Temporal changes in associations between high temperature and hospitalizations by greenspace: Analysis in the Medicare population in 40 U.S. northeast counties

Temporal changes in associations between high temperature and hospitalizations by greenspace: Analysis in the Medicare population in 40 U.S. northeast counties

Although research indicates health and well-being benefits of greenspace, little is known regarding how greenspace may influence adaptation to health risks from heat, particularly how these risks change over time. Using daily hospitalization rates of Medicare beneficiaries ≥65 years for 2000–2016 in...

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Main Authors: Seulkee Heo, Chen Chen, Honghyok Kim, Benjamin Sabath, Francesca Dominici, Joshua L. Warren, Qian Di, Joel Schwartz, Michelle L. Bell
Format: Article
Language:English
Published: Elsevier 2021-11-01
Series:Environment International
Subjects:
Adaptation
Climate change
Greenspace
Heat
Hospitalization
Temperature
Online Access:http://www.sciencedirect.com/science/article/pii/S0160412021003627
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spelling doaj-f3ac9e6b23bf483aa717f21cccd145d42021-08-18T04:21:08ZengElsevierEnvironment International0160-41202021-11-01156106737Temporal changes in associations between high temperature and hospitalizations by greenspace: Analysis in the Medicare population in 40 U.S. northeast countiesSeulkee Heo0Chen Chen1Honghyok Kim2Benjamin Sabath3Francesca Dominici4Joshua L. Warren5Qian Di6Joel Schwartz7Michelle L. Bell8School of the Environment, Yale University, New Haven, CT, USA; Corresponding author at: 195 Prospect Street, New Haven, CT, USA.School of the Environment, Yale University, New Haven, CT, USASchool of the Environment, Yale University, New Haven, CT, USAHarvard T.H. CHAN School of Public Health, Harvard University, Boston, MA, USAHarvard T.H. CHAN School of Public Health, Harvard University, Boston, MA, USADepartment of Biostatistics, School of Public Health, Yale University, New Haven, CT, USAVanke School of Public Health, Tsinghua University, Beijing, ChinaHarvard T.H. CHAN School of Public Health, Harvard University, Boston, MA, USASchool of the Environment, Yale University, New Haven, CT, USAAlthough research indicates health and well-being benefits of greenspace, little is known regarding how greenspace may influence adaptation to health risks from heat, particularly how these risks change over time. Using daily hospitalization rates of Medicare beneficiaries ≥65 years for 2000–2016 in 40 U.S. Northeastern urban counties, we assessed how temperature-related hospitalizations from cardiovascular causes (CVD) and heat stroke (HS) changed over time. We analyzed effect modification of those temporal changes by Enhanced Vegetation Index (EVI), approximating greenspace. We used a two-stage analysis including a generalized additive model and meta-analysis. Results showed that relative risk (RR) (per 1 °C increase in lag0–3 temperature) for temperature-HS hospitalization was higher in counties with the lowest quartile EVI (RR = 2.7, 95% CI: 2.0, 3.4) compared to counties with the highest quartile EVI (RR = 0.40, 95% CI: 0.14, 1.13) in the early part of the study period (2000–2004). RR of HS decreased to 0.88 (95% CI: 0.31, 2.53) in 2013-2016 in counties with the lowest quartile EVI. RR for HS changed over time in counties in the highest quartile EVI, with RRs of 0.4 (95% CI: −0.7, 1.4) in 2000–2004 and 2.4 (95% CI: 1.6, 3.2) in 2013–2016. Findings suggest that adaptation to heat-health associations vary by greenness. Greenspace may help lower risks from heat but such health risks warrant continuous local efforts such as heat-health plans.http://www.sciencedirect.com/science/article/pii/S0160412021003627AdaptationClimate changeGreenspaceHeatHospitalizationTemperature
collection DOAJ
language English
format Article
sources DOAJ
author Seulkee Heo
Chen Chen
Honghyok Kim
Benjamin Sabath
Francesca Dominici
Joshua L. Warren
Qian Di
Joel Schwartz
Michelle L. Bell
spellingShingle Seulkee Heo
Chen Chen
Honghyok Kim
Benjamin Sabath
Francesca Dominici
Joshua L. Warren
Qian Di
Joel Schwartz
Michelle L. Bell
Temporal changes in associations between high temperature and hospitalizations by greenspace: Analysis in the Medicare population in 40 U.S. northeast counties
Environment International
Adaptation
Climate change
Greenspace
Heat
Hospitalization
Temperature
author_facet Seulkee Heo
Chen Chen
Honghyok Kim
Benjamin Sabath
Francesca Dominici
Joshua L. Warren
Qian Di
Joel Schwartz
Michelle L. Bell
author_sort Seulkee Heo
title Temporal changes in associations between high temperature and hospitalizations by greenspace: Analysis in the Medicare population in 40 U.S. northeast counties
title_short Temporal changes in associations between high temperature and hospitalizations by greenspace: Analysis in the Medicare population in 40 U.S. northeast counties
title_full Temporal changes in associations between high temperature and hospitalizations by greenspace: Analysis in the Medicare population in 40 U.S. northeast counties
title_fullStr Temporal changes in associations between high temperature and hospitalizations by greenspace: Analysis in the Medicare population in 40 U.S. northeast counties
title_full_unstemmed Temporal changes in associations between high temperature and hospitalizations by greenspace: Analysis in the Medicare population in 40 U.S. northeast counties
title_sort temporal changes in associations between high temperature and hospitalizations by greenspace: analysis in the medicare population in 40 u.s. northeast counties
publisher Elsevier
series Environment International
issn 0160-4120
publishDate 2021-11-01
description Although research indicates health and well-being benefits of greenspace, little is known regarding how greenspace may influence adaptation to health risks from heat, particularly how these risks change over time. Using daily hospitalization rates of Medicare beneficiaries ≥65 years for 2000–2016 in 40 U.S. Northeastern urban counties, we assessed how temperature-related hospitalizations from cardiovascular causes (CVD) and heat stroke (HS) changed over time. We analyzed effect modification of those temporal changes by Enhanced Vegetation Index (EVI), approximating greenspace. We used a two-stage analysis including a generalized additive model and meta-analysis. Results showed that relative risk (RR) (per 1 °C increase in lag0–3 temperature) for temperature-HS hospitalization was higher in counties with the lowest quartile EVI (RR = 2.7, 95% CI: 2.0, 3.4) compared to counties with the highest quartile EVI (RR = 0.40, 95% CI: 0.14, 1.13) in the early part of the study period (2000–2004). RR of HS decreased to 0.88 (95% CI: 0.31, 2.53) in 2013-2016 in counties with the lowest quartile EVI. RR for HS changed over time in counties in the highest quartile EVI, with RRs of 0.4 (95% CI: −0.7, 1.4) in 2000–2004 and 2.4 (95% CI: 1.6, 3.2) in 2013–2016. Findings suggest that adaptation to heat-health associations vary by greenness. Greenspace may help lower risks from heat but such health risks warrant continuous local efforts such as heat-health plans.
topic Adaptation
Climate change
Greenspace
Heat
Hospitalization
Temperature
url http://www.sciencedirect.com/science/article/pii/S0160412021003627
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