288 - Parental Heat Safety Practices for Children During Extreme Weather: Evidence from a Statewide Survey

Publication Number: 2278.288

Ashley P. Keese, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Annika Macy, Ann & Robert H. Lurie Children's Hospital of Chicago, Evanston, IL, United States; Carly Menker, University of Illinois College of Medicine, Chicago, IL, United States; MIchelle Macy, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Marie Heffernan, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States

Background: Children are especially vulnerable to heat-related illness due to their higher body surface area-to-mass ratio, dependence on caregivers, and limited thermoregulation. Forecast models suggest heat-related deaths will roughly double by 2036-2065 in the United States. As heat events increase in frequency and intensity, understanding caregiver engagement in heat safety practices is critical for building climate resilience and for guiding outreach and clinical education.

Objective: To characterize the prevalence and sociodemographic correlates of three heat safety practices for children (hydration, heat-appropriate clothing, and activity modification) among Illinois parents.

Design/Methods: A cross-sectional survey of 1,078 Illinois parents was administered via NORC from September to October 2024 through the Voices of Child Health in Illinois program. Weighted analyses accounted for the combined probability and nonprobability sampling design. Parents reported if, during hot weather, they (1) encouraged children to drink more water, (2) dressed them in light clothing, and (3) limited outdoor activity or ensured regular rest breaks. We conducted descriptive and weighted logistic regression analyses to examine associations between practices and parent race and ethnicity, education, income, urbanicity, child school type, and child primary care access.

Results: Most parents (84%) encouraged children to drink water during hot weather, 67% dressed children in light clothing. Fewer parents reported that they limited outdoor time (43%) or ensured rest breaks (58%). Hispanic parents were more than twice as likely as Black, non-Hispanic parents to report encouraging hydration (aOR 2.49; 95% CI 1.10-5.64). Parents with higher income were less likely to report using light clothing (aOR 0.44; 95% CI 0.21-0.94). Limiting outdoor activity was most common among parents of children < 5 years (58%) and Hispanic parents (54%).

Conclusion(s): While hydration and heat-appropriate clothing were commonly practiced among Illinois parents, activity modification and rest were less consistently reported. Demographic differences highlight opportunities for tailored public health messaging and integration of heat safety guidance into pediatric care. Strengthening clinical communication about heat safety, especially in anticipation of warmer months, can help reduce children's vulnerability to HRI.

Table 1. Weighted Characteristics of Survey Respondents (N = 1,078)
Note. FPL =Federal poverty level.
There were no responses in the sample who reported their gender as ""Non-binary or third gender"" or ""An identity not listed""; 4 respondents did not list a gender.
Household child age was categorized as children 0-5 years (early childhood), all children 6-10 years (middle childhood), or ≥1 child 11 years or older (adolescence).

Table 2. Weighted Distribution of Parental Heat Safety Behaviors Among Illinois Families, 2024
Note: p-values are from Rao-Scott χ² tests comparing proportions across groups. Analyses account for survey design and weighting. FPL = federal poverty level.

Table 3. Adjusted Odds Ratios for Parental Heat Safety Practices by Sociodemographic Characteristics, Illinois Parents, 2024
Note. CI = confidence interval. LB = lower bound. UB = upper bound. Bolded values are statistically significant because the odds ratio does not include 1.0.