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Cornu T, Marchal B, Renmans D. How do urban green spaces influence heat-related mortality in elderly? A realist synthesis. BMC Public Health 2024; 24:457. [PMID: 38350957 PMCID: PMC10865713 DOI: 10.1186/s12889-024-17973-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/03/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND An important consequence of climate change for urban health is heat-related mortality. Vulnerable groups, especially elderly, will be the most affected. A solution put forward in many reports and policy documents is the introduction or expansion of urban green spaces. While they have a proven effect in decreasing the ambient temperature and reducing heat related mortality, the causal pathways are far from clear. Moreover, results vary for different contexts, population types and characteristics of green spaces as they are 'complex systems thrusted into complex systems'. To our knowledge, there is no systematic synthesis of the literature that examines the mechanisms by which and the circumstances under which green spaces work to decrease heat-related mortality for elderly. METHODS We performed a realist synthesis- a theory-driven review method- to develop a complexity- and context-sensitive program theory. As a first step, a causal loop diagram was constructed which describes the possible pathways through which urban green spaces influence heat-related mortality in elderly. In a second step, one of the pathways - how they may lead to a reduction of heat-related mortality by increasing social capital - was further explored for underlying mechanisms, the context in which they work and the differentiated patterns of outcomes they generate. Literature was searched for evidence supporting or contradicting the initial programme theory, resulting in a refined theory. RESULTS Results show how urban green space can impact on heat-related mortality in elderly by its influence on their exposure to outdoor and indoor heat, by improving their resilience as well as by affecting their access to treatment. Urban green spaces and their interactions with social capital affect the access to health information, social support, and the capacity for effective lobbying. Several mechanisms help to explain these observed demi-regularities, among others perceived behavioural control, perceived usefulness, receptiveness, ontological security, and self-interest. If and how they are triggered depends on the characteristics of the urban green space, the population, and other contextual factors. CONCLUSION Looking into the impact of urban green spaces on heat-related mortality in elderly, researchers and policy makers should take interest in the role of social capital.
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Affiliation(s)
- Tom Cornu
- Chair Care and the Natural Living Environment, University of Antwerp, Antwerpen, Belgium.
| | - Bruno Marchal
- Complexity and Health unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Dimitri Renmans
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
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Zhang J, You Q. Avoidable heat risk under scenarios of carbon neutrality by mid-century. Sci Total Environ 2023:164679. [PMID: 37301407 DOI: 10.1016/j.scitotenv.2023.164679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/30/2023] [Accepted: 06/03/2023] [Indexed: 06/12/2023]
Abstract
To prevent anthropogenic warming of the climate system above dangerous thresholds, governments are required by the Paris Agreement to peak global anthropogenic CO2 emissions and to reach a net zero CO2 emissions level (also known as carbon neutrality). Growing concerns are being expressed about the increasing heat stress caused by the interaction of changes in temperature and humidity in the context of global warming. Although much effort has been made to examine future changes in heat stress and associated risks, gaps remain in understanding the quantitative benefits of heat-risk avoidance from carbon-neutral policies, limited by the traditional climate projections from the Coupled Model Intercomparison Project Phase 6 (CMIP6). Here we quantify the avoided heat risk during 2040-2049 under two scenarios of global carbon neutrality by 2060 and 2050, i.e., moderate green (MODGREEN) and strong green (STRGREEN) recovery scenarios, relative to the baseline scenario (FOSSIL), based on multi-model large ensemble climate projections from a new climate model intercomparison project (CovidMIP) that endorsed by CMIP6. We show that global population exposure to extreme heat stress increases by approximately four times its current level during 2040-2049 under the FOSSIL scenario, whereas the heat exposure could be reduced by as much as 12 % and 23 % under the MODGREEN and STRGREEN scenarios, respectively. Moreover, global mean heat-related mortality risk is mitigated by 14 % (24 %) under the MODGREEN (STRGREEN) scenario during 2040-2049 relative to the FOSSIL scenario. Additionally, the aggravating heat risk could be mitigated by around a tenth by achieving carbon neutrality 10 years earlier (2050 versus 2060). In terms of spatial pattern, this heat-risk avoidance from low-carbon policies is typically greater in low-income countries. Our findings assist governments in advancing early climate change mitigation policy-making.
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Affiliation(s)
- Jintao Zhang
- Department of Atmospheric and Oceanic Sciences, Fudan University, Shanghai 200438, China; Chinese Academy of Meteorological Sciences, China Meteorological Administration, Beijing 100081, China
| | - Qinglong You
- Department of Atmospheric and Oceanic Sciences, Fudan University, Shanghai 200438, China; CMA-FDU Joint Laboratory of Marine Meteorology, Shanghai 200438, China.
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Yezli S, Khan AH, Yassin YM, Khan AA, Alotaibi BM, Bouchama A. Human tolerance to extreme heat: evidence from a desert climate population. J Expo Sci Environ Epidemiol 2023:10.1038/s41370-023-00549-7. [PMID: 37138035 DOI: 10.1038/s41370-023-00549-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Ambient temperatures exceeding 40 °C are projected to become common in many temperate climatic zones due to global warming. Therefore, understanding the health effects of continuous exposure to high ambient temperatures on populations living in hot climatic regions can help identify the limits of human tolerance. OBJECTIVE We studied the relationship between ambient temperature and non-accidental mortality in the hot desert city of Mecca, Saudi Arabia, between 2006 and 2015. METHODS We used a distributed lag nonlinear model to estimate the mortality-temperature association over 25 days of lag. We determined the minimum mortality temperature (MMT) and the deaths that are attributable to heat and cold. RESULTS We analyzed 37,178 non-accidental deaths reported in the ten-year study period among Mecca residents. The median average daily temperature was 32 °C (19-42 °C) during the same study period. We observed a U-shaped relationship between daily temperature and mortality with an MMT of 31.8 °C. The total temperature-attributable mortality of Mecca residents was 6.9% (-3.2; 14.8) without reaching statistical significance. However, extreme heat, higher than 38 °C, was significantly associated with increased risk of mortality. The lag structure effect of the temperature showed an immediate impact, followed by a decline in mortality over many days of heat. No effect of cold on mortality was observed. IMPACT STATEMENT High ambient temperatures are projected to become future norms in temperate climates. Studying populations familiar with desert climates for generations with access to air-conditioning would inform on the mitigation measures to protect other populations from heat and on the limits of human tolerance to extreme temperatures. We studied the relationship between ambient temperature and all-cause mortality in the hot desert city of Mecca. We found that Mecca population is adapted to high temperatures, although there was a limit to tolerance to extreme heat. This implies that mitigation measures should be directed to accelerate individual adaptation to heat and societal reorganization.
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Affiliation(s)
- Saber Yezli
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
- Global Centre for Mass Gathering Medicine, Ministry of Health, Riyadh, 12341, Saudi Arabia.
- Experimental Medicine Department, King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences 11481, Riyadh, Saudi Arabia.
| | - Altaf H Khan
- Department of Biostatistics and Bioinformatics, King Abdullah International Center for Medical Research / King Saud bin Abdulaziz University for Health Sciences 11481, Riyadh, Saudi Arabia
| | - Yara M Yassin
- Global Centre for Mass Gathering Medicine, Ministry of Health, Riyadh, 12341, Saudi Arabia
| | - Anas A Khan
- Global Centre for Mass Gathering Medicine, Ministry of Health, Riyadh, 12341, Saudi Arabia
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh, 12372, Saudi Arabia
| | - Badriah M Alotaibi
- Global Centre for Mass Gathering Medicine, Ministry of Health, Riyadh, 12341, Saudi Arabia
| | - Abderrezak Bouchama
- Experimental Medicine Department, King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences 11481, Riyadh, Saudi Arabia.
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Błażejczyk K, Twardosz R, Wałach P, Czarnecka K, Błażejczyk A. Heat strain and mortality effects of prolonged central European heat wave-an example of June 2019 in Poland. Int J Biometeorol 2022; 66:149-161. [PMID: 34698932 PMCID: PMC8727406 DOI: 10.1007/s00484-021-02202-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/21/2021] [Accepted: 10/01/2021] [Indexed: 05/21/2023]
Abstract
The occurrence of long-lasting severe heat stress, such as in July-August 2003, July 2010, or in April-May 2018 has been one of the biggest meteorological threats in Europe in recent years. The paper focuses on the biometeorological and mortality effects of the hot June that was observed in Central Europe in 2019. The basis of the study was hourly and daily Universal Thermal Climate Index (UTCI) values at meteorological stations in Poland for June 2019. The average monthly air temperature and UTCI values from 1951 to 2018 were analysed as background. Grosswetterlagen calendar of atmospheric circulation was used to assess synoptic conditions of heat wave. Several heat strain measures were applied : net heat storage (S), modelled heart rate (HR), sultriness (HSI), and UTCI index. Actual total mortality (TM) and modelled strong heat-related mortality (SHRM) were taken as indicators of biometeorological consequences of the hot June in 2019. The results indicate that prolonged persistence of unusually warm weather in June 2019 was determined by the synoptic conditions occurring over the European region and causing advection of tropical air. They led to the emergence of heat waves causing 10% increase in TM and 5 times bigger SHRM then in preceding 10 years. Such increase in SHRM was an effect of overheating and overload of circulatory system of human organism.
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Affiliation(s)
- Krzysztof Błażejczyk
- Climate Impacts Laboratory, Institute of Geography and Spatial Organization, Polish Academy of Sciences, Twarda 51/55, 00-818 Warszawa, Poland
| | - Robert Twardosz
- Faculty of Geography and Geology, Jagiellonian University in Cracow, Gronostajowa 7, 30-387 Kraków, Poland
| | - Piotr Wałach
- Institute of Meteorology and Water Management, National Research Institute, Borowego 14, 30-215 Kraków, Poland
| | - Kaja Czarnecka
- Climate Impacts Laboratory, Institute of Geography and Spatial Organization, Polish Academy of Sciences, Twarda 51/55, 00-818 Warszawa, Poland
| | - Anna Błażejczyk
- Laboratory of Bioclimatology and Environmental Ergonomic, Łukowska 17/55, 04-133 Warszawa, Poland
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Morais L, Lopes A, Nogueira P. Human health outcomes at the neighbourhood scale implications: Elderly's heat-related cardiorespiratory mortality and its influencing factors. Sci Total Environ 2021; 760:144036. [PMID: 33348162 DOI: 10.1016/j.scitotenv.2020.144036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/18/2020] [Accepted: 11/18/2020] [Indexed: 06/12/2023]
Abstract
The excessively warm weather, especially in cities, can lead to several adverse impacts, including heat-related mortality, becoming an increasingly important public health issue. Previous studies on heat-related mortality have assessed risk factors at the municipal scale, missing the intra-urban variability in heat risk and vulnerability. The knowledge of the spatial intra-variability can help to design spatially targeted measures to better protect citizens' health. Through hot spot analysis, we identified the neighbourhood-scale spatial pattern of heat-related cardiorespiratory mortality in the elderly, during the yearly warmest five months of a three years period. Potential associations between spatial variability in heat-related mortality and several independent factors in each neighbourhood were investigated and their predictions. Two approaches were adopted: one is eminently statistical, using Generalized Linear Models (GLM) and another using Geographically Weighted Regression (GWR). This new recent regression technique is increasing in international attention on spatial modelling. The spatial model explains about 60% of the spatial variations in elderly's heat-related cardiorespiratory mortality. The two-analyses produced an overlapping set of predictor variables, with emphasis on the elderly, vegetation cover and employment. The results also show that the areas where heat-related mortality is high, are also the areas where the number of deaths is higher than expected. These neighbourhoods should be considered as the most vulnerable to heat-related mortality. We concluded that studying human health outcomes at neighbourhood-scale is relevant for public health heat-related plans. Essential suggestions are provided to decision-making support and city planners designing strategies to reduce heat-related mortality.
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Affiliation(s)
- Liliane Morais
- Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - António Lopes
- Institute of Geography and Spatial Planning (IGOT), University of Lisbon, Lisbon, Portugal.
| | - Paulo Nogueira
- Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisbon, Lisbon, Portugal; National School of Public Health (CISP), New University of Lisbon, Lisbon, Portugal.
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Jänicke B, Kim KR, Cho C. A simple high-resolution heat-stress forecast for Seoul, Korea: coupling climate information with an operational numerical weather prediction model. Int J Biometeorol 2020; 64:1197-1205. [PMID: 32166440 DOI: 10.1007/s00484-020-01893-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 01/30/2020] [Accepted: 03/03/2020] [Indexed: 06/10/2023]
Abstract
To provide a simple high-resolution heat-stress forecast for Seoul, Korea, we coupled a high-resolution climate simulation (25 m grid spacing) for an average heat day with the operational forecasting model (5 km grid spacing). Thereby, we accounted for the meso-scale weather conditions and local-scale air temperature induced by land cover and the urban heat island effect. Moreover, we estimated the impacts of heat events using heat-related mortality rate. Applying the simple high-resolution heat-stress forecast for July and August 2016, we detected a substantial spatial variability in maximum air temperature and heat-related mortality rate in Seoul. The evaluation of simulated maximum air temperature compared to observations revealed a small deviation (MB = 0.11 K, RMSD = 1.40 K). Despite the limitation of using average conditions, it was an efficient way to identify particularly affected areas, neighbourhoods, and districts for releasing more location-specific heat-stress warnings.
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Affiliation(s)
- Britta Jänicke
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, Jeju-do, 63568, Republic of Korea.
| | - Kyu Rang Kim
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, Jeju-do, 63568, Republic of Korea
| | - Changbum Cho
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, Jeju-do, 63568, Republic of Korea
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7
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Urban A, Kyselý J, Plavcová E, Hanzlíková H, Štěpánek P. Temporal changes in years of life lost associated with heat waves in the Czech Republic. Sci Total Environ 2020; 716:137093. [PMID: 32044496 DOI: 10.1016/j.scitotenv.2020.137093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/09/2020] [Accepted: 02/01/2020] [Indexed: 06/10/2023]
Abstract
Seniors constitute the population group generally most at risk of mortality due to heat stress. As life expectancy increases and health conditions of elderly people improve over time, vulnerability of the population to heat changes as well. We employed the years-of-life-lost (YLL) approach, considering life expectancy at the time of each death, to investigate how population ageing affects temporal changes in heat-related mortality in the Czech Republic. Using an updated gridded meteorological database, we identified heat waves during 1994-2017, and analysed temporal changes in their impacts on YLL and mortality. The mean impact of a heat-wave day on relative excess mortality and YLL had declined by approximately 2-3% per decade. That decline abated in the current decade, however, and the decreasing trend in mean excess mortality as well as YLL vanished when the short-term mortality displacement effect was considered. Moreover, the cumulative number of excess deaths and YLL during heat waves rose due to increasing frequency and intensity of heat waves during the examined period. The results show that in studies of temporal changes it is important to differentiate between mean effects of heat waves on mortality and the overall death burden associated with heat waves. Analysis of the average ratio of excess YLL/death per heat-wave day indicated that the major heat-vulnerable population group shifted towards older age (70+ years among males and 75+ years among females). Our findings highlight the importance of focusing heat-protection measures especially upon the elderly population, which is most heat-vulnerable and whose numbers are rising.
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Affiliation(s)
- Aleš Urban
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic.
| | - Jan Kyselý
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic; Global Change Research Institute of the Czech Academy of Sciences, Brno, Czech Republic
| | - Eva Plavcová
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - Hana Hanzlíková
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic; Institute of Geophysics of the Czech Academy of Sciences, Prague, Czech Republic
| | - Petr Štěpánek
- Global Change Research Institute of the Czech Academy of Sciences, Brno, Czech Republic; Institute of Geophysics of the Czech Academy of Sciences, Prague, Czech Republic; Czech Hydrometeorological Institute, Regional Office Brno, Brno, Czech Republic
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Urban A, Hondula DM, Hanzlíková H, Kyselý J. The predictability of heat-related mortality in Prague, Czech Republic, during summer 2015-a comparison of selected thermal indices. Int J Biometeorol 2019; 63:535-548. [PMID: 30739159 DOI: 10.1007/s00484-019-01684-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/21/2018] [Accepted: 01/28/2019] [Indexed: 06/09/2023]
Abstract
We compared selected thermal indices in their ability to predict heat-related mortality in Prague, Czech Republic, during the extraordinary summer 2015. Relatively, novel thermal indices-Universal Thermal Climate Index and Excess Heat Factor (EHF)-were compared with more traditional ones (apparent temperature, simplified wet-bulb globe temperature (WBGT), and physiologically equivalent temperature). The relationships between thermal indices and all-cause relative mortality deviations from the baseline (excess mortality) were estimated by generalized additive models for the extended summer season (May-September) during 1994-2014. The resulting models were applied to predict excess mortality in 2015 based on observed meteorology, and the mortality estimates by different indices were compared. Although all predictors showed a clear association between thermal conditions and excess mortality, we found important variability in their performance. The EHF formula performed best in estimating the intensity of heat waves and magnitude of heat-impacts on excess mortality on the most extreme days. Afternoon WBGT, on the other hand, was most precise in the selection of heat-alert days during the extended summer season, mainly due to a relatively small number of "false alerts" compared to other predictors. Since the main purpose of heat warning systems is identification of days with an increased risk of heat-related death rather than prediction of exact magnitude of the excess mortality, WBGT seemed to be a slightly favorable predictor for such a system.
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Affiliation(s)
- Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic.
| | - David M Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University, P.O. Box 875302, Tempe, AZ, 85287-5302, USA
| | - Hana Hanzlíková
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic
- Institute of Geophysics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 141 31, Prague 4, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Kamýcká 129, 165 21, Prague 6, Czech Republic
- Global Change Research Centre, Czech Academy of Sciences, Bělidla 986, 603 00, Brno, Czech Republic
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Jänicke B, Holtmann A, Kim KR, Kang M, Fehrenbach U, Scherer D. Quantification and evaluation of intra-urban heat-stress variability in Seoul, Korea. Int J Biometeorol 2019; 63:1-12. [PMID: 30460432 DOI: 10.1007/s00484-018-1631-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 10/03/2018] [Accepted: 10/07/2018] [Indexed: 06/09/2023]
Abstract
This study quantifies heat-stress hazard (air temperature), vulnerability (heat vulnerability index and age score), and risk (heat-related mortality) on the district scale in Seoul, Korea, for a comprehensive heat-stress impact assessment. Moreover, the heat-stress impact assessment is evaluated by checking the spatial consistency between heat-stress hazard, vulnerability, and risk, which was rarely done before. We applied numerical and geo-empirical models to simulate the spatial pattern of heat-stress hazard. For heat-stress vulnerability, we used demographic and socioeconomic factors. Heat-related mortality was estimated based on an event-based heat-stress risk analysis. Results are that heat-stress hazard, vulnerability, and risk are spatially variable in Seoul. The highest heat-stress hazard was detected in the districts Mapo, Yeongdeungpo, and Yangcheon, the highest vulnerability in Jongno and the highest risk in Jongno and Yangcheon. The different components (heat-stress hazard, vulnerability, and risk) and variables (heat vulnerability index and percentage of seniors) showed different spatial patterns. Knowledge about the causes of higher heat-stress risk, either the hazard or vulnerability, is helpful to design tailored adaptation measures that focus on the reduction of thermal loads or on the preparation of the vulnerable population. The evaluation showed that heat-stress vulnerability and hazard explain the spatial pattern of risk only partly. This highlights the need to evaluate heat-stress impact assessment systems to produce reliable urban heat-stress maps.
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Affiliation(s)
- Britta Jänicke
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, 63568, Jeju-do, Republic of Korea.
| | - Achim Holtmann
- Institute of Ecology, Technische Universität Berlin, Rothenburgstraße 12, 12165, Berlin, Germany
| | - Kyu Rang Kim
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, 63568, Jeju-do, Republic of Korea
| | - Misun Kang
- Applied Meteorological Research Division, National Institute of Meteorological Sciences, 33, Seohobuk-ro, Seogwipo-si, 63568, Jeju-do, Republic of Korea
| | - Ute Fehrenbach
- Institute of Ecology, Technische Universität Berlin, Rothenburgstraße 12, 12165, Berlin, Germany
| | - Dieter Scherer
- Institute of Ecology, Technische Universität Berlin, Rothenburgstraße 12, 12165, Berlin, Germany
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Martinez GS, Diaz J, Hooyberghs H, Lauwaet D, De Ridder K, Linares C, Carmona R, Ortiz C, Kendrovski V, Adamonyte D. Cold-related mortality vs heat-related mortality in a changing climate: A case study in Vilnius (Lithuania). Environ Res 2018; 166:384-393. [PMID: 29936286 DOI: 10.1016/j.envres.2018.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/23/2018] [Accepted: 06/01/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Direct health effects of extreme temperatures are a significant environmental health problem in Lithuania, and could worsen further under climate change. This paper attempts to describe the change in environmental temperature conditions that the urban population of Vilnius could experience under climate change, and the effects such change could have on excess heat-related and cold-related mortality in two future periods within the 21st century. METHODS We modelled the urban climate of Vilnius for the summer and winter seasons during a sample period (2009-2015) and projected summertime and wintertime daily temperatures for two prospective periods, one in the near (2030-2045) and one in the far future (2085-2100), under the Representative Concentration Pathway (RCP) 8.5. We then analysed the historical relationship between temperature and mortality for the period 2009-2015, and estimated the projected mortality in the near future and far future periods under a changing climate and population, assuming alternatively no acclimatisation and acclimatisation to heat and cold based on a constant-percentile threshold temperature. RESULTS During the sample period 2009-2015 in summertime we observed an increase in daily mortality from a maximum daily temperature of 30 °C (the 96th percentile of the series), with an average of around 7 deaths per year. Under a no acclimatisation scenario, annual average heat-related mortality would rise to 24 deaths/year (95% CI: 8.4-38.4) in the near future and to 46 deaths/year (95% CI: 16.4-74.4) in the far future. Under a heat acclimatisation scenario, mortality would not increase significantly in the near or in the far future. Regarding wintertime cold-related mortality in the sample period 2009-2015, we observed increased mortality on days on which the minimum daily temperature fell below - 12 °C (the 7th percentile of the series), with an average of around 10 deaths a year. Keeping the threshold temperature constant, annual average cold-related mortality would decrease markedly in the near future, to 5 deaths/year (95% CI: 0.8-7.9) and even more in the far future, down to 0.44 deaths/year (95% C: 0.1-0.8). Assuming a "middle ground" between the acclimatisation and non-acclimatisation scenarios, the decrease in cold-related mortality will not compensate the increase in heat-related mortality. CONCLUSION Thermal extremes, both heat and cold, constitute a serious public health threat in Vilnius, and in a changing climate the decrease in mortality attributable to cold will not compensate for the increase in mortality attributable to heat. Study results reinforce the notion that public health prevention against thermal extremes should be designed as a dynamic, adaptive process from the inception.
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Affiliation(s)
| | - Julio Diaz
- National School of Public Health, Carlos III Institute of Health (ISCIII), Spain.
| | - Hans Hooyberghs
- Flemish Institute for Technological Research (VITO), Belgium.
| | - Dirk Lauwaet
- Flemish Institute for Technological Research (VITO), Belgium.
| | - Koen De Ridder
- Flemish Institute for Technological Research (VITO), Belgium.
| | - Cristina Linares
- National School of Public Health, Carlos III Institute of Health (ISCIII), Spain.
| | - Rocio Carmona
- National School of Public Health, Carlos III Institute of Health (ISCIII), Spain.
| | - Cristina Ortiz
- National School of Public Health, Carlos III Institute of Health (ISCIII), Spain.
| | - Vladimir Kendrovski
- WHO European Centre for Environment and Health (World Health Organization Regional Office for Europe), Germany.
| | - Dovile Adamonyte
- Centre for Health Education and Diseases Prevention (SMLPC), Lithuania.
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Li Y, Ren T, Kinney PL, Joyner A, Zhang W. Projecting future climate change impacts on heat-related mortality in large urban areas in China. Environ Res 2018; 163:171-185. [PMID: 29448153 DOI: 10.1016/j.envres.2018.01.047] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/10/2018] [Accepted: 01/31/2018] [Indexed: 06/08/2023]
Abstract
Global climate change is anticipated to raise overall temperatures and has the potential to increase future mortality attributable to heat. Urban areas are particularly vulnerable to heat because of high concentrations of susceptible people. As the world's largest developing country, China has experienced noticeable changes in climate, partially evidenced by frequent occurrence of extreme heat in urban areas, which could expose millions of residents to summer heat stress that may result in increased health risk, including mortality. While there is a growing literature on future impacts of extreme temperatures on public health, projecting changes in future health outcomes associated with climate warming remains challenging and underexplored, particularly in developing countries. This is an exploratory study aimed at projecting future heat-related mortality risk in major urban areas in China. We focus on the 51 largest Chinese cities that include about one third of the total population in China, and project the potential changes in heat-related mortality based on 19 different global-scale climate models and three Representative Concentration Pathways (RCPs). City-specific risk estimates for high temperature and all-cause mortality were used to estimate annual heat-related mortality over two future twenty-year time periods. We estimated that for the 20-year period in Mid-21st century (2041-2060) relative to 1970-2000, incidence of excess heat-related mortality in the 51 cities to be approximately 37,800 (95% CI: 31,300-43,500), 31,700 (95% CI: 26,200-36,600) and 25,800 (95% CI: 21,300-29,800) deaths per year under RCP8.5, RCP4.5 and RCP2.6, respectively. Slowing climate change through the most stringent emission control scenario RCP2.6, relative to RCP8.5, was estimated to avoid 12,900 (95% CI: 10,800-14,800) deaths per year in the 51 cities in the 2050s, and 35,100 (95% CI: 29,200-40,100) deaths per year in the 2070s. The highest mortality risk is primarily in cities located in the North, East and Central regions of China. Population adaptation to heat is likely to reduce excess heat mortality, but the extent of adaptation is still unclear. Future heat mortality risk attributable to exposure to elevated warm season temperature is likely to be considerable in China's urban centers, with substantial geographic variations. Climate mitigation and heat risk management are needed to reduce such risk and produce substantial public health benefits.
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Affiliation(s)
- Ying Li
- Department of Environmental Health, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Ting Ren
- School of Environment and Natural Resources, Renmin University of China, Beijing 100872, China
| | - Patrick L Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA
| | - Andrew Joyner
- Department of Geosciences, East Tennessee State University, Johnson City, TN 37614, USA
| | - Wei Zhang
- School of Environment and Natural Resources, Renmin University of China, Beijing 100872, China.
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Martinez GS, Diaz J, Hooyberghs H, Lauwaet D, De Ridder K, Linares C, Carmona R, Ortiz C, Kendrovski V, Aerts R, Van Nieuwenhuyse A, Bekker-Nielsen Dunbar M. Heat and health in Antwerp under climate change: Projected impacts and implications for prevention. Environ Int 2018; 111:135-143. [PMID: 29207285 PMCID: PMC5786665 DOI: 10.1016/j.envint.2017.11.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/15/2017] [Accepted: 11/16/2017] [Indexed: 05/16/2023]
Abstract
BACKGROUND Excessive summer heat is a serious environmental health problem in several European cities. Heat-related mortality and morbidity is likely to increase under climate change scenarios without adequate prevention based on locally relevant evidence. METHODS We modelled the urban climate of Antwerp for the summer season during the period 1986-2015, and projected summer daily temperatures for two periods, one in the near (2026-2045) and one in the far future (2081-2100), under the Representative Concentration Pathway (RCP) 8.5. We then analysed the relationship between temperature and mortality, as well as with hospital admissions for the period 2009-2013, and estimated the projected mortality in the near future and far future periods under changing climate and population, assuming alternatively no acclimatization and acclimatization based on a constant threshold percentile temperature. RESULTS During the sample period 2009-2013 we observed an increase in daily mortality from a maximum daily temperature of 26°C, or the 89th percentile of the maximum daily temperature series. The annual average heat-related mortality in this period was 13.4 persons (95% CI: 3.8-23.4). No effect of heat was observed in the case of hospital admissions due to cardiorespiratory causes. Under a no acclimatization scenario, annual average heat-related mortality is multiplied by a factor of 1.7 in the near future (24.1deaths/year CI 95%: 6.78-41.94) and by a factor of 4.5 in the far future (60.38deaths/year CI 95%: 17.00-105.11). Under a heat acclimatization scenario, mortality does not increase significantly in the near or in the far future. CONCLUSION These results highlight the importance of a long-term perspective in the public health prevention of heat exposure, particularly in the context of a changing climate, and the calibration of existing prevention activities in light of locally relevant evidence.
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Affiliation(s)
- Gerardo Sanchez Martinez
- The UNEP-DTU Partnership, United Nations City, Marmorvej 41, Copenhagen, Denmark; WHO European Centre for Environment and Health (World Health Organization Regional Office for Europe), Platz der Vereinten Nationen 1, Bonn, Germany.
| | - Julio Diaz
- National School of Public Health, Carlos III Institute of Health (ISCIII), Spain.
| | - Hans Hooyberghs
- Flemish Institute for Technological Research (VITO), Belgium.
| | - Dirk Lauwaet
- Flemish Institute for Technological Research (VITO), Belgium.
| | - Koen De Ridder
- Flemish Institute for Technological Research (VITO), Belgium.
| | - Cristina Linares
- National School of Public Health, Carlos III Institute of Health (ISCIII), Spain.
| | - Rocio Carmona
- National School of Public Health, Carlos III Institute of Health (ISCIII), Spain.
| | - Cristina Ortiz
- National School of Public Health, Carlos III Institute of Health (ISCIII), Spain.
| | - Vladimir Kendrovski
- WHO European Centre for Environment and Health (World Health Organization Regional Office for Europe), Platz der Vereinten Nationen 1, Bonn, Germany.
| | - Raf Aerts
- Health and Environment, Scientific Institute of Public Health (WIV-ISP), Belgium; Department of Earth and Environmental Sciences, University of Leuven (KU Leuven), Belgium.
| | - An Van Nieuwenhuyse
- Health and Environment, Scientific Institute of Public Health (WIV-ISP), Belgium; Department of Public Health and Primary Care, Environmental Health, University of Leuven (KU Leuven), Belgium.
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Benmarhnia T, Kihal-Talantikite W, Ragettli MS, Deguen S. Small-area spatiotemporal analysis of heatwave impacts on elderly mortality in Paris: A cluster analysis approach. Sci Total Environ 2017; 592:288-294. [PMID: 28319715 DOI: 10.1016/j.scitotenv.2017.03.102] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 02/21/2017] [Accepted: 03/10/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Heat-waves have a substantial public health burden. Understanding spatial heterogeneity at a fine spatial scale in relation to heat and related mortality is central to target interventions towards vulnerable communities. OBJECTIVES To determine the spatial variability of heat-wave-related mortality risk among elderly in Paris, France at the census block level. We also aimed to assess area-level social and environmental determinants of high mortality risk within Paris. METHODS We used daily mortality data from 2004 to 2009 among people aged >65 at the French census block level within Paris. We used two heat wave days' definitions that were compared to non-heat wave days. A Bernoulli cluster analysis method was applied to identify high risk clusters of mortality during heat waves. We performed random effects meta-regression analyses to investigate factors associated with the magnitude of the mortality risk. RESULTS The spatial approach revealed a spatial aggregation of death cases during heat wave days. We found that small scale chronic PM10 exposure was associated with a 0.02 (95% CI: 0.001; 0.045) increase of the risk of dying during a heat wave episode. We also found a positive association with the percentage of foreigners and the percentage of labor force, while the proportion of elderly people living in the neighborhood was negatively associated. We also found that green space density had a protective effect and inversely that the density of constructed feature increased the risk of dying during a heat wave episode. CONCLUSION We showed that a spatial variation in terms of heat-related vulnerability exists within Paris and that it can be explained by some contextual factors. This study can be useful for designing interventions targeting more vulnerable areas and reduce the burden of heat waves.
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Affiliation(s)
- Tarik Benmarhnia
- Department of Family Medicine and Public Health, Scripps Institution of Oceanography, University of California, San Diego, CA, USA.
| | | | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel 4002, Switzerland; University of Basel, Basel 4003, Switzerland
| | - Séverine Deguen
- EHESP School of Public Health-Rennes, Sorbonne-Paris Cité, France
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14
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Martinez GS, Baccini M, De Ridder K, Hooyberghs H, Lefebvre W, Kendrovski V, Scott K, Spasenovska M. Projected heat-related mortality under climate change in the metropolitan area of Skopje. BMC Public Health 2016; 16:407. [PMID: 27183821 PMCID: PMC4868033 DOI: 10.1186/s12889-016-3077-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 05/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Excessive summer heat is a serious environmental health problem in Skopje, the capital and largest city of the former Yugoslav Republic of Macedonia. This paper attempts to forecast the impact of heat on mortality in Skopje in two future periods under climate change and compare it with a historical baseline period. METHODS After ascertaining the relationship between daily mean ambient air temperature and daily mortality in Skopje, we modelled the evolution of ambient temperatures in the city under a Representative Concentration Pathway scenario (RCP8.5) and the evolution of the city population in two future time periods: 2026-2045 and 2081-2100, and in a past time period (1986-2005) to serve as baseline for comparison. We then calculated the projected average annual mortality attributable to heat in the absence of adaptation or acclimatization during those time windows, and evaluated the contribution of each source of uncertainty on the final impact. RESULTS Our estimates suggest that, compared to the baseline period (1986-2005), heat-related mortality in Skopje would more than double in 2026-2045, and more than quadruple in 2081-2100. When considering the impact in 2081-2100, sampling variability around the heat-mortality relationship and climate model explained 40.3 and 46.6 % of total variability. CONCLUSION These results highlight the importance of a long-term perspective in the public health prevention of heat exposure, particularly in the context of a changing climate.
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Affiliation(s)
- Gerardo Sanchez Martinez
- WHO European Centre for Environment and Health, WHO Regional Office for Europe, Platz der Vereinten Nationen 1, 53113, Bonn, Germany.
| | - Michela Baccini
- Department of Statistics, Informatics and Applications (DiSIA), University of Florence, Viale Morgagni 59, 50134, Florence, Italy.,Biostatistics Unit, Cancer Prevention and Research Institute (ISPO), Via Cosimo Il Vecchio 2, 50139, Florence, Italy
| | - Koen De Ridder
- VITO (Flemish Institute for Technological Research), Urban Climate Team, Boeretang 200, 2400, Mol, Belgium
| | - Hans Hooyberghs
- VITO (Flemish Institute for Technological Research), Urban Climate Team, Boeretang 200, 2400, Mol, Belgium
| | - Wouter Lefebvre
- VITO (Flemish Institute for Technological Research), Urban Climate Team, Boeretang 200, 2400, Mol, Belgium
| | - Vladimir Kendrovski
- WHO European Centre for Environment and Health, WHO Regional Office for Europe, Platz der Vereinten Nationen 1, 53113, Bonn, Germany
| | - Kristen Scott
- WHO European Centre for Environment and Health, WHO Regional Office for Europe, Platz der Vereinten Nationen 1, 53113, Bonn, Germany
| | - Margarita Spasenovska
- WHO Country Office, the former Yugoslav Republic of Macedonia, Drezdenska 22, 1000, Skopje, Macedonia
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15
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Greene JS, Kalkstein LS, Kim KR, Choi YJ, Lee DG. The application of the European heat wave of 2003 to Korean cities to analyze impacts on heat-related mortality. Int J Biometeorol 2016; 60:231-43. [PMID: 26076864 DOI: 10.1007/s00484-015-1020-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Revised: 05/20/2015] [Accepted: 05/21/2015] [Indexed: 05/06/2023]
Abstract
The goal of this research is to transpose the unprecedented 2003 European excessive heat event to six Korean cities and to develop meteorological analogs for each. Since this heat episode is not a model but an actual event, we can use a plausible analog to assess the risk of increasing heat on these cities instead of an analog that is dependent on general circulation (GCM) modeling or the development of arbitrary scenarios. Initially, the 2003 summer meteorological conditions from Paris are characterized statistically and these characteristics are transferred to the Korean cites. Next, the new meteorological dataset for each Korean city is converted into a daily air mass calendar. We can then determine the frequency and character of "offensive" air masses in the Korean cities that are historically associated with elevated heat-related mortality. One unexpected result is the comparative severity of the very hot summer of 1994 in Korea, which actually eclipsed the 2003 analog. The persistence of the offensive air masses is considerably greater for the summer of 1994, as were dew point temperatures for a majority of the Korean cities. For all the Korean cities but one, the summer of 1994 is associated with more heat-related deaths than the analog summer, in some cases yielding a sixfold increase over deaths in an average summer. The Korean cities appear less sensitive to heat-related mortality problems during very hot summers than do large eastern and Midwestern US cities, possibly due to a lesser summer climate variation and efficient social services available during extreme heat episodes.
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Affiliation(s)
- J Scott Greene
- Department of Geography and Environmental Sustainability, University of Oklahoma, Norman, OK, USA.
| | - Laurence S Kalkstein
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Coral Gables, FL, USA
| | - Kyu Rang Kim
- National Institute of Meteorological Research, Korea Meteorological Administration, Seoul, Korea
| | - Young-Jean Choi
- National Institute of Meteorological Research, Korea Meteorological Administration, Seoul, Korea
| | - Dae-Geun Lee
- National Institute of Meteorological Research, Korea Meteorological Administration, Seoul, Korea
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16
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Abstract
The health impacts of exposure to summertime heat are a significant problem in New York City (NYC) and for many cities and are expected to increase with a warming climate. Most studies on heat-related mortality have examined risk factors at the municipal or regional scale and may have missed the intra-urban variation of vulnerability that might inform prevention strategies. We evaluated whether place-based characteristics (socioeconomic/demographic and health factors, as well as the built and biophysical environment) may be associated with greater risk of heat-related mortality for seniors during heat events in NYC. As a measure of relative vulnerability to heat, we used the natural cause mortality rate ratio among those aged 65 and over (MRR65+), comparing extremely hot days (maximum heat index 100 °F+) to all warm season days, across 1997–2006 for NYC's 59 Community Districts and 42 United Hospital Fund neighborhoods. Significant positive associations were found between the MRR65+ and neighborhood-level characteristics: poverty, poor housing conditions, lower rates of access to air-conditioning, impervious land cover, surface temperatures aggregated to the area-level, and seniors’ hypertension. Percent Black/African American and household poverty were strong negative predictors of seniors’ air conditioning access in multivariate regression analysis.
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Affiliation(s)
- Joyce Klein Rosenthal
- Harvard University Graduate School of Design, Department of Urban Planning & Design, 48 Quincy Street, Cambridge, MA 02138, USA; Columbia University Graduate School of Architecture, Planning & Preservation, Urban Planning Program, 400 Avery Hall, 1172 Amsterdam Avenue, New York, NY 10027, USA.
| | - Patrick L Kinney
- Columbia University Mailman School of Public Health, Department of Environmental Health Sciences, 722W. 168th St., New York, NY 10032, USA.
| | - Kristina B Metzger
- New York City Department of Health and Mental Hygiene, Bureau of Environmental, Surveillance and Policy, 120 Worth Street, New York, NY 10013, USA
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17
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Hondula DM, Georgescu M, Balling RC. Challenges associated with projecting urbanization-induced heat-related mortality. Sci Total Environ 2014; 490:538-544. [PMID: 24880543 DOI: 10.1016/j.scitotenv.2014.04.130] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 04/15/2014] [Accepted: 04/30/2014] [Indexed: 06/03/2023]
Abstract
Maricopa County, Arizona, anchor to the fastest growing megapolitan area in the United States, is located in a hot desert climate where extreme temperatures are associated with elevated risk of mortality. Continued urbanization in the region will impact atmospheric temperatures and, as a result, potentially affect human health. We aimed to quantify the number of excess deaths attributable to heat in Maricopa County based on three future urbanization and adaptation scenarios and multiple exposure variables. Two scenarios (low and high growth projections) represent the maximum possible uncertainty range associated with urbanization in central Arizona, and a third represents the adaptation of high-albedo cool roof technology. Using a Poisson regression model, we related temperature to mortality using data spanning 1983-2007. Regional climate model simulations based on 2050-projected urbanization scenarios for Maricopa County generated distributions of temperature change, and from these predicted changes future excess heat-related mortality was estimated. Subject to urbanization scenario and exposure variable utilized, projections of heat-related mortality ranged from a decrease of 46 deaths per year (-95%) to an increase of 339 deaths per year (+359%). Projections based on minimum temperature showed the greatest increase for all expansion and adaptation scenarios and were substantially higher than those for daily mean temperature. Projections based on maximum temperature were largely associated with declining mortality. Low-growth and adaptation scenarios led to the smallest increase in predicted heat-related mortality based on mean temperature projections. Use of only one exposure variable to project future heat-related deaths may therefore be misrepresentative in terms of direction of change and magnitude of effects. Because urbanization-induced impacts can vary across the diurnal cycle, projections of heat-related health outcomes that do not consider place-based, time-varying urban heat island effects are neglecting essential elements for policy relevant decision-making.
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Affiliation(s)
- David M Hondula
- Center for Policy Informatics, Arizona State University, Phoenix, AZ 85004, USA; School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ 85287, USA.
| | - Matei Georgescu
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ 85287, USA; Global Institute of Sustainability, Arizona State University, Tempe, AZ 85287, USA
| | - Robert C Balling
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ 85287, USA; Global Institute of Sustainability, Arizona State University, Tempe, AZ 85287, USA
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