PCLM-D-23-00259

Extreme Heat & Public Perception in Portland, Oregon: Evidence of a Compounding Vulnerability Effect for Climate Hazards

PLOS Climate

Dear Dr. Suldovsky,

Thank you for submitting your manuscript to PLOS Climate. After careful consideration, we feel that it has merit but does not fully meet PLOS Climate’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

==============================

We look forward to your revision to clarify the methods and statistical analysis, which will greatly strengthen the paper.

==============================

Please submit your revised manuscript by Mar 08 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at climate@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pclm/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

We look forward to receiving your revised manuscript.

Kind regards,

Erin Coughlan de Perez, PhD

Academic Editor

PLOS Climate

Journal Requirements:

1. Please provide separate figure files in .tif or .eps format.

For more information about figure files please see our guidelines:  

https://journals.plos.org/globalpublichealth/s/figures 

https://journals.plos.org/globalpublichealth/s/figures#loc-file-requirements 

2. We ask that a manuscript source file is provided at Revision. Please upload your manuscript file as a .doc, .docx, .rtf or .tex.

Additional Editor Comments (if provided):

This study is important and interesting in its scope and conclusions. The reviewers found that the methods sections were not clear, so we are suggesting a major revision in which you re-write the methods sections and some of the results sections to be more specific about the sampling, survey implementation, and statistical tests.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does this manuscript meet PLOS Climate’s publication criteria? Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe methodologically and ethically rigorous research with conclusions that are appropriately drawn based on the data presented.

Reviewer #1: Yes

Reviewer #2: Partly

**********

2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Have the authors made all data underlying the findings in their manuscript fully available (please refer to the Data Availability Statement at the start of the manuscript PDF file)?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS Climate does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Dear Drs. Suldovsky, Kramer, and Fink,

The paper entitled, “Extreme Heat and Public Perception in Portland, Oregon: Evidence of a Compounding Vulnerability Effect for Climate Hazards,” uses a community survey from Portland, Oregon to better understand the influence of compounding vulnerability from race, disability, and poverty statuses on extreme heat perceptions and trust in emergency response.

Overall, I find this work to be important, timely, and relevant to the journal. I thank the authors for a well-structured manuscript that is easy to read and with survey methods that are extremely well explained and sound. Below I offer a few suggestions to help strengthen this manuscript.

Please explain your choices in statistical methods, specifically ANOVA and Tukey post hoc analyses, in the methods section. These tests are heavily leaned on – why did you choose the tests you did and how do they apply to your data? Are these methods supported by previously published work?

Figures 1 – 6 are a bit fuzzy. This might come from the conversion to a PDF or the file I received.

Reviewer #2: This is a timely and valuable study. The authors clearly state their hypotheses, and it seems the data support the conclusions. However, there needs to be more information in the methods section to help the reader understand the study and the data.

There needs to be a more compressive discussion of the survey methodology and how the authors obtained a representative sample. How were the participants sampled and what was the survey response rate? In addition, the methods for making the survey representative, and the year/source population for which it is representative needs to be better described to justify generalizing results. In lines 193-194, it says the sample is statistically representative but not of what population. What population did you compare with to ensure representativeness (Multnomah County)? Was the survey not weighted because it was considered representative?

Please also add information about the statistical tests in the methods, perhaps in a section titled “statistical analyses”. The tests are mentioned in the results but not described in the methods. Results for tests of reliability of the 5-point scales are described in the methods (for example, line 214) but the reliability tests used are not described. Move the first few sentences about software and statistical tests from the Results into the statistical analyses section in methods.

When describing the survey instrument in methods, were trust questions specifically about extreme heat (as implied by abstract and article title) or did the wording also include other types of emergencies (unclear from description in methods)?

If questions on which results are based included multiple environmental emergencies, that is still valuable but needs to be clear throughout the paper. Please consider publishing the questionnaire in supplemental materials.

Please also consider including descriptive characteristics (age, race, disability status, poverty, etc) of your sample in Table 1 or as a table in supplemental materials, rather than including them piecemeal throughout the text. This would also allow for presentation of descriptive results for questions underpinning your independent and dependent variables (i.e. # and % of responses for the 5 point scales).

For the tables and figures, make sure titles are complete and understandable, for example “Trust in police among…” or “Differences among levels of trust by number of vulnerability indicators among Portland residents” or something like that instead of “Summary one-way ANOVA statistics.” That they are one-way ANOVA statistics can be explained in the table notes.

It’s important that trust of first responders is lower across the board as vulnerability rises, as the authors rightly highlight. It’s also interesting and actionable that trust is relatively high on the 5-point scale for firefighters and less so, but still relatively high, for medical workers (the group mean for trust in medical worker of people with 2+ indicators is still higher, for example, than the group mean trust for people with 0 indicators for police and government). It may be worth noting that in the abstract and earlier in the discussion, as these responders could potentially be more utilized in preparation for and during weather emergencies.

Specific comments:

p. 4 Can heat vulnerability specific to Oregon be cited, for instance, the review of the heat dome deaths: 20220624_final-heat-report-2021_SmallFile-2.pdf (multco-web7-psh-files-usw2.s3-us-west-2.amazonaws.com) This indicates that older age, lack of air conditioning (probably related to income) were vulnerability factors for heat stroke death in Portland. Non-Hispanic Whites were more likely to die, so discussion of reasons why people of color may also be uniquely vulnerable is also warranted (i.e. vulnerabilities introduced by structural racism).

p. 5 when mental disabilities in the introduction, it would help the reader to define which conditions were associated with the outcomes. For example, cognitive conditions like dementia mental health conditions like schizophrenia or depression, and/or learning disabilities?

p. 5 lines 97-98, are there theories as to why temperature related health disparities increase over time for PWD?

p. 6. When discussing vulnerability by race, important to note that heat vulnerability by race is not a biologic trait but is determined by racist systems that induce vulnerability by limiting access health care, high-quality housing, education and high paying jobs, etc. (see for reference: Structural racism and health inequities in the USA: evidence and interventions - PubMed (nih.gov))

p.10-11 Please also note the number of how many people said “not sure” and were removed from analysis (for example line 212). If descriptive responses to questions underlying the dependent measures are included, the numbers of people who said “not sure” and were removed from analysis can be included in the table for readers to refer to.

p. 10-11. Did the harm, need, and trust questions ask ONLY about heat, or were they more general (as stated in lines 221-222)? If more general, then that needs to be clear throughout the article that results are describing response to questions about these emergencies, not just heat.

p. 12 What is considered a psychosocial disability in this study?

p. 19-20 Is there any literature to contextualize why trust in police and government (the groups with the highest levels of lack of trust) may be lower among people of color, low-income people, and those with disabilities?

**********

6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

Do you want your identity to be public for this peer review? If you choose “no”, your identity will remain anonymous but your review may still be made public.

For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PCLM-D-23-00259R1

Extreme Heat & Public Perception in Portland, Oregon: Evidence of a Compounding Vulnerability Effect for Climate Hazards

PLOS Climate

Dear Dr. Suldovsky,

Thank you for submitting your manuscript to PLOS Climate. After careful consideration, we feel that it has merit but does not fully meet PLOS Climate’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

==============================

Dear Authors,

Thank you for this resubmission. I agree you have adequately responded to the reviewer comments. My only request is that you add confidence intervals (error bars) to the results in Figures 1-6. Please resubmit with that minor revision. It would be ideal to add confidence intervals on the blue dots as well as shading showing the confidence intervals around the sample mean estimate.

==============================

Please submit your revised manuscript by Apr 17 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at climate@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pclm/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

We look forward to receiving your revised manuscript.

Kind regards,

Erin Coughlan de Perez, PhD

Academic Editor

PLOS Climate

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments (if provided):

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Extreme Heat & Public Perception in Portland, Oregon: Evidence of a Compounding Vulnerability Effect for Climate Hazards

PCLM-D-23-00259R2

Dear Dr. Suldovsky,

We are pleased to inform you that your manuscript 'Extreme Heat & Public Perception in Portland, Oregon: Evidence of a Compounding Vulnerability Effect for Climate Hazards' has been provisionally accepted for publication in PLOS Climate.

Before your manuscript can be formally accepted you will need to complete some formatting changes, which you will receive in a follow-up email from a member of our team. 

Please note that your manuscript will not be scheduled for publication until you have made the required changes, so a swift response is appreciated.

IMPORTANT: The editorial review process is now complete. PLOS will only permit corrections to spelling, formatting or significant scientific errors from this point onwards. Requests for major changes, or any which affect the scientific understanding of your work, will cause delays to the publication date of your manuscript.

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they'll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact climate@plos.org.

Thank you again for supporting Open Access publishing; we are looking forward to publishing your work in PLOS Climate.

Best regards,

Erin Coughlan de Perez, PhD

Academic Editor

PLOS Climate

***********************************************************

Reviewer Comments (if any, and for reference):