IMPLICATIONS This brief highlights mental well-being as an underexplored dimension of heat vulnerability in Chinese cities, identifying barriers like inadequate cooling infrastructure, limited institutional support, and insufficient social support. Our spatial analyses reveal urban heat distribution patterns, with areas of lower vegetation showing higher vulnerability scores. We also note discrepancies in indicator classification, such as the older population being used as a sensitivity measure versus exposure across the literature, underscoring the need for standardised methodologies to ensure comparable findings. However, our work has limitations. Firstly, we only included Summer 2023 data, which restricts the temporal generalisability of our findings. Secondly, our use of coarse adaptation data may result in the omission of fine-grained variations in how individuals respond to extreme heat. Moreover, there are cultural sensitivities and potential recall bias during interviews, particularly among those aged 70 and above, which could have impacted the quality of our findings. We also encountered challenges in recruiting older participants, which further limits the depth of our research on lived experiences. Nevertheless, our findings underscore the need for tailored urban planning to mitigate heat vulnerability and enhance resilience among older populations. Our policy and practice recommendations include: At the , older adults should monitor their mental health for signs of distress, adjust their daily routines — such as avoiding peak heat hours — utilise traditional cooling methods like drinking herbal teas, and maintain social connections to reduce feelings of isolation. In Jinan, short-term strategies such as using fans and light clothing are effective, whereas older residents of Guangzhou require long-term solutions that combine traditional and modern cooling techniques. At the , Jinan requires seasonal heat warning systems via SMS, radio, and community broadcasts, along with summer electricity subsidies and accessible cooling centres within a 15-minute walk. Guangzhou needs permanent cooling centres equipped with dehumidification and mental health support through counselling and peer groups. Both cities should enhance their green spaces and offer free transportation for seniors with mobility limitations. Lastly, at the , governments should prioritise mental health screenings, increase funding for climate health adaptation, and promote cross-sector collaboration, such as between meteorology and health sectors, for timely interventions. A global health database could integrate adaptation strategies and health data to guide international best practices. 3 FALL 2025 NO.102 / SUSTAINABILITY & CLIMATE RISKS THOUGHT LEADERSHIP BRIEF SERIES
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