Climate change and temperature extremes: A review of heat- and cold-related morbidity and mortality concerns of municipalities

Abstract

Cold and hot weather are associated with mortality and morbidity. Although the burden of temperature-associated mortality may shift towards high temperatures in the future, cold temperatures may represent a greater current-day problem in temperate cities. Hot and cold temperature vulnerabilities may coincide across several personal and neighborhood characteristics, suggesting opportunities for increasing present and future resilience to extreme temperatures. We present a narrative literature review encompassing the epidemiology of cold- and heat-related mortality and morbidity, related physiologic and environmental mechanisms, and municipal responses to hot and cold weather, illustrated by Detroit, Michigan, USA, a financially burdened city in an economically diverse metropolitan area. The Detroit area experiences sharp increases in mortality and hospitalizations with extreme heat, while cold temperatures are associated with more gradual increases in mortality, with no clear threshold. Interventions such as heating and cooling centers may reduce but not eliminate temperature-associated health problems. Furthermore, direct hemodynamic responses to cold, sudden exertion, poor indoor air quality and respiratory epidemics likely contribute to cold-related mortality. Short- and long-term interventions to enhance energy and housing security and housing quality may reduce temperature-related health problems. Extreme temperatures can increase morbidity and mortality in municipalities like Detroit that experience both extreme heat and prolonged cold seasons amidst large socioeconomic disparities. The similarities in physiologic and built-environment vulnerabilities to both hot and cold weather suggest prioritization of strategies that address both present-day cold and near-future heat concerns.

The Mortality Risk and Socioeconomic Vulnerability Associated with High and Low Temperature in Hong Kong

“…The adverse effect of extreme temperature on human health has been intensively reported during the last decade [ 1 , 2 ]. Epidemiological evidence shows that both high and low temperature were associated with increased mortality and morbidity in western, Asian and African countries [ 3 , 4 , 5 ].…”

Mortality Related to Cold Temperatures in Two Capitals of the Baltics: Tallinn and Riga

“…The impact of cold temperatures on mortality is a phenomenon that is not exclusive to northern countries. It has also been reported across different temperature zones, where recent studies have shown that more temperature-attributable deaths are caused by cold than by heat [7,8,9], and effect estimates (relative risks—RRs) for cold are higher than those for heat [10,11].…”

Is There a Need to Integrate Human Thermal Models with Weather Forecasts to Predict Thermal Stress?

“…Heat stress is receiving a lot of coverage in media as global temperature increases and a large part of the global population experience exclusively heat stress, however mortality is higher in winter than in summer in temperate climate [43,44]. Excess morbidity and mortality is attributed to a varied winter weather which is forecasted by climate models even though the global mean temperature is expected to rise [45].…”