Spatial distribution of old neighborhoods based on heat-related health risks assessment: A case study of Changsha City, China

•A heat-related health risk assessment framework for old neighborhoods was developed.•This framework for evaluation at neighborhood level was validated feasible.•This framework proves especially beneficial for quantifying heat-related health risk.•This framework can deliver targeted information for decision-making processes. Assessing the heat-related health risks is crucial for promoting the sustainable development of cities, particularly in the face of extreme climates and urban human settlement governance. Heat health risk assessment serves as a foundational element within the risk governance framework, serving to mitigate heat-related morbidity and mortality rates. The revitalization of old neighborhoods, especially those situated in city centers with deficient facilities, emerges as a critical imperative within this context. This study chose Changsha, a city in Central China that is severely affected by high temperatures and has numerous old neighborhoods, as a case study. We developed a heat risk framework that incorporates city level risk, exposure, vulnerability, and the adaptation of old neighborhoods. Validated through data accessed from medical facilities visit, the framework effectively reflects the distribution of heat risks. By combining qualitative and quantitative methods, we investigated the correlation between heat health risk levels and the behaviors of residents in old neighborhoods. The results indicate that urban planners should prioritize comprehensive renovations in medium-risk neighborhoods, resident behavior management in low-risk neighborhoods, and the indoor thermal environment in high-risk neighborhoods. This framework plays an important role in the assessment of future spatial risk for old neighborhoods renewal.