Environment/Climate Change
Extreme Heat Temperature and Hospital Admission among Older Adults in Greater Boston Metropolitan Areas. Youn Soo Jung* Youn Soo Jung Antonella Zanobetti Kari Nadeau Scott Delaney Daniel Mork Michelle Audirac Danielle Braun
Abstract
Importance Extreme heat (EH), a consequence of climate change, is a leading cause of weather-related fatalities in the United States. In Massachusetts, the average temperature has increased by nearly 3.5°F. Moreover, EH disproportionately affects different communities, which can exacerbate existing social inequities.
Objective: To identify the risk of heat-related hospitalizations due to EH events in each community of Greater Boston Metropolitan areas and how this differed by individual and neighborhood characteristics.
Design, Setting, and Population Using Medicare data (2000-2016), we constructed cohorts of individuals hospitalized with heat related illness during summer (May-September). EH day was defined as a day with a heat index over the 90th percentile, and Heatwave periods were defined as two or more consecutive days that had EH. We applied a case-crossover design to estimate city-specific associations between EH and heat-related hospitalizations by in the Greater Boston areas. Interaction terms between exposure and individual (>84 years, dual eligibility, sex, race (non-Hispanic white, non-Hispanic black, and others)) and residential ZIP-code (green space, percentage of population without high school degree, of below poverty line and of Black population) characteristics were included in the model for effect modification analyses. We pooled city-specific results using a random effects meta-analysis.
Results Heat-related admissions increased by 13.5% (95% confidence interval (CI) 7.8 – 19.5%) during the EH day and 16.9% (95% CI 11.4-22.7%) during the Heatwave. Associations were stronger in males, age group between 65-84 years and in zip codes with higher percentage of black population.
Conclusions Our data suggests that the risk of heat-related hospitalizations may be influenced by individual and neighborhood characteristics.