Carina J Gronlund1, Antonella Zanobetti2, Gregory A Wellenius3, Joel D Schwartz2, Marie S O'Neill4. 1. University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI. 2. Harvard School of Public Health, Department of Environmental Health, Boston, MA. 3. Brown University School of Public Health, Department of Epidemiology, Providence, RI. 4. University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI; University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI.
Abstract
BACKGROUND: Extreme heat (EH) is a growing concern with climate change, and protecting human health requires knowledge of vulnerability factors. We evaluated whether associations between EH (maximum temperature > 97th percentile) and hospitalization for renal, heat and respiratory diseases among people ≥ 65 years differed by individual and area-level characteristics. METHODS: We used Medicare billing records, airport weather data, U.S. Census data and satellite land cover imagery in 109 US cities, May-September, 1992-2006, in a time-stratified case-crossover design. Interaction terms between EH and individual (> 78 years, black race, sex) and home ZIP-code (percentages of non-green space, high school education, housing built before 1940) characteristics were incorporated in a single model. Next, we pooled city-specific effect estimates or regressed them on quartiles of air conditioning prevalence (ACP) in a multivariate random effects meta-analysis. RESULTS: EH and combined renal/heat/respiratory hospitalization associations were stronger among blacks, the very old, in ZIP codes with lower educational attainment or older housing and in cities with lower ACP. For example, for EH versus non-heat days, we found a 15% (95% CI 11%-19%) increase in renal/heat/respiratory hospitalizations among individuals in ZIP codes with higher percent of older homes in contrast to a 9% (95% CI 6%-12%) increase in hospitalizations in ZIP codes with lower percent older homes. CONCLUSION: Vulnerability to EH-associated hospitalization may be influenced by age, educational attainment, housing age and ACP.
BACKGROUND: Extreme heat (EH) is a growing concern with climate change, and protecting human health requires knowledge of vulnerability factors. We evaluated whether associations between EH (maximum temperature > 97th percentile) and hospitalization for renal, heat and respiratory diseases among people ≥ 65 years differed by individual and area-level characteristics. METHODS: We used Medicare billing records, airport weather data, U.S. Census data and satellite land cover imagery in 109 US cities, May-September, 1992-2006, in a time-stratified case-crossover design. Interaction terms between EH and individual (> 78 years, black race, sex) and home ZIP-code (percentages of non-green space, high school education, housing built before 1940) characteristics were incorporated in a single model. Next, we pooled city-specific effect estimates or regressed them on quartiles of air conditioning prevalence (ACP) in a multivariate random effects meta-analysis. RESULTS: EH and combined renal/heat/respiratory hospitalization associations were stronger among blacks, the very old, in ZIP codes with lower educational attainment or older housing and in cities with lower ACP. For example, for EH versus non-heat days, we found a 15% (95% CI 11%-19%) increase in renal/heat/respiratory hospitalizations among individuals in ZIP codes with higher percent of older homes in contrast to a 9% (95% CI 6%-12%) increase in hospitalizations in ZIP codes with lower percent older homes. CONCLUSION: Vulnerability to EH-associated hospitalization may be influenced by age, educational attainment, housing age and ACP.
Entities:
Keywords:
climate change; heat waves; hospital admissions; morbidity; temperature
Authors: S Vandentorren; P Bretin; A Zeghnoun; L Mandereau-Bruno; A Croisier; C Cochet; J Ribéron; I Siberan; B Declercq; M Ledrans Journal: Eur J Public Health Date: 2006-10-06 Impact factor: 3.367
Authors: Fadia T Shaya; Mark S Maneval; Confidence M Gbarayor; Kyongsei Sohn; Anand A Dalal; Dongyi Du; Steven M Scharf Journal: Chest Date: 2009-03-24 Impact factor: 9.410
Authors: Mercedes Medina-Ramón; Antonella Zanobetti; David Paul Cavanagh; Joel Schwartz Journal: Environ Health Perspect Date: 2006-09 Impact factor: 9.031
Authors: A Smargiassi; M S Goldberg; C Plante; M Fournier; Y Baudouin; T Kosatsky Journal: J Epidemiol Community Health Date: 2009-04-14 Impact factor: 3.710
Authors: Adesuwa S Ogbomo; Carina J Gronlund; Marie S O'Neill; Tess Konen; Lorraine Cameron; Robert Wahl Journal: Int J Biometeorol Date: 2016-10-30 Impact factor: 3.787
Authors: Carina J Gronlund; Lianne Sheppard; Sara D Adar; Marie S O'Neill; Amy Auchincloss; Jaime Madrigano; Joel Kaufman; Ana V Diez Roux Journal: Epidemiology Date: 2018-11 Impact factor: 4.822
Authors: Patricia D Koman; Frank Romo; Peter Swinton; Graciela B Mentz; Ricardo F de Majo; Natalie R Sampson; Michael J Battaglia; Kimberly Hill-Knott; Guy O Williams; Marie S O'Neill; Amy J Schulz Journal: Health Place Date: 2019-10-22 Impact factor: 4.078
Authors: Satbyul Estella Kim; Hyewon Lee; Jayeun Kim; Young Kyu Lee; Minjin Kang; Yasuaki Hijioka; Ho Kim Journal: Environ Health Date: 2019-06-14 Impact factor: 5.984
Authors: Elham Hatef; Zachary Predmore; Elyse C Lasser; Hadi Kharrazi; Karin Nelson; Idamay Curtis; Stephan Fihn; Jonathan P Weiner Journal: AIMS Public Health Date: 2019-07-03
Authors: Shengzhi Sun; Kate R Weinberger; Amruta Nori-Sarma; Keith R Spangler; Yuantong Sun; Francesca Dominici; Gregory A Wellenius Journal: BMJ Date: 2021-11-24