Association of Ethnic Background with Public Knowledge and Adaptive Behaviors Towards

Heatwaves in Pakistan
Farman Ullah1*, Francesco Barone-Adesi1,2, Ives Hubloue4, Luca Ragazzoni1,3 Martina Valente1,3
1 CRIMEDIM – Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health - Università del Piemonte Orientale (UPO), 28100 Novara, Italy
2 Department of Translational Medicine, Università del Piemonte Orientale (UPO), 28100 Novara, Italy
3 Department of Sustainable Development and Ecological Transition, Università del Piemonte Orientale (UPO), 13100 Vercelli, Italy
4 Research Group on Emergency and Disaster Medicine (REGEDIM), Vrije Universiteit Brussel (VUB), Brussels, Belgium

Introduction Figure 1. Individual Adaptive Behaviors and Ethnic Background Figure 3. Overall Adaptive Behaviors and Ethnic Background

Climate change-induced heatwaves are the leading weather-

related causes of death across the world. Since the mid-20th
century, the frequency and intensity of heatwaves have increased
with recent reports projecting substantial warming in temperature
extremes by the end of the 21st century. Heatwaves have long
been recognized as a serious public health threat. Developing
countries are particularly susceptible to heatwave impacts, partly
due to inadequate infrastructure and poor adaptation measures.
Effective adaptation measures can reduce the risks to people and
ecosystems. In this study, we attempted to assess public
knowledge and adaptive behaviors towards heatwaves across
Pakistan and analyze the association of ethnic background with
public knowledge and adaptive behaviors.

Methods Pearson chi2(4) = 19.9079 Pr = 0.001

Pearson
IQR, chi2(4) range
interquartile = 31.8442
from 25%Pr =
to0.000
75%; Score was expressed as the median (IQR). Total
This study is based on a cross-sectional study design. Data were Overall
322 adaptive behaviors
participants (100%) outwere calculated
of 322 by summing
responded up the
knowledge individual adaptive behaviors and
tests.
collected across Pakistan among a sample of volunteers aged 18 Figure 2. Household Adaptive Behaviors and Ethnic Background household adaptive behaviors

years and above registered with Alkidmat Foundation, Pakistan,

using an online survey questionnaire. Demographic data, as well as Table 1. Demographic characteristics of the participants
heatwaves knowledge (using 12 statements) and adaptive
behaviors at the individual level (14 statements) and household
level (16 statements), were collected. For heatwaves knowledge, a
3-point Likert scale was used while the adaptive behaviors were
measured using a 5-point Likert scale. Chi-square tests were used
for finding the association between ethnic background with
knowledge and adaptive behaviors.

Results
A total of 686 respondents filled out the survey. Most
respondents were in the age group 35-54 (45.92%), were male
(71.14%), and married (71.57%), 71.14% of them had higher
educational levels. Ethnicity-wise, most of the participants were
Pearson chi2(4) = 34.0095 Pr = 0.000
Pashtuns (34.99%), followed by Punjabis (17.78%), other ethnicities
(17.20%), Urdu Speakers (16.47%), and Sindhi and Baluchi
(13.56%). Islamabad (5.39%), and Gilgit Baltistan (2.92%). The
majority resided in urban areas (60.64%). Most of the people
showed a high level of heatwave knowledge (59.91%), however, no Conclusion
association was observed between ethnic background and
adaptive behaviors at any level. Most of the respondents had good
Heatwaves pose a significant threat to individuals as well as
individual (79.30%), household (70.12%), and overall adaptive
households. Policies and practices can be culturally tailored and
behaviors (66.47%). Chi-squared test show that there is a 1 Married refers to those who have been married and includes married, widowed, divorced, or separated.
should consider the unique needs of different ethnic groups. This can 2 Not employed means unemployed, students, retired, and those staying at home (e.g., housewives, etc.).
significant association between ethnic background and individual include targeted health education campaigns and community-based
3 Living with others means living with friends, close or extended family members.

adaptive behaviors (χ2(4) = 19.9079, p = 0.001), household

4 Other ethnicities included Kashmiri, Saraiki, Hindko, Brahvi, Balti, Shina, Wakhi, etc.
programs addressing' specific cultural and linguistic needs. This will * Pakistani Rupee (PKR)= 0.0061 USD as of August 2021

adaptive behaviors (χ2(4) = 34.0095, p = 0.000), and overall inform policies and practices to improve heatwave preparedness by
** Educational level classified according to the Pakistan Higher Education criteria.

adaptive behaviors (χ2(4) = 31.8442, p = 0.000). targeting specific ethnic groups and addressing cultural differences.