Urban heat stress and health: A systematic literature review of dimensions and indicators for planning and design

In recent years, extreme temperatures have gained significant attention in urban studies, leading to the search for various adaptation and mitigation measures. While many studies employ heat-related indicators to assess climate-related health impacts, a better understanding of the multi-dimensional nature of these indicators can enhance their integration into urban policies, planning and design. This research aims to examine various dimensions of urban heat stress in built environments, using a systematic review of scientific articles (n = 146) and consequently, establishing a framework for effectively stratifying examples of related indicators across different dimensions. The results showcase dimensions including demographic, economic, health, urban climate, social, urban morphology, and institutional. However, literature disproportionately emphasizes demographic, health and climate dimensions, while social, urban morphology and institutional ones receive comparatively less attention. On the other hand, the co-occurrence analysis reveals connections among these dimensions and their related indicators, underlining the need for a holistic understanding of heat stress impacts. Additionally, the spatial distribution of the selected papers brings attention to the lack of studies in the regions identified as most exposed according to the Koppen Climate Classification. Accordingly, we advocate for more multidimensional and context-specific studies that bridge existing gaps. This research provides valuable insights for policymakers, planners, urban designers and researchers on advancing the understanding of urban heat stress in built environments and its impact on urban health.