Extreme heat events pose a significant threat to human health, affecting both physical and mental well-being. Women in rural areas suffer from heat exposure due to their gender-specific responsibilities and restricted cooling access, which elevates their climate-related psychological distress. This study examines the intersection between heat exposure, physiological strain, and heat-related mental health burdens among rural women in Tamil Nadu, India. A cross-sectional study was conducted between April and August 2025 across 15 rural villages in Tamil Nadu, India, among 350 rural women. Ambient temperature was quantified using Wet Bulb Globe Temperature (WBGT) monitors (QuestTemp 3 M) during the peak hours. Data was collected using a structured, modified HOTHAPS questionnaire that covered demographics, heat exposure patterns, self-reported heat-related illnesses (HRIs), and the social impacts of heat. Psychological stress due to heat exposures was evaluated using a culturally adapted Hogg Eco-Anxiety Scale (HEAS), a multi-domain tool that measures rumination, affective responses, behavioral changes, and personal impact concerns. Multivariable logistic regression was performed in Statistical Package for the Social Sciences (SPSS) version 16.0 to examine associations between heat exposure and health outcomes, adjusting for age, education, income, and the availability of cooling resources. Participants (mean age 34.5 ± 7.5 years) experienced an average daily WBGT of 30.4 ± 2.3 °C, with 85% women exposed above the WBGT (≥ 28 °C). 75% of women reported HRIs, primarily fatigue (60%), heat rash (57%), and muscle cramps (45%). Exposure to high heat (WBGT ≥ 28.0 °C) increased the risk of HRI (OR: 10.5; 95% CI: 5.7–19.1). 80% of them reported moderate-to-severe heat-related psychological distress, with 34% reporting severe levels. Eco-anxiety was significantly higher among those with extreme heat exposure (OR: 6.3, 95% CI: 2.9–14.1), and this exposure independently predicted impaired household functioning, including reduced caregiving capacity (aOR: 3.1, 95% CI: 1.8–5.4). Rural women in Tamil Nadu experience substantial heat-related physical and psychological health burdens. The high prevalence of HRIs and eco-anxiety levels among women underscores urgent needs for gender-sensitive heat adaptation strategies integrating both physical protection and mental health support in climate resilience planning.
KG et al. (Thu,) studied this question.