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Background: Most excess deaths that occur during extreme hot weather events do not have natural heat recorded as an underlying or contributing cause. This study aims to identify the specific individuals who died because of hot weather using only secondary data. A novel approach was developed in which the expected number

Background: Most excess deaths that occur during extreme hot weather events do not have natural heat recorded as an underlying or contributing cause. This study aims to identify the specific individuals who died because of hot weather using only secondary data. A novel approach was developed in which the expected number of deaths was repeatedly sampled from all deaths that occurred during a hot weather event, and compared with deaths during a control period. The deaths were compared with respect to five factors known to be associated with hot weather mortality. Individuals were ranked by their presence in significant models over 100 trials of 10,000 repetitions. Those with the highest rankings were identified as probable excess deaths. Sensitivity analyses were performed on a range of model combinations. These methods were applied to a 2009 hot weather event in greater Vancouver, Canada.

Results: The excess deaths identified were sensitive to differences in model combinations, particularly between univariate and multivariate approaches. One multivariate and one univariate combination were chosen as the best models for further analyses. The individuals identified by multiple combinations suggest that marginalized populations in greater Vancouver are at higher risk of death during hot weather.

Conclusions: This study proposes novel methods for classifying specific deaths as expected or excess during a hot weather event. Further work is needed to evaluate performance of the methods in simulation studies and against clinically identified cases. If confirmed, these methods could be applied to a wide range of populations and events of interest.

Created2016-11-15
Description

The image of “Shostakovich” and the relationships surrounding it in the West during the Cold War can be viewed from several angles. Selected Cold War encounters between the United States and the Soviet Union involving Shostakovich’s music—especially the 1959 New York Philharmonic tour to the USSR—offer insight into three perspectives

The image of “Shostakovich” and the relationships surrounding it in the West during the Cold War can be viewed from several angles. Selected Cold War encounters between the United States and the Soviet Union involving Shostakovich’s music—especially the 1959 New York Philharmonic tour to the USSR—offer insight into three perspectives on Shostakovich symphonies in the Cold War: (1) the direct, (2) the implicit, and (3) the micro/intimate. This heuristic hones our understanding of the various types of relationships cultivated with music during the Cold War, while also widening the discussion of Shostakovich’s symbolic presentation during the conflict.

ContributorsSchmelz, Peter (Contributor) / Herberger Institute for Design and the Arts (Contributor)
Created2015-04-03
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Description

The Arctic, even more so than other parts of the world, has warmed substantially over the past few decades. Temperature and humidity influence the rate of development, survival and reproduction of pathogens and thus the incidence and prevalence of many infectious diseases. Higher temperatures may also allow infected host species

The Arctic, even more so than other parts of the world, has warmed substantially over the past few decades. Temperature and humidity influence the rate of development, survival and reproduction of pathogens and thus the incidence and prevalence of many infectious diseases. Higher temperatures may also allow infected host species to survive winters in larger numbers, increase the population size and expand their habitat range. The impact of these changes on human disease in the Arctic has not been fully evaluated. There is concern that climate change may shift the geographic and temporal distribution of a range of infectious diseases. Many infectious diseases are climate sensitive, where their emergence in a region is dependent on climate-related ecological changes. Most are zoonotic diseases, and can be spread between humans and animals by arthropod vectors, water, soil, wild or domestic animals. Potentially climate-sensitive zoonotic pathogens of circumpolar concern include Brucella spp., Toxoplasma gondii, Trichinella spp., Clostridium botulinum, Francisella tularensis, Borrelia burgdorferi, Bacillus anthracis, Echinococcus spp., Leptospira spp., Giardia spp., Cryptosporida spp., Coxiella burnetti, rabies virus, West Nile virus, Hantaviruses, and tick-borne encephalitis viruses.

ContributorsParkinson, Alan J. (Author) / Evengard, Birgitta (Author) / Semenza, Jan C. (Author) / Ogden, Nicholas (Author) / Borresen, Malene L. (Author) / Berner, Jim (Author) / Brubaker, Michael (Author) / Sjostedt, Anders (Author) / Evander, Magnus (Author) / Hondula, David M. (Author) / Menne, Bettina (Author) / Pshenichnaya, Natalia (Author) / Gounder, Prabhu (Author) / Larose, Tricia (Author) / Revich, Boris (Author) / Hueffer, Karsten (Author) / Albihn, Ann (Author) / College of Public Service and Community Solutions (Contributor)
Created2014-09-30
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Description

Background: Extreme heat is a leading weather-related cause of mortality in the United States, but little guidance is available regarding how temperature variable selection impacts heat–mortality relationships.
Objectives: We examined how the strength of the relationship between daily heat-related mortality and temperature varies as a function of temperature observation time, lag,

Background: Extreme heat is a leading weather-related cause of mortality in the United States, but little guidance is available regarding how temperature variable selection impacts heat–mortality relationships.
Objectives: We examined how the strength of the relationship between daily heat-related mortality and temperature varies as a function of temperature observation time, lag, and calculation method.
Methods: Long time series of daily mortality counts and hourly temperature for seven U.S. cities with different climates were examined using a generalized additive model. The temperature effect was modeled separately for each hour of the day (with up to 3-day lags) along with different methods of calculating daily maximum, minimum, and mean temperature. We estimated the temperature effect on mortality for each variable by comparing the 99th versus 85th temperature percentiles, as determined from the annual time series.

Results: In three northern cities (Boston, MA; Philadelphia, PA; and Seattle, WA) that appeared to have the greatest sensitivity to heat, hourly estimates were consistent with a diurnal pattern in the heat-mortality response, with strongest associations for afternoon or maximum temperature at lag 0 (day of death) or afternoon and evening of lag 1 (day before death). In warmer, southern cities, stronger associations were found with morning temperatures, but overall the relationships were weaker. The strongest temperature–mortality relationships were associated with maximum temperature, although mean temperature results were comparable.

Conclusions: There were systematic and substantial differences in the association between temperature and mortality based on the time and type of temperature observation. Because the strongest hourly temperature–mortality relationships were not always found at times typically associated with daily maximum temperatures, temperature variables should be selected independently for each study location. In general, heat-mortality was more closely coupled to afternoon and maximum temperatures in most cities we examined, particularly those typically prone to heat-related mortality.

Created2015-12-04
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Description

Background: Extreme heat is a public health challenge. The scarcity of directly comparable studies on the association of heat with morbidity and mortality and the inconsistent identification of threshold temperatures for severe impacts hampers the development of comprehensive strategies aimed at reducing adverse heat-health events.

Objectives: This quantitative study was designed

Background: Extreme heat is a public health challenge. The scarcity of directly comparable studies on the association of heat with morbidity and mortality and the inconsistent identification of threshold temperatures for severe impacts hampers the development of comprehensive strategies aimed at reducing adverse heat-health events.

Objectives: This quantitative study was designed to link temperature with mortality and morbidity events in Maricopa County, Arizona, USA, with a focus on the summer season.
Methods: Using Poisson regression models that controlled for temporal confounders, we assessed daily temperature–health associations for a suite of mortality and morbidity events, diagnoses, and temperature metrics. Minimum risk temperatures, increasing risk temperatures, and excess risk temperatures were statistically identified to represent different “trigger points” at which heat-health intervention measures might be activated.

Results: We found significant and consistent associations of high environmental temperature with all-cause mortality, cardiovascular mortality, heat-related mortality, and mortality resulting from conditions that are consequences of heat and dehydration. Hospitalizations and emergency department visits due to heat-related conditions and conditions associated with consequences of heat and dehydration were also strongly associated with high temperatures, and there were several times more of those events than there were deaths. For each temperature metric, we observed large contrasts in trigger points (up to 22°C) across multiple health events and diagnoses.

Conclusion: Consideration of multiple health events and diagnoses together with a comprehensive approach to identifying threshold temperatures revealed large differences in trigger points for possible interventions related to heat. Providing an array of heat trigger points applicable for different end-users may improve the public health response to a problem that is projected to worsen in the coming decades.

Created2015-07-28
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Description

To build 21st century sustainable cities, officials are installing alternative infrastructure technologies to reduce atmospheric environmental problems such as the urban heat island (UHI). The purpose of this study is to further our understanding of how ground-level UHI mitigation strategies in compact urban areas impact air temperatures. The term ‘cool

To build 21st century sustainable cities, officials are installing alternative infrastructure technologies to reduce atmospheric environmental problems such as the urban heat island (UHI). The purpose of this study is to further our understanding of how ground-level UHI mitigation strategies in compact urban areas impact air temperatures. The term ‘cool pavement’ refers to both reflective and porous pavements. While cool pavements are identified as UHI mitigation strategies, we evaluated their in-situ effectiveness on air and surface temperatures. Using a case-control research design, we measured the impact of these pavements on air temperature relative to conventional asphalt in alleys. In locations where high vertical walls constrained the release of solar radiation, reflective pavements increased air temperatures. In two neighborhoods, reflective concrete increased daytime 3-meter air temperatures by 0.9° C and 0.5° C respectively and had no influence on nighttime temperatures. Unlike reflective pavement, porous pavements permit percolation and may contribute to cooling through evaporation. However, our research illustrated that porous asphalt and porous concrete increased maximum daytime air temperatures by 0.8° C and 0.5° C and did not lower nighttime air temperatures. While porous concrete pavers had significantly warmer midday air temperatures, it was the only cool pavement strategy to yield lower early evening air temperatures relative to conventional asphalt. Even immediately after rain events, the air temperatures above the porous pavements were not significantly cooler. This research demonstrates our need to evaluate real world installations of cool pavement to determine their actual impact on decreasing summertime temperatures.

ContributorsCoseo, Paul (Author) / Larsen, Larissa (Author) / Herberger Institute for Design and the Arts (Contributor)
Created2015-09-14
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Description

Background: Multiple methods are employed for modeling adaptation when projecting the impact of climate change on heat-related mortality. The sensitivity of impacts to each is unknown because they have never been systematically compared. In addition, little is known about the relative sensitivity of impacts to “adaptation uncertainty” (i.e., the inclusion/exclusion

Background: Multiple methods are employed for modeling adaptation when projecting the impact of climate change on heat-related mortality. The sensitivity of impacts to each is unknown because they have never been systematically compared. In addition, little is known about the relative sensitivity of impacts to “adaptation uncertainty” (i.e., the inclusion/exclusion of adaptation modeling) relative to using multiple climate models and emissions scenarios.

Objectives: This study had three aims: a) Compare the range in projected impacts that arises from using different adaptation modeling methods; b) compare the range in impacts that arises from adaptation uncertainty with ranges from using multiple climate models and emissions scenarios; c) recommend modeling method(s) to use in future impact assessments.

Methods: We estimated impacts for 2070–2099 for 14 European cities, applying six different methods for modeling adaptation; we also estimated impacts with five climate models run under two emissions scenarios to explore the relative effects of climate modeling and emissions uncertainty.

Results: The range of the difference (percent) in impacts between including and excluding adaptation, irrespective of climate modeling and emissions uncertainty, can be as low as 28% with one method and up to 103% with another (mean across 14 cities). In 13 of 14 cities, the ranges in projected impacts due to adaptation uncertainty are larger than those associated with climate modeling and emissions uncertainty.

Conclusions: Researchers should carefully consider how to model adaptation because it is a source of uncertainty that can be greater than the uncertainty in emissions and climate modeling. We recommend absolute threshold shifts and reductions in slope.

ContributorsGosling, Simon N. (Author) / Hondula, David M. (Author) / Bunker, Aditi (Author) / Ibarreta, Dolores (Author) / Liu, Junguo (Author) / Zhang, Xinxin (Author) / Sauerborn, Rainer (Author) / College of Liberal Arts and Sciences (Contributor)
Created2017-08-16
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Description

This study dealt with emotional responses elicited by certain products, which helped to understand the attributes of the product leading to emotional responses. Emotional Design is a way of design that is using emotions generated by people as reference and measurement. Making good use of emotional design could let the

This study dealt with emotional responses elicited by certain products, which helped to understand the attributes of the product leading to emotional responses. Emotional Design is a way of design that is using emotions generated by people as reference and measurement. Making good use of emotional design could let the user discover resonance in the interaction between user and product, which could help the product to be more attractive to users. This research proposes to apply qualitative research method to uncover the secrets of emotional bonds between users and products This study also offered an useful tool to examine the strength and weakness of a certain product from perspective of emotion, and the insights could help designers to refine the product to become emotional attractive, thus create better user experience and bigger opportunity for the product on the market in the future.

ContributorsShin, Dosun (Author) / Wang, Zheng (Author) / Herberger Institute for Design and the Arts (Contributor)
Created2015-10-23
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Description

Background: Environmental heat exposure is a public health concern. The impacts of environmental heat on mortality and morbidity at the population scale are well documented, but little is known about specific exposures that individuals experience.

Objectives: The first objective of this work was to catalyze discussion of the role of personal

Background: Environmental heat exposure is a public health concern. The impacts of environmental heat on mortality and morbidity at the population scale are well documented, but little is known about specific exposures that individuals experience.

Objectives: The first objective of this work was to catalyze discussion of the role of personal heat exposure information in research and risk assessment. The second objective was to provide guidance regarding the operationalization of personal heat exposure research methods.

Discussion: We define personal heat exposure as realized contact between a person and an indoor or outdoor environment that poses a risk of increases in body core temperature and/or perceived discomfort. Personal heat exposure can be measured directly with wearable monitors or estimated indirectly through the combination of time–activity and meteorological data sets. Complementary information to understand individual-scale drivers of behavior, susceptibility, and health and comfort outcomes can be collected from additional monitors, surveys, interviews, ethnographic approaches, and additional social and health data sets. Personal exposure research can help reveal the extent of exposure misclassification that occurs when individual exposure to heat is estimated using ambient temperature measured at fixed sites and can provide insights for epidemiological risk assessment concerning extreme heat.

Conclusions: Personal heat exposure research provides more valid and precise insights into how often people encounter heat conditions and when, where, to whom, and why these encounters occur. Published literature on personal heat exposure is limited to date, but existing studies point to opportunities to inform public health practice regarding extreme heat, particularly where fine-scale precision is needed to reduce health consequences of heat exposure.

ContributorsKuras, Evan (Author) / Richardson, Molly B. (Author) / Calkins, Miriam M. (Author) / Ebi, Kristie L. (Author) / Hess, Jeremy J. (Author) / Kintziger, Kristina W. (Author) / Jagger, Meredith A. (Author) / Middel, Ariane (Author) / Scott, Anna A. (Author) / Spector, June T. (Author) / Uejio, Christopher K. (Author) / Vanos, Jennifer K. (Author) / Zaitchik, Benjamin F. (Author) / Gohlke, Julia M. (Author) / Hondula, David M. (Author) / College of Public Service and Community Solutions (Contributor)
Created2017-08-01
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Description

Background: Extreme heat is a leading weather-related cause of illness and death in many locations across the globe, including subtropical Australia. The possibility of increasingly frequent and severe heat waves warrants continued efforts to reduce this health burden, which could be accomplished by targeting intervention measures toward the most vulnerable

Background: Extreme heat is a leading weather-related cause of illness and death in many locations across the globe, including subtropical Australia. The possibility of increasingly frequent and severe heat waves warrants continued efforts to reduce this health burden, which could be accomplished by targeting intervention measures toward the most vulnerable communities.

Objectives: We sought to quantify spatial variability in heat-related morbidity in Brisbane, Australia, to highlight regions of the city with the greatest risk. We also aimed to find area-level social and environmental determinants of high risk within Brisbane.

Methods: We used a series of hierarchical Bayesian models to examine city-wide and intracity associations between temperature and morbidity using a 2007–2011 time series of geographically referenced hospital admissions data. The models accounted for long-term time trends, seasonality, and day of week and holiday effects.

Results: On average, a 10°C increase in daily maximum temperature during the summer was associated with a 7.2% increase in hospital admissions (95% CI: 4.7, 9.8%) on the following day. Positive statistically significant relationships between admissions and temperature were found for 16 of the city’s 158 areas; negative relationships were found for 5 areas. High-risk areas were associated with a lack of high income earners and higher population density.

Conclusions: Geographically targeted public health strategies for extreme heat may be effective in Brisbane, because morbidity risk was found to be spatially variable. Emergency responders, health officials, and city planners could focus on short- and long-term intervention measures that reach communities in the city with lower incomes and higher population densities, including reduction of urban heat island effects.

Created2014-08-01