increase of 15 to 20 days with temperatures above 95 degrees between 2041 and 2070. There are around 4,000 emergency department visits for heat-related illness per heat season (May 1 through Sept. 30) in North Carolina. HRI disproportionately affects farmers, factory workers, people over the age of 65, and students. In general, people with limited access to temperature control (i.e. air conditioning) are more likely to be affected by HRI1,2,3.

The North Carolina Division of Public Health identified Scotland County and three other counties in the state as having high-risk populations for HRI. Scotland County is part of the Sandhills region, an area which is particularly at danger in the face of rising temperatures due to geography, demographics and other factors.

Kathie Cox, Heat Health Educator II/PIO and Heat Prevention Specialist with Scotland County Health Department, is working to educate county residents on HRI and to decrease the incidence of HRI. Her objective is to make information accessible and widely distributed, especially among high-risk groups such as student-athletes, non-native English speakers and seniors.

In order to reach people of all demographics, Cox utilizes creative and diverse methods to deliver information to Scotland County residents.

In recent articles published by the local newspaper in May, Cox recounted a personal narrative in which she spent hours in the heat mowing her lawn and, later that day, began experiencing symptoms of heat exhaustion. Through this account, Cox advised fellow residents of Scotland County to be aware of their own heat exposure and water intake as temperatures began to rise with the onset of the heat season. She explained that “62 percent of [heat] illness was among males, mostly among 25-44 year-olds,” and that emergency department visits commonly noted “working outdoors” and “recreation” for patients with HRI. Cox publishes such articles regularly, and likely reaches a wide audience in the newspaper’s readership.

Cox and the Scotland County Health Department also utilize social media to reach residents. Their Facebook page, with a following of nearly 300 people, spotlights a wide range of public health issues from opioid addiction to sunscreen use.

To talk to people directly about HRI, Cox has worked with churches around Scotland County. One church in particular is home to several Spanish-speaking residents. Cox provided them with information through a Spanish-speaking coworker. Reaching the members of this church gives Cox the opportunity to address concerns in a high-risk population which is often affected by a language barrier when receiving information via sources such as social media or radio. At various such speaking events, Cox has received feedback from people that they were surprised to hear that many different forms of HRI exist. Additionally, after listening to Cox speak, many people, both young and old, said that they were more likely to pay attention to weather reports and to take care of themselves when experiencing high heat.

In June 2018, Cox provided HRI informational postcards at a Men’s Community Health Night Out event in Scotland County. The series of postcards, originally created by NC DPH staff and edited by Cox and a colleague, are simple yet effective. On the front side, each postcard lists signs and symptoms of a different HRI. On the back side, the postcards state actions to take in the case of HRI. The postcards, shown below, use both words and images to appeal to a variety of age groups and learning levels.

Cox also provides information on cooling stations, provided by the Scotland County Health Department, which are available for use by adults and children. Additionally, at this event, cancer physicians will talk about skin cancer prevention and heat illness.

Cox has formed numerous other partnerships in Scotland County for individual- and community-level interventions. With the Scotland County Parks and Recreation Department, she has coordinated to distribute information to residents using the county’s outdoor facilities and the coaches and staff working with children. Through the United Way’s recent Safety Town program, she helped teach young children to never get inside a vehicle without adult supervision through the Spot-the-Tot program and has worked with school nurses to educate them on the various types of HRI. Additionally, she has partnered with high school coaching staff to address HRI in student-athletes. She has also informed the Laurinburg Housing Authority on the importance of proper cooling in homes and distributing HRI materials. Finally, Cox regularly provides HRI updates and bulletins to all county-wide staff.

Cox has worked to affect institutional awareness of HRI, as well. She has shared resources with the Board of Health and the Health Department to inform policy decisions. Additionally, she has spoken with N.C. State Rep. Garland E. Pierce to impress upon him the necessity to address HRI at a state and local level.

Her multipronged approach to decreasing heat-related illness in Scotland County shows evidence of success and continues to change the way people think about this significant public health concern