The Cost of Cool Air
In March 2026, the Australian Council of Social Service (ACOSS) published survey data that should reframe how the country thinks about heatwaves. Among 2,070 respondents, 75% said they struggle to cool their homes during summer—a sharp rise from 54% in 2025. Nine in ten reported that their homes get too hot, and many described choosing between food and medicine to pay energy bills.
The health consequences were equally stark: 93% reported difficulty sleeping, 60% reported physical health impacts, 60% reported mental health impacts, and 17% had sought medical attention for heat-related health effects in the past year, up from 14% in 2025. People with a disability or chronic illness were three times more likely to seek medical attention for heat-related illness.
These are not lifestyle inconveniences. They are clinical exposures occurring inside Australian homes.
Heat as a Housing Problem
Australia’s heat-health conversation has traditionally focused on outdoor conditions: the temperature, the duration, the warning level. But the ACOSS data directs attention indoors, where the most vulnerable populations spend the most time. A dwelling that cannot be cooled is not merely uncomfortable—it is a chronic health exposure. Poorly insulated rentals, west-facing apartments without external shading, and homes without functional air conditioning become heat traps during multi-day events.
The survey found that 82% of people with disabilities said cost-of-living stress affected their ability to manage heatwaves, with 39% worrying about energy costs every single day. The choice between cooling and eating is not a hypothetical trade-off. It is a daily calculation that carries measurable health consequences.
The Shifting Face of Heat Vulnerability
The January 2026 heatwave provided a real-world test of these survey findings. Emergency departments in Melbourne and Sydney reported sharp increases in patients not only among the elderly but also among people living in overheated buildings without access to cooling, outdoor workers, and individuals with pre-existing conditions. Researchers noted that vulnerability to heat has shifted over time—from primarily elderly people living alone to populations facing socioeconomic disadvantage, chronic illness, homelessness, and migration status.
This shift has direct implications for public health targeting. Heat warning systems that rely on general broadcast messaging may reach the population broadly but fail to change behaviour among people who cannot afford to run an air conditioner, cannot leave an outdoor job, or do not have secure housing in which to shelter. Effective heat-health communication must be paired with material support: energy bill relief, access to cooled public spaces, home retrofitting, and proactive outreach to people with disabilities and chronic illness.
The Health System’s Invisible Patient Load
The 17% of respondents who sought medical attention for heat-related health effects represent a fraction of the total burden. Many more likely managed symptoms at home, used emergency departments as a last resort, or deteriorated without formal care. The ACOSS findings align with health system data showing that heat is most strongly associated with emergency department presentations for respiratory and mental health conditions, with relative risks increasing per degree of temperature change.
The inequity is compounded by geography. Low-income households are more likely to live in urban heat islands, less likely to have access to private transport to reach cooled spaces, and more likely to work in heat-exposed occupations. Each of these factors amplifies the others. A heatwave does not create inequality, but it makes existing inequality biologically visible—in blood pressure, in sleep deprivation, in hospital admissions, and in premature death.
What Equitable Heat Policy Would Require
Closing the gap requires treating cooling as health infrastructure rather than a consumer good. That means energy efficiency standards for rental properties, subsidised cooling for households with chronic illness or disability, urban greening targeted at heat-vulnerable suburbs, and heat-health messaging that is delivered through trusted community networks rather than generic alerts. The 2026 data provides both the moral case and the practical map.
