ReviewPreventing heat-related morbidity and mortality: New approaches in a changing climate
Introduction
Heat-related mortality and morbidity occurs across industrialized and less developed nations. Heat-related mortality disproportionately affects lower socioeconomic status individuals, those without access to indoor air conditioning and the elderly [1]. With climate change, concern about increasing duration, intensity and frequency of heat waves [2] has added to the urgency of preparing properly to protect health during hot weather. This paper briefly reviews epidemiologic evidence on links between heat exposure and adverse health outcomes, discusses options for prevention of such outcomes, and describes the role of local authorities in implementing preventive activities. Next, we present an approach for developing a computer-based decision tool to enable local authorities to estimate how heat might impact the health of residents and to choose a range of potential strategies for mitigating these effects.
Section snippets
The epidemiology of heat and health
Excess mortality during hot weather has been reported in several epidemiological studies, and recent reviews assess that literature and the less extensive body of work on other health outcomes [1], [3], [4]. Other reports show associations between heat exposure and cause-specific hospital admissions [5], [6], [7], but these can be inconsistent with the mortality associations in the same communities [8], [9]. The heat-related epidemiology literature has utilized case–control, case-crossover,
Heat health warning systems
The differences between communities in terms of climate, geography, and demographics illustrate the need for locally tailored, short- and long-term intervention strategies. After the heat waves in Chicago during the 1990s and France during 2003 and 2006, improved access to cooling centers, increased air conditioning prevalence, and heat health warning systems have been implemented. A heat health warning system is a ‘system that uses meteorological forecasts to initiate acute public health
Decision tools
Decision tools can help communities better understand location-specific heat-health associations and vulnerabilities, and the available infrastructure for implementing prevention programs. Such tools ideally allow for use of community-specific information on heat-health associations, population characteristics, settlement patterns, transportation, energy use, climate and other factors.
A new decision tool for developing local heat illness prevention programs
As part of a similar multi-disciplinary collaboration between researchers and local governments, we propose to integrate information about heat health vulnerability, risk and adaptation options into a new computer-based interactive tool designed to guide local governments through a comprehensive adaptation planning and implementation process. This new tool, being developed by International Council for Local Environmental Initiatives (ICLEI)-Local Governments for Sustainability USA and
Discussion and conclusions
Ample evidence exists that exposure to high temperatures can result in a variety of adverse health effects, including death, and preventing such effects requires a range of intervention types. With climate change increasing the frequency of hot weather, among other effects, multiple collaborations worldwide are attempting to apply research results to prevention efforts that are both sustainable and effective at the local level.
Some of the challenges inherent in this type of work, and
Author contributions
All authors participated in the paper with contributions detailed next. Marie O’Neill, Jonathan Kish, Carina Gronlund and Jalonne White-Newsome made the first draft of the manuscript and prepared the figures. Rebecca Carter developed Table 1. Xico Manarolla, Rebecca Carter, Joel Schwartz and Antonella Zanobetti participated with the rest of the team in structuring the paper and developing the ideas described in the manuscript. All authors provided comments and suggestions and assisted with
Competing interest
All authors have seen and approved the final version and none of the authors have conflicts of interest to declare.
Funding information
Funding was provided by U.S. Environmental Protection Agency Science to Achieve Results (STAR) Program grant R832752010, and 1R18EH00348-01 from the U.S. Centers for Disease Control and Prevention, and the Graham Environmental Sustainability Institute at University of Michigan.
Provenance
Commissioned and externally peer reviewed.
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