Exposure to Natural Cold and Heat: Hypothermia and Hyperthermia Medicare Claims, United States, 2004–2005

Noe, Rebecca S.; Jin, Jill; Wolkin, Amy

doi:10.2105/ajph.2011.300557

Cited by 43 publications

(30 citation statements)

References 20 publications

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“…Individual racial and ethnic identity is often strongly associated with heat-associated morbidity and mortality in the U.S. For example, blacks have often been found to have increased vulnerability [11, 21, 45-51, 52] and Asians have been found to have decreased vulnerability [49]. However, some studies have not found race or ethnicity to be associated with heat-associated health effects [53-55], and in a study of high temperatures and emergency room visits for various cardio-respiratory diseases in California, as compared to whites, risks were higher among Hispanics for some diseases and lower among blacks, Hispanics or Asians for others [56].…”

Section: Race/ethnicitymentioning

confidence: 99%

Racial and Socioeconomic Disparities in Heat-Related Health Effects and Their Mechanisms: a Review

2014

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Adaptation to increasing extreme heat in a changing climate requires a precise understanding of who is most vulnerable to the health effects of extreme heat. The evidence for race, ethnicity, income, education and occupation, at the individual and area levels, as indicators of vulnerability is reviewed. The evidence for the social, behavioral and technological mechanisms by which racial and socioeconomic disparities in vulnerability exist is also reviewed. These characteristics include cardiorespiratory, renal and endocrine comorbidities; cognitive, mental or physical disabilities; medication use; housing characteristics; neighborhood characteristics such as urban heat islands, crime and safety; social isolation; and individual behaviors such as air conditioning use, opening windows and using fans and use of cooler public spaces. Pre-existing and future research identifying these more proximal indicators of vulnerability will provide information that is more generalizable across locations and time to aid in identifying who to target for prevention of heat-associated morbidity and mortality.

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Section: Race/ethnicitymentioning

confidence: 99%

Racial and Socioeconomic Disparities in Heat-Related Health Effects and Their Mechanisms: a Review

2014

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“…Age has been found to modify the association between EH and mortality, with EH effects greater among individuals at least 65 years old (Basu 2009). Some U.S. studies have suggested increased vulnerability by racial and ethnic characteristics, with increased vulnerability among non-whites or blacks (Fletcher et al 2012, Lin et al 2009, Medina-Ramon et al 2006, Noe et al 2012, O’Neill et al 2003, Schwartz 2005, Ye et al 2012, Zanobetti et al 2013) and decreased vulnerability among Asians (Noe et al 2012), while other studies have not found increased vulnerability by racial and ethnic characteristics (Green et al 2010, Pillai et al 2014). Beyond individual racial effects, there may be neighborhood-level effects of living in a community of racial minorities(Morenoff and Lynch 2004), where resources and information for coping with EH may be further limited as a result of present and historical racial segregation.…”

Section: Introductionmentioning

confidence: 99%

Vulnerability to renal, heat and respiratory hospitalizations during extreme heat among U.S. elderly

et al. 2016

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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.

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“…From 2001 to 2004, HRI was the most frequent cause of environmental exposure-related injury treated in emergency departments (EDs) across the U.S. [6], while annual Medicare claims for hyperthermia treated in EDs have been estimated at over $36 million [7]. HRI ranges in severity from mild cramps to heat exhaustion to heat stroke, and can quickly progress across this spectrum if treatment is not provided [8].…”

Section: Introductionmentioning

confidence: 99%

Impact of Extreme Heat Events on Emergency Department Visits in North Carolina (2007–2011)

et al. 2015

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Extreme heat is the leading cause of weather-related mortality in the U.S. Extreme heat also affects human health through heat stress and can exacerbate underlying medical conditions that lead to increased morbidity and mortality. In this study, data on emergency department (ED) visits for heat-related illness (HRI) and other selected diseases were analyzed during three heat events across North Carolina from 2007 to 2011. These heat events were identified based on the issuance and verification of heat products from local National Weather Service forecast offices (i.e. Heat Advisory, Heat Watch, and Excessive Heat Warning). The observed number of ED visits during these events were compared to the expected number of ED visits during several control periods to determine excess morbidity resulting from extreme heat. All recorded diagnoses were analyzed for each ED visit, thereby providing insight into the specific pathophysiological mechanisms and underlying health conditions associated with exposure to extreme heat. The most common form of HRI was heat exhaustion, while the percentage of visits with heat stroke was relatively low (<10%). The elderly (>65 years of age) were at greatest risk for HRI during the early summer heat event (8.9 visits per 100,000), while young and middle age adults (18-44 years of age) were at greatest risk during the mid-summer event (6.3 visits per 100,000). Many of these visits were likely due to work-related exposure. The most vulnerable demographic during the late summer heat event was adolescents (15-17 years of age), which may relate to the timing of organized sports. This demographic also exhibited the highest visit rate for HRI among all three heat events (10.5 visits per 100,000). Significant increases (p < 0.05) in visits with cardiovascular and cerebrovascular diseases were noted during the three heat events (3-8%). The greatest increases were found in visits with hypotension during the late summer event (23%) and sequelae during the early summer event (30%), while decreases were noted for visits with hemorrhagic stroke during the middle and late summer events (13-24%) and for visits with aneurysm during the early summer event (15%). Significant increases were also noted in visits with respiratory diseases (5-7%). The greatest increases in this category were found in visits with pneumonia and influenza (16%), bronchitis and emphysema (12%), and COPD (14%) during the early summer event. Significant increases in visits with nervous system disorders were also found during the early summer event (16%), while increases in visits with diabetes were noted during the mid-summer event (10%).

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Exposure to Natural Cold and Heat: Hypothermia and Hyperthermia Medicare Claims, United States, 2004–2005

Abstract: This study highlighted the magnitude of these preventable conditions among older adults and disabled persons and the burden on the Medicare system. These results can help target public education and preparedness activities for extreme weather events.

Cited by 43 publications

References 20 publications

Racial and Socioeconomic Disparities in Heat-Related Health Effects and Their Mechanisms: a Review

Racial and Socioeconomic Disparities in Heat-Related Health Effects and Their Mechanisms: a Review

Vulnerability to renal, heat and respiratory hospitalizations during extreme heat among U.S. elderly

Impact of Extreme Heat Events on Emergency Department Visits in North Carolina (2007–2011)

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