Heat warnings, mortality, and hospital admissions among older adults in the United States
Background: Heat warnings are issued in advance of forecast extreme heat events, yet little evidence is available regarding their effectiveness in reducing heat-related illness and death. We estimated the association of heat warnings and advisories (collectively, “alerts”) issued by the United State...
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doaj-4268436ad2b74730bc6d4d8f92f509312021-10-01T04:47:06ZengElsevierEnvironment International0160-41202021-12-01157106834Heat warnings, mortality, and hospital admissions among older adults in the United StatesKate R. Weinberger0Xiao Wu1Shengzhi Sun2Keith R. Spangler3Amruta Nori-Sarma4Joel Schwartz5Weeberb Requia6Benjamin M. Sabath7Danielle Braun8Antonella Zanobetti9Francesca Dominici10Gregory A. Wellenius11School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada; Corresponding author at: School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia, V6T 1Z3, Canada.Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USABoston University School of Public Health, 715 Albany Street, Boston, MA 02118, USABoston University School of Public Health, 715 Albany Street, Boston, MA 02118, USABoston University School of Public Health, 715 Albany Street, Boston, MA 02118, USAHarvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USASchool of Public Policy and Government, Fundação Getúlio Vargas, Brasilia, SGAN (Setor de Grandes Áreas Norte) Quadra 602 – Módulos A, B e C – Asa Norte, Brasilia, DF 70830-051, BrasilHarvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USAHarvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Department of Data Science, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USAHarvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USAHarvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USABoston University School of Public Health, 715 Albany Street, Boston, MA 02118, USABackground: Heat warnings are issued in advance of forecast extreme heat events, yet little evidence is available regarding their effectiveness in reducing heat-related illness and death. We estimated the association of heat warnings and advisories (collectively, “alerts”) issued by the United States National Weather Service with all-cause mortality and cause-specific hospitalizations among Medicare beneficiaries aged 65 years and older in 2,817 counties, 2006–2016. Methods: In each county, we compared days with heat alerts to days without heat alerts, matched on daily maximum heat index and month. We used conditional Poisson regression models stratified on county, adjusting for year, day of week, federal holidays, and lagged daily maximum heat index. Results: We identified a matched non-heat alert day for 92,029 heat alert days in 2,817 counties, or 54.6% of all heat alert days during the study period. Contrary to expectations, heat alerts were not associated with lower risk of mortality (RR: 1.005 [95% CI: 0.997, 1.013]). However, heat alerts were associated with higher risk of hospitalization for fluid and electrolyte disorders (RR: 1.040 [95% CI: 1.015, 1.065]) and heat stroke (RR: 1.094 [95% CI: 1.038, 1.152]). Results were similar in sensitivity analyses additionally adjusting for same-day heat index, ozone, and PM2.5. Conclusions: Our results suggest that heat alerts are not associated with lower risk of mortality but may be associated with higher rates of hospitalization for fluid and electrolyte disorders and heat stroke, potentially suggesting that heat alerts lead more individuals to seek or access care.http://www.sciencedirect.com/science/article/pii/S0160412021004591Extreme heatEarly warning systemsMortalityHospitalizationUnited StatesMedicare |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kate R. Weinberger Xiao Wu Shengzhi Sun Keith R. Spangler Amruta Nori-Sarma Joel Schwartz Weeberb Requia Benjamin M. Sabath Danielle Braun Antonella Zanobetti Francesca Dominici Gregory A. Wellenius |
spellingShingle |
Kate R. Weinberger Xiao Wu Shengzhi Sun Keith R. Spangler Amruta Nori-Sarma Joel Schwartz Weeberb Requia Benjamin M. Sabath Danielle Braun Antonella Zanobetti Francesca Dominici Gregory A. Wellenius Heat warnings, mortality, and hospital admissions among older adults in the United States Environment International Extreme heat Early warning systems Mortality Hospitalization United States Medicare |
author_facet |
Kate R. Weinberger Xiao Wu Shengzhi Sun Keith R. Spangler Amruta Nori-Sarma Joel Schwartz Weeberb Requia Benjamin M. Sabath Danielle Braun Antonella Zanobetti Francesca Dominici Gregory A. Wellenius |
author_sort |
Kate R. Weinberger |
title |
Heat warnings, mortality, and hospital admissions among older adults in the United States |
title_short |
Heat warnings, mortality, and hospital admissions among older adults in the United States |
title_full |
Heat warnings, mortality, and hospital admissions among older adults in the United States |
title_fullStr |
Heat warnings, mortality, and hospital admissions among older adults in the United States |
title_full_unstemmed |
Heat warnings, mortality, and hospital admissions among older adults in the United States |
title_sort |
heat warnings, mortality, and hospital admissions among older adults in the united states |
publisher |
Elsevier |
series |
Environment International |
issn |
0160-4120 |
publishDate |
2021-12-01 |
description |
Background: Heat warnings are issued in advance of forecast extreme heat events, yet little evidence is available regarding their effectiveness in reducing heat-related illness and death. We estimated the association of heat warnings and advisories (collectively, “alerts”) issued by the United States National Weather Service with all-cause mortality and cause-specific hospitalizations among Medicare beneficiaries aged 65 years and older in 2,817 counties, 2006–2016. Methods: In each county, we compared days with heat alerts to days without heat alerts, matched on daily maximum heat index and month. We used conditional Poisson regression models stratified on county, adjusting for year, day of week, federal holidays, and lagged daily maximum heat index. Results: We identified a matched non-heat alert day for 92,029 heat alert days in 2,817 counties, or 54.6% of all heat alert days during the study period. Contrary to expectations, heat alerts were not associated with lower risk of mortality (RR: 1.005 [95% CI: 0.997, 1.013]). However, heat alerts were associated with higher risk of hospitalization for fluid and electrolyte disorders (RR: 1.040 [95% CI: 1.015, 1.065]) and heat stroke (RR: 1.094 [95% CI: 1.038, 1.152]). Results were similar in sensitivity analyses additionally adjusting for same-day heat index, ozone, and PM2.5. Conclusions: Our results suggest that heat alerts are not associated with lower risk of mortality but may be associated with higher rates of hospitalization for fluid and electrolyte disorders and heat stroke, potentially suggesting that heat alerts lead more individuals to seek or access care. |
topic |
Extreme heat Early warning systems Mortality Hospitalization United States Medicare |
url |
http://www.sciencedirect.com/science/article/pii/S0160412021004591 |
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