Striving for Rural Heat Resilience: A Systematic Literature Review

Extreme heat, an increasing cause of weather-related deaths worldwide, poses escalating risks to both urban and rural communities. While urban heat and its impacts have received scholarly and practitioner attention for deca-des, rural heat has tended to be overlooked. To address this, we conducted a systematic literature review using Scopus, yielding 52 articles specifically addressing extreme heat in rural communities in the United States, Canada, and Australia. This review synthesizes the impacts of extreme heat on rural communities and current efforts and challenges in addressing rural heat risks. Among 52 articles, about three-quarters focus on the impact of extreme heat on public health across diverse groups. Key findings include the following: 1) outdoor workers (e.g., farmers) face particularly high risks due to prolonged exposure to heat; 2) the elderly, Indigenous people, and visitors in rural regions are also vulnerable to extreme heat; 3) rural heat risks are often shaped by the intersectional vulnerabilities of rural communities and governance gaps, such as inadequate or missing regulations to protect workers; and 4) compared to urban heat governance, rural heat governance remains underdeveloped in many areas, highly fragmented, and inconsistent across regions, which leaves vulnerable populations more exposed. We use a heat mitigation (e.g., home weatherization), management (e.g., occupational heat safety standards), and heat governance (i.e., policies and actions taken by governments, institutions, and communities) framework to identify gaps in current approach and discuss future research direction toward an integrated and robust approach to increase rural heat resilience. SIGNIFICANCE STATEMENT: As climate change brings more frequent extreme heat events, rural communities in countries like the United States, Canada, and Australia face growing risks but often receive less attention than cities. This literature review explores how extreme heat impacts rural areas, which can be more vulnerable due to limited resources, aging populations and infrastructures, and outdoor-based economies like farming. By examining interdisciplinary studies, the review identifies key challenges, local responses, and opportunities for more effective policy. It emphasizes the need to understand how rural settings may differ not only from dense urban areas but also from one another and to ensure rural areas are included in heat resilience efforts, whether by building on their own initiatives or improving access to tailored, place-based governance tools.