Modernizing Heat Alerts in North Carolina: A Health-Based Framework for Subregional Risk Communication
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2025-12-16
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In response to rising extreme heat risks across North Carolina, this study refines and evaluates the North Carolina Division of Public Health (NCDPH) Climate and Health Program’s Heat Health Alert System (HHAS), a health-based warning framework first introduced in 2018. Building on prior development, the authors introduce a new set of season-specific Heat Index thresholds for eight climatologically derived regions, calibrated using historical health outcomes—specifically, emergency department visits and excess mortality records from 2007 to 2022. This comparative analysis shows areas of agreement but also highlights systematic differences, particularly in the timing and sensitivity of warnings.
Data used in this report were obtained via the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT), NCDPH’s syndromic surveillance system. NC DETECT is funded by the NCDPH Federal Public Health Emergency Preparedness Grant and managed through collaboration between NCDPH and the UNC-Chapel Hill Department of Emergency Medicine’s Carolina Center for Health Informatics. The NC DETECT Data Oversight Committee is not responsible for the scientific validity or accuracy of methodology, results, statistical analyses, or conclusions presented.
This work is supported by the Centers for Disease Control and Prevention Climate-Ready States and Cities Initiative, Building Resilience Against Climate Effects (BRACE) Cooperative Agreement No. 5 NUE1EH001449-03-00.
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Clark, Jordan, Emily Nagamoto, Sarah Hatcher, Courtney Williams, Autumn Locklear, Nikhil Kothegal and Ashley Ward (2025). Modernizing Heat Alerts in North Carolina: A Health-Based Framework for Subregional Risk Communication. Retrieved from https://hdl.handle.net/10161/33880.
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Ashley Ward
Ashley’s work focuses on the health impacts of climate extremes and community resilience. She directs the Heat Policy Innovation Hub at Duke University’s Nicholas Institute for Energy, Environment & Sustainability. In this role, Ashley brings together scientists and communities to develop and deploy innovative policy solutions that reduce the impacts of extreme heat on human health and well-being.
Ashley’s career has focused on engaging communities to identify and address issues related to climate change, and helping communities develop long-term, sustainable strategies relevant to their needs.
Ashley’s previous work with NOAA’s Carolinas Regional Integrated Sciences and Assessments (RISA) team connected rural and urban communities and policy-decision makers with relevant climate and health data, particularly related to vulnerabilities and impacts.
Ashley has continued to bridge the gap between science, data, policy, and community at Duke’s Nicholas Institute. In this setting, she works with communities, public agencies, and policymakers to create and inform effective policy solutions to difficult environmental challenges.
Prior to launching the Heat Policy Innovation Hub, Ashley has worked on the Internet of Water (IoW) Coalition at the Nicholas Institute, helping public agencies modernize their water data infrastructure to better manage water resources. On the IoW team, Ashley has led stakeholder and policy engagement, pilot programs, and the development of the Technology Adoption Program (TAP) designed to guide public agencies through the organizational and behavioral changes needed to modernize their water data infrastructure.
Before her work with Duke and RISA, Ashley completed her PhD in geography and worked with communities throughout NC on a host of issues such as local food availability and asset-based economic development strategies. Ashley’s passion is building coalitions to advance scientific understanding and communicate information in a way that is relevant for use by decision-makers. Having worked in a broad range of communities with varying levels of capacity, Ashley is particularly thoughtful about meeting communities where they are and working from there to achieve community goals.
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