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Identifying Individual Risk Factors and Documenting the Pattern of Heat-Related Illness through Analyses of Hospitalization and Patterns of Household Cooling

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  • Michael T Schmeltz
  • Grace Sembajwe
  • Peter J Marcotullio
  • Jean A Grassman
  • David U Himmelstein
  • Stephanie Woolhandler

Abstract

Background: As climate change increases the frequency and intensity of extreme heat events researchers and public health officials must work towards understanding the causes and outcomes of heat-related morbidity and mortality. While there have been many studies on both heat-related illness (HRI), there are fewer on heat-related morbidity than on heat-related mortality. Objective: To identify individual and environmental risk factors for hospitalizations and document patterns of household cooling. Methods: We performed a pooled cross-sectional analysis of secondary U.S. data, the Nationwide Inpatient Sample. Risk ratios were calculated from multivariable models to identify risk factors for hospitalizations. Hierarchical modeling was also employed to identify relationships between individual and hospital level predictors of hospitalizations. Patterns of air conditioning use were analyzed among the vulnerable populations identified. Results: Hospitalizations due to HRI increased over the study period compared to all other hospitalizations. Populations at elevated risk for HRI hospitalization were blacks, males and all age groups above the age of 40. Those living in zip-codes in the lowest income quartile and the uninsured were also at an increased risk. Hospitalizations for HRI in rural and small urban clusters were elevated, compared to urban areas. Conclusions: Risk factors for HRI include age greater than 40, male gender and hospitalization in rural areas or small urban clusters. Our analysis also revealed an increasing pattern of HRI hospitalizations over time and decreased association between common comorbidities and heat illnesses which may be indicative of underreporting.

Suggested Citation

  • Michael T Schmeltz & Grace Sembajwe & Peter J Marcotullio & Jean A Grassman & David U Himmelstein & Stephanie Woolhandler, 2015. "Identifying Individual Risk Factors and Documenting the Pattern of Heat-Related Illness through Analyses of Hospitalization and Patterns of Household Cooling," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-15, March.
    • Handle: RePEc:plo:pone00:0118958
    DOI: 10.1371/journal.pone.0118958
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    References listed on IDEAS

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    1. Michael T. Schmeltz & Peter J. Marcotullio & David U. Himmelstein & Steffie Woolhandler & Grace Sembajwe, 2016. "Outcomes of hospitalizations for common illnesses associated with a comorbid heat-related illness in the United States, 2001–2010," Climatic Change, Springer, vol. 138(3), pages 567-584, October.
    2. Leila Heidari & Andrea Winquist & Mitchel Klein & Cassandra O’Lenick & Andrew Grundstein & Stefanie Ebelt Sarnat, 2016. "Susceptibility to Heat-Related Fluid and Electrolyte Imbalance Emergency Department Visits in Atlanta, Georgia, USA," IJERPH, MDPI, vol. 13(10), pages 1-17, October.
    3. Michael T. Schmeltz & Elisaveta P. Petkova & Janet L. Gamble, 2016. "Economic Burden of Hospitalizations for Heat-Related Illnesses in the United States, 2001–2010," IJERPH, MDPI, vol. 13(9), pages 1-11, September.
    4. Ruth McDermott-Levy & Madeline Scolio & Kabindra M. Shakya & Caroline H. Moore, 2021. "Factors That Influence Climate Change-Related Mortality in the United States: An Integrative Review," IJERPH, MDPI, vol. 18(15), pages 1-21, August.
    5. Michael T Schmeltz & Janet L Gamble, 2017. "Risk characterization of hospitalizations for mental illness and/or behavioral disorders with concurrent heat-related illness," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-15, October.

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