Building Heat-Resilient Cities

A Blueprint for Cooler Urban Futures

Extreme heat is fast becoming one of the most urgent urban challenges of our era. By 2035, nearly 43% of India’s population will live in cities, and for millions, rising temperatures will turn daily routines into daily battles. Picture the construction worker laboring under a relentless sun, a family struggling to sleep in a poorly ventilated home, and a child walking to school along heat-soaked streets. For them, heat is more than discomfort — it is a serious health risk — an economic strain, and at times, a threat to survival.

The encouraging news is that solutions already exist. Around the world, urban planners, governments, health systems, and communities are experimenting with innovative ways to cool cities and protect people. From redesigning neighborhoods with green cover and reflective surfaces, to equipping health systems to detect and treat heat-related illnesses, cities are proving that resilience is possible. Organizations like PCI India are already on the ground, mobilizing communities and health systems to ensure that adaptation reaches the most vulnerable.

The Urban Heat Trap

Urbanization is a double-edged sword. While it drives growth and opportunity, it also magnifies the dangers of heat. Cities experience the Urban Heat Island (UHI) effect, where temperatures rise several degrees higher than in nearby rural areas.

Why does this happen?

• Loss of greenery: Trees, wetlands, and open spaces are replaced by concrete and asphalt.
• Heat-retaining materials: Surfaces like cement and tarmac soak up heat during the day and release it slowly at night.
• Dense construction: Packed high-rises block natural airflow, trapping heat in crowded neighborhoods.
• Waste heat: Exhaust from vehicles, air conditioners, and industries further warm the air.

The impact is striking. In cities like Delhi and Mumbai, areas with little tree cover often record temperatures 4–7°C higher than greener suburbs. And the burden is not shared equally; the poorest residents, often living in cramped housing without cooling or shading, are hit the hardest. PCI India’s vulnerability assessments in urban settlements confirm that slum clusters and informal housing are disproportionately exposed to heat risks, particularly affecting women, children, and outdoor workers.

Why It Matters

Extreme heat isn’t just uncomfortable, it undermines health, livelihoods, and the very habitability of cities. Heatwaves kill more people worldwide than any other climate-related disaster. In South Asia, where populations are dense and infrastructure is strained, the risks are especially severe:

• Children are highly vulnerable to dehydration, heat exhaustion, and seizures.
• Older adults face elevated risks of cardiovascular stress and heatstroke.
• Outdoor workers—street vendors, construction laborers, delivery riders—spend long hours under direct sun, often without access to shade, water, or cooling.

But the ripple effects go far beyond health:

• Energy spiral : Rising demand for fans and air conditioners drives up electricity use, increasing emissions and deepening the crisis.
• Infrastructure strain: Road’s crack, rail lines warp, and water systems buckle under surging demand.
• Economic losses: By 2030, India could lose 5.8% of working hours to heat stress, with labor-intensive sectors hit the hardest.

Pathways to Cooler Cities

The good news? Cities can fight back. Solutions fall into three complementary categories: green, blue, and white.

Green Solutions: Cooling with Nature

• Shade trees along streets and highways can lower surrounding temperatures by up to 10°C.
• Green roofs and walls insulate buildings while cooling neighborhoods.
• Pocket parks—even small green spaces—serve as urban oases for communities.

Blue Solutions: Cooling with Water

• Restore lakes and ponds, which act as natural air conditioners.
• Rain gardens and bioswales capture stormwater while cooling the air.
• Public water features like fountains, canals, or misting systems add relief in plazas and squares.

White & Built Solutions: Reflect and Protect

• Cool roofs and pavements with reflective coatings bounce sunlight away.
• Climate-smart buildings with ventilation, shaded balconies, and insulation reduce indoor heat.
• District cooling systems provide centralized, energy-efficient cooling to multiple buildings.

Thoughtfully combining these interventions can transform urban heat from a silent threat into a manageable challenge, making cities safer, cooler, and more livable.

Adapting Health Systems to Rising Heat

While cooling cities is crucial, strengthening health systems is equally important to protect people from the heat that’s already here. Adaptation can save lives.

1. Early Warning & Response

• Implement heatwave alert systems via SMS, radio, and community platforms.
• Link warnings to action protocols adjust school hours, pause outdoor work, and prepare hospitals for heat-related cases.

2. Heat-Ready Healthcare Facilities

• Capacity building of service providers to recognize and treat heatstroke quickly.
• Equip primary health centers with essential supplies, oral rehydration solutions, IV fluids, misting and cooling fans.
• Maintain backup power and water systems to ensure hospitals function during peak heat.

3. Protecting the Health Workforce

• Provide frontline workers, ASHAs, ANM’s, and other outdoor staff, with heat safety kits (hats, hydration packs).
• Adjust duty schedules to avoid peak heat hours. 

4. Data & Surveillance

• Track heat-related illnesses and deaths using existing health information systems and conduct mortality audits.
• Conduct Vulnerability assessments for targeted and timely interventions

A Call to Action

As intensity and duration of heat intensifies, building heat-resilient cities is no longer optional, it is imperative. Extreme heat threatens health, productivity, and equity, but solutions are within reach:

• Green infrastructure to restore natural cooling.
• Blue interventions to harness water’s cooling power.
• White and built solutions to reflect heat and improve building efficiency.
• Adapted health systems ready to respond to heat emergencies.

PCI India’s programs ranging from urban vulnerability assessments to SHG-based heat adaptation demonstrate how communities, health systems, and governments can work together to protect lives. Every shaded street, restored lake, reflective rooftop, and trained health workers brings us closer to cooler, safer, and more equitable cities. The time to act is now. Together, we can ensure that India’s urban futures are livable, resilient, and prepared for the heat ahead.

The author is Dr Anuj Dandotia, Associate Director – Health and Nutrition, PCI India