Living through the heat: How urban children and young people experience and envision healthier cities

Climate change is driving more frequent and intense heatwaves, posing growing risks to urban populations, particularly children and young people (CYP). This study examined how heatwaves affect the health, well-being, and daily lives of CYP across six rapidly urbanising cities: Accra, Kumasi, Ouagadougou, Port Harcourt, Manila, and Dar es Salaam. We conducted online surveys during both heatwave and non-heatwave periods, collecting 2,269 valid responses. Heatwaves were defined as periods when apparent temperatures exceeded the 90th percentile of historical monthly averages for at least three consecutive days, validated by national meteorological data. Non-heatwave periods were defined as days within the same month and city when apparent temperatures were less than or equal to the 10-year average daily mean. Participants, CYP aged 13-29 and parents of children under 18, were recruited via targeted digital advertisements on Meta and Google. Quantitative data were analysed using descriptive statistics, chi-square tests, and logistic regression to assess associations between heatwave exposure and self-reported health symptoms, well-being, and daily disruptions. Thematic analysis of open-ended responses identified community priorities for climate resilience. Heatwaves were associated with higher reports of headaches, low mood, anxiety or stress, not enough food, and increased reliance on family support. Adverse effects were more pronounced among younger and lower-income participants. Participants highlighted five priorities for climate-resilient cities: more green spaces, improved water and sanitation, cleaner environments, stronger health and education services, and greater youth participation in decision-making. The results highlight the growing burden of heat-related health symptoms and daily activity disruptions among CYP and youth-informed strategies to reduce the unequal impacts of extreme heat in urban areas.