San Francisco’s Unique Heat and Air Quality Challenges

Known for its famously cool and damp summers, residents of San Francisco may not perceive the dangers they face from extreme heat events. Though temperatures on San Francisco’s hottest days of the year are usually cooler than those of many other cities, heat events in the City can take a heavy toll on public health. Buildings and infrastructure there were simply not designed to accommodate extreme temperatures. Additionally, most residents are not acclimatized to hot conditions when they occur. 

Tall, close buildings in San Francisco warm up under sunlight energy through the day. The urban environment offers little respite from extreme heat.

Historically, San Francisco experienced extreme heat events 3 to 4 times a year. By mid-century, however, according to the Cal-Adapt High Emissions Scenario, the City is projected to see an average of 7 extreme heat events per year. And especially hot years could see up to 25 extreme heat events. To prepare for these conditions, city health officials such as Matt Wolff are now working to minimize the health impacts of heat events through adaptation, mitigation, and emergency preparedness and response. 

A public health emergency

To date, San Francisco’s most severe heat wave occurred in 2017. On Friday, September 1st, temperatures reached 106°F, the highest temperature ever recorded in the City. Saturday brought another round of soaring temperatures—only the third time in history that temperatures reached triple digits two days in a row. 

Emergency preparedness and response agencies in the City disseminated public messaging and emergency alerts, activated the homeless outreach team, and opened cooling stations. Despite these efforts, the health impacts were still severe. The number of 911 calls received was nearly double its usual rate, putting a strain on emergency and health services. Hundreds of people in the City were hospitalized for heat illness and six people died.

Creating a Heat and Smoke Resilience Plan

At the time of this record-breaking heat event, Matt Wolff was working for the San Francisco Department of Public Health. An urban planner by training, Matt had been an analyst with the Climate Health Program, which was funded by CDC’s Climate Ready States and Cities Initiative. 

Matt saw that the city did not have a team focused on heat: he recognized that an interdisciplinary team would be necessary to create a comprehensive heat resilience plan. A complete planning team would need to include health and emergency response agencies to manage responses to heat and land use agencies that could adapt San Francisco’s built environment to help reduce sources of potential health impacts. Matt also noticed that emergency preparedness and response agencies did not have the capacity to build medium-to-long-term heat resilience strategies. He reflected, “We were like firefighters dealing with fire. A heat event would happen, we’d activate our plan to deal with it, and then we wouldn’t think about it until the next heat event.”  

Matt and his team wanted to change this dynamic by convening city departments to create a resilience plan for extreme heat and air quality. Matt had experienced that when resilience plans were created in isolation, there was difficulty gaining buy-in for implementation. This time, Matt wanted to foster partnerships that were effective and sustainable, ensuring the plan would be actualized. 

Matt also seized upon a policy window. He saw that there was a convergence of intensifying health risks, increased public attention and political will, and deepening knowledge of solutions. The Mayor’s Office issued Directive 18-04 to plan for heat resilience, and Matt was ready to bring public health expertise, skills, and partners together to respond. 

San Francisco's Heat and Air Quality Resilience plan (PDF download).

In his role at the Department of Public Health, Matt led efforts to convene community, public, private, and academic partners. He guided efforts to co-create a plan to address current heat and air quality events, and to proactively prepare for future events. The collaborative efforts produced San Francisco's Heat and Air Quality Resilience Plan. The plan outlines concrete steps to identify the public health impacts of extreme heat and wildfire smoke and implement evidence-based solutions.

Engaging Community Members

Matt knew that meaningful engagement with the community would be necessary to co-create a successful plan. Partners recruited 10 community-based organizations representing those areas of the City that were most impacted by poor air quality and extreme heat. The set of these organizations—known as the Community Readiness Team—facilitated direct participation with residents; engaging these frontline organziations was essential, as they are uniquely positioned to assess resident needs, convey messages, and distribute emergency resources. These groups also brought first-hand knowledge of air-conditioned public spaces that might serve as cooling centers during extreme heat events.

An Intentional Process Generated Important Insights

Matt and his staff facilitated six Community Readiness Team meetings to incorporate the priorities of the community-based organizations into building the plan. At each event, project staff tracked the number of organizations and participants and gathered additional information on how they could facilitate public input. 

The Community Readiness Team followed a five-step process to develop their plan:

1. Create objectives outlining the programs, services, and structure to build resilience to extreme heat and wildfire smoke.
2. Identify economic, political, and social barriers hindering resilience.
3. Conduct a landscape analysis to understand current actions.
4. Brainstorm strategies to support ongoing actions.
5. Prioritize strategies based on efficacy and feasibility.

Following the six meetings, staff interviewed each organization to generate potential strategies for overcoming barriers. They categorized themes into three topics: emergency response, weatherization, and communications.

Interviews revealed that many community members prefer to shelter in place during extreme heat or wildfire smoke emergencies. This preference is influenced by limited transportation access, poor communication, and insufficient programming at respite centers. This insight was incorporated into the Heat and Air Quality Resilience Plan: the plan stipulates that the City should support community-based organizations in managing specific building uses (e.g., senior housing complexes) to care for their clients—so they can accommodate preferences to shelter in place.

Takeaways from the Resilience Plan

San Francisco's Heat and Air Quality Resilience Plan highlights crucial lessons for those involved in developing climate change resilience strategies. One key lesson is to take advantage of policy windows when they open.  This entailed watching for trends that impact the well-being of community members, expanding political and leadership support, and keeping tabs on emerging solutions or coalescing agreements on specific strategies. Another key lesson is recognizing the central role of community engagement in emergency planning, exemplified by the active involvement of the Community Readiness Team. The final plan they developed emphasizes the need to tailor resilience plans to community needs, and to prioritize communication and relationship building.

Examples of strategies in the plan that are currently underway include adapting San Francisco’s buildings to reduce exposure to extreme heat and poor air quality, using health issues to help neighborhoods see the value of green infrastructure, and creating city services that can predict and adapt to climate-related stressors.