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Clark A, Grineski S, Curtis DS, Cheung ESL. Identifying groups at-risk to extreme heat: Intersections of age, race/ethnicity, and socioeconomic status. ENVIRONMENT INTERNATIONAL 2024; 191:108988. [PMID: 39217722 DOI: 10.1016/j.envint.2024.108988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 07/31/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024]
Abstract
Anthropogenic climate change has resulted in a significant rise in extreme heat events, exerting considerable but unequal impacts on morbidity and mortality. Numerous studies have identified inequities in heat exposure across different groups, but social identities have often been viewed in isolation from each other. Children (5 and under) and older adults (65 and older) also face elevated risks of heat-related health impacts. We employ an intersectional cross-classificatory approach to analyze the distribution of heat exposure between sociodemographic categories split into age groups in the contiguous US. We utilize high-resolution daily air temperature data to establish three census tract-level heat metrics (i.e., average summer temperature, heat waves, and heat island days). We pair those metrics with American Community Survey estimates on racial/ethnic, socioeconomic, and disability status by age to calculate population weighted mean exposures and absolute disparity metrics. Our findings indicate few substantive differences between age groups overall, but more substantial differences between sociodemographic categories within age groups, with children and older adults from socially marginalized backgrounds facing greater exposure than adults from similar backgrounds. When looking at sociodemographic differences by age, people of color of any age and older adults without health insurance emerge as the most exposed groups. This study identifies groups who are most exposed to extreme heat. Policy and program interventions aimed at reducing the impacts of heat should take these disparities in exposure into account to achieve health equity objectives.
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Affiliation(s)
- Austin Clark
- School of Environment, Society & Sustainability, University of Utah, Salt Lake City, UT, 84112 USA.
| | - Sara Grineski
- Department of Sociology, University of Utah, Salt Lake City, UT, 84112 USA.
| | - David S Curtis
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, 84112 USA.
| | - Ethan Siu Leung Cheung
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, 84112 USA.
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Forceville G, Lemonsu A, Goria S, Stempfelet M, Host S, Alessandrini JM, Cordeau E, Pascal M. Spatial contrasts and temporal changes in fine-scale heat exposure and vulnerability in the Paris region. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 906:167476. [PMID: 37778556 DOI: 10.1016/j.scitotenv.2023.167476] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/20/2023] [Accepted: 09/28/2023] [Indexed: 10/03/2023]
Abstract
Heat is identified as a key climate risk in Europe. Vulnerability to heat can be aggravated by enhanced exposure (e.g., urban heat island), individual susceptibility (e.g., age, income), and adaptive capacity (e.g., home ownership, presence of vegetation). We investigated the spatial and temporal patterns of the environmental and social drivers of vulnerability to heat in the Paris region, France, over the 2000-2020 period, and their association with mortality (restricted to 2000-2017). Daily temperatures were modeled for the 5265 IRIS of the Paris region for 2000-2020. Annual land use and socioeconomic data were collected for each IRIS. They were used to identify a priori five classes of heat-vulnerable areas based on a cluster analysis. The temperature-mortality relationship was investigated using a time-series approach stratified by clusters of vulnerability. The Paris region exhibited a strong urban heat island effect, with a marked shift in temperature distributions after 2015. The clustering suggested that the most heat-vulnerable IRIS in the Paris region have a high or very high exposure to temperature in a highly urbanized environment with little vegetation, but are not systematically associated with social deprivation. A similar J-shape temperature-mortality relationship was observed in the five clusters. Between 2000 and 2017, around 8000 deaths were attributable to heat, 5600 of which were observed in the most vulnerable clusters. Vulnerability assessments based on geographical indicators are key tools for urban planners and decision-makers. They complement the knowledge about individual risk factors but should be further evaluated through interdisciplinary collaborations.
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Affiliation(s)
- Gauthier Forceville
- Santé publique France, National French Public Health Agency, Saint Maurice, France
| | - Aude Lemonsu
- CNRM, Université de Toulouse, Météo-France, CNRS, Toulouse, France
| | - Sarah Goria
- Santé publique France, National French Public Health Agency, Saint Maurice, France
| | - Morgane Stempfelet
- Santé publique France, National French Public Health Agency, Saint Maurice, France
| | | | | | | | - Mathilde Pascal
- Santé publique France, National French Public Health Agency, Saint Maurice, France.
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Li A, Toll M, Bentley R. Mapping social vulnerability indicators to understand the health impacts of climate change: a scoping review. Lancet Planet Health 2023; 7:e925-e937. [PMID: 37940212 DOI: 10.1016/s2542-5196(23)00216-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 11/10/2023]
Abstract
The need to assess and measure how social vulnerability influences the health impacts of climate change has resulted in a rapidly growing body of research literature. To date, there has been no overarching, systematic examination of where this evidence is concentrated and what inferences can be made. This scoping review provides an overview of studies published between 2012 and 2022 on social vulnerability to the negative health effects of climate change. Of the 2115 studies identified from four bibliographic databases (Scopus, Web of Science, PubMed, and CAB Direct), 230 that considered indicators of social vulnerability to climate change impacts on health outcomes were selected for review. Frequency and thematic analyses were conducted to establish the scope of the social vulnerability indicators, climate change impacts, and health conditions studied, and the substantive themes and findings of this research. 113 indicators of social vulnerability covering 15 themes were identified, with a small set of indicators receiving most of the research attention, including age, sex, ethnicity, education, income, poverty, unemployment, access to green and blue spaces, access to health services, social isolation, and population density. The results reveal an undertheorisation and few indicators that conceptualise and operationalise social vulnerability beyond individual sociodemographic characteristics by identifying structural and institutional dimensions of vulnerability, and a preponderance of social vulnerability research in high-income countries. This Review highlights the need for future research, data infrastructure, and policy attention to address structural, institutional, and sociopolitical conditions, which will better support climate resilience and adaptation planning.
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Affiliation(s)
- Ang Li
- NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
| | - Mathew Toll
- NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Rebecca Bentley
- NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
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Zafeiratou S, Samoli E, Analitis A, Gasparrini A, Stafoggia M, de’ Donato FK, Rao S, Zhang S, Breitner S, Masselot P, Aunan K, Schneider A, Katsouyanni K. Assessing heat effects on respiratory mortality and location characteristics as modifiers of heat effects at a small area scale in Central-Northern Europe. Environ Epidemiol 2023; 7:e269. [PMID: 37840857 PMCID: PMC10569755 DOI: 10.1097/ee9.0000000000000269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/06/2023] [Accepted: 08/02/2023] [Indexed: 10/17/2023] Open
Abstract
Background Heat effects on respiratory mortality are known, mostly from time-series studies of city-wide data. A limited number of studies have been conducted at the national level or covering non-urban areas. Effect modification by area-level factors has not been extensively investigated. Our study assessed the heat effects on respiratory mortality at a small administrative area level in Norway, Germany, and England and Wales, in the warm period (May-September) within 1996-2018. Also, we examined possible effect modification by several area-level characteristics in the framework of the EU-Horizon2020 EXHAUSTION project. Methods Daily respiratory mortality counts and modeled air temperature data were collected for Norway, Germany, and England and Wales at a small administrative area level. The temperature-mortality association was assessed by small area-specific Poisson regression allowing for overdispersion, using distributed lag non-linear models. Estimates were pooled at the national level and overall using a random-effect meta-analysis. Age- and sex-specific models were also applied. A multilevel random-effects model was applied to investigate the modification of the heat effects by area-level factors. Results A rise in temperature from the 75th to 99th percentile was associated with a 27% (95% confidence interval [CI] = 19%, 34%) increase in respiratory mortality, with higher effects for females. Increased population density and PM2.5 concentrations were associated with stronger heat effects on mortality. Conclusions Our study strengthens the evidence of adverse heat effects on respiratory mortality in Northern Europe by identifying vulnerable subgroups and subregions. This may contribute to the development of targeted policies for adaptation to climate change.
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Affiliation(s)
- Sofia Zafeiratou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service (ASL ROMA 1), Rome, Italy
| | | | - Shilpa Rao
- Division for Climate and Environment, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Zentrum München (HMGU), Neuherberg, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Zentrum München (HMGU), Neuherberg, Germany
| | - Pierre Masselot
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Kristin Aunan
- CICERO Center for International Climate Research, Norway
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München (HMGU), Neuherberg, Germany
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
- Environmental Research Group, MRC Centre for Environment and Health, Imperial College, London, United Kingdom
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Wu C, Shui W, Huang Z, Wang C, Wu Y, Wu Y, Xue C, Huang Y, Zhang Y, Zheng D. Urban heat vulnerability: A dynamic assessment using multi-source data in coastal metropolis of Southeast China. Front Public Health 2022; 10:989963. [PMID: 36339225 PMCID: PMC9632749 DOI: 10.3389/fpubh.2022.989963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 09/08/2022] [Indexed: 01/26/2023] Open
Abstract
Extreme heat caused by global climate change has become a serious threat to the sustainable development of urban areas. Scientific assessment of the impacts of extreme heat on urban areas and in-depth knowledge of the cross-scale mechanisms of heat vulnerability forming in urban systems are expected to support policymakers and stakeholders in developing effective policies to mitigate the economic, social, and health risks. Based on the perspective of the human-environment system, this study constructed a conceptual framework and index system of "exposure-susceptibility-adaptive capacity" for urban heat vulnerability (UHV) and proposed its assessment methods. Taking Xiamen City, a coastal metropolis, as an example, spatial analysis and Geodetector were used to explore the spatial and temporal changes, spatial characteristics, and patterns of UHV under multiple external disturbances from natural to anthropological factors, and to reveal the main factors influencing UHV forming and spatial differentiation. Results showed that the exposure, susceptibility, adaptive capacity, and UHV in Xiamen City had a spatial structure of "coastal-offshore-inland". On the hot day, both the exposure and UHV showed a temporal pattern of "rising and then falling, peaking at 14:00" and a spatial pattern of "monsoonal-like" movement between coast and inland. Coastal zoning with favorable socioeconomic conditions had less magnitude of changes in UHV, where the stability of the urban system was more likely to be maintained. During the hot months, the high UHV areas were mainly distributed in the inland, while coastal areas showed low UHV levels. Further, coastal UHV was mainly dominated by "heat exposure", offshore by "comprehensive factors", and inland in the northern mountainous areas by "lack of adaptive capacity". Multi-scale urban adaptive capacity was confirmed to alter spatial distribution of exposure and reshape the spatial pattern of UHV. This study promotes the application of multi-scale vulnerability framework to disaster impact assessment, enriches the scientific knowledge of the urban system vulnerability, and provides scientific references for local targeted cooling policy development and extreme heat resilience building programs.
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Affiliation(s)
- Chaowei Wu
- College of Environment and Safety Engineering, Fuzhou University, Fuzhou, China
- School of Public Health, Fudan University, Shanghai, China
| | - Wei Shui
- College of Environment and Safety Engineering, Fuzhou University, Fuzhou, China
| | - Zhigang Huang
- Fujian Meteorological Bureau, Fuzhou, China
- Fujian Meteorological Service Center, Fujian Meteorological Bureau, Fuzhou, China
| | - Chunhui Wang
- Fujian Meteorological Service Center, Fujian Meteorological Bureau, Fuzhou, China
| | - Yuehui Wu
- Taining Meteorological Bureau, Taining, China
| | - Yinpan Wu
- College of Environment and Safety Engineering, Fuzhou University, Fuzhou, China
| | - Chengzhi Xue
- College of Environment and Safety Engineering, Fuzhou University, Fuzhou, China
| | - Yunhui Huang
- College of Environment and Safety Engineering, Fuzhou University, Fuzhou, China
| | - Yiyi Zhang
- Department of Geography, McGill University, Montreal, QC, Canada
| | - Dongyang Zheng
- Fujian Zhitianqi Information Technology Co., Ltd, Fuzhou, China
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Silveira IH, Cortes TR, Oliveira BFA, Junger WL. Temperature and cardiovascular mortality in Rio de Janeiro, Brazil: effect modification by individual-level and neighbourhood-level factors. J Epidemiol Community Health 2020; 75:69-75. [PMID: 32863272 DOI: 10.1136/jech-2020-215002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/06/2020] [Accepted: 08/08/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Many factors related to susceptibility or vulnerability to temperature effects on mortality have been proposed in the literature. However, there is limited evidence of effect modification by some individual-level factors such as occupation, colour/race, education level and community-level factors. We investigated the effect modification of the temperature-cardiovascular mortality relationship by individual-level and neighbourhood-level factors in the city of Rio de Janeiro, Brazil. METHODS We used a case-crossover study to estimate the total effect of temperature on cardiovascular mortality in Rio de Janeiro between 2001 and 2018, and the effect modification by individual-level and neighbourhood-level factors. Individual-level factors included sex, age, colour/race, education, and place of death. Neighbourhood-level characteristics included social development index (SDI), income, electricity consumption and demographic change. We used conditional Poisson regression models combined with distributed lag non-linear models, adjusted for humidity and public holidays. RESULTS Our results suggest a higher vulnerability to high temperatures among the elderly, women, non-hospitalised deaths, and people with a lower education level. Vulnerability to low temperatures was higher among the elderly, men, non-white people, and for primary education level. As for neighbourhood-level factors, we identified greater vulnerability to low and high temperatures in places with lower SDI, lower income, lower consumption of electricity, and higher demographic growth. CONCLUSION The effects of temperature on cardiovascular disease mortality in Rio de Janeiro vary according to individual-level and neighbourhood-level factors. These findings are valuable to inform policymakers about the most vulnerable groups and places, in order to develop more effective and equitable public policies.
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Affiliation(s)
| | - Taísa Rodrigues Cortes
- Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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