98
M. D. Setiawati et al.
Fig. 6.4 Spatial distribution of heat stress level (UTCI) in Medan City (Source authors)
factor loading in the component 1 indicates that vegetation density has a strong
cooling effect where it can reduce the HVI index.
Based on the interview with local health agency, the most cases of heat-related
injury was heat exhaustion, but it rarely needs hospital treatment. Thus, there is
no data reported yet regarding heat-related illness in the study area. In 2016, one
heatstroke case was reported in Bali-Indonesia and caused mortality (Satya et al.
2018). Satya et al. (2018) stated that heatstroke is an uncommon case in Indonesia,
so the possibility of a diagnostic error by a doctor will be very high. Since there
is no reliable data of heat-related injuries, we tried to confirm our result with the
most vulnerable people of heat-related mortality that is people with cardiovascular
diseases and respiratory illness (Reid et al. 2009; Curriero et al. 2002). However,
cardiovascular diseases cases were also not reported by local health agency, thus,
hypertension cases were used as the most important risk factor for cardiovascular
disease.