Integrating new indicators of predictors that shape the public's perception of local extreme temperature in China.

The public's risk perception of local extreme heat or cold plays a critical role in community health and prevention under climate change. However, there is limited evidence on such issues in China where extreme weather is occurring more frequently due to climate change. Here, a total of 2500 residents were selected using a three-step sampling method and investigated by a questionnaire in two representative cities. We investigated risk perception of extreme heat in Beijing and extreme cold in Harbin in 2013, aiming to examine their possible correlations with multiple epidemiological factors. We found that exposure, vulnerability, and adaptive ability were significant predictors in shaping public risk perceptions of local extreme temperature. In particular, a 1°C increase in daily temperature resulted in an increased odds of perceiving serious extreme heat in Beijing (OR=1.091; 95% CI: 1.032, 1.153), while a 1°C increase in daily temperature resulted in a decreased odds of perceiving serious extreme cold in Harbin (OR=0.965; 95% CI: 0.939, 0.992). Therefore for both extreme heat and cold, frequent local extreme temperature exposure may amplify a stronger communication. Health interventions for extreme temperature should consider exposure, vulnerability, and adaptive ability factors. This will help improve the public's perception of climatic changes and their willingness to balance adaption and mitigation appropriately.