Programs and Communities

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.

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.

We use the Northeast US Urban Climate Archipelago as a case study to explore three key limitations of planning and policy initiatives to mitigate extreme urban heat. These limitations are: (1) a lack of understanding of spatial considerations—for example, how nearby urban areas interact, affecting, and being affected by, implementation of such policies; (2) an emphasis on air temperature reduction that neglects assessments of other important meteorological parameters, such as humidity, mixing heights, and urban wind fields; and (3) too narrow of a temporal focus—either time of day, season, or current vs. future climates. Additionally, the absence of a direct policy/planning linkage between heat mitigation goals and actual human health outcomes, in general, leads to solutions that only indirectly address the underlying problems. These issues are explored through several related atmospheric modeling case studies that reveal the complexities of designing effective urban heat mitigation strategies. We conclude with recommendations regarding how policy-makers can optimize the performance of their urban heat mitigation policies and programs. This optimization starts with a thorough understanding of the actual end-point goals of these policies, and concludes with the careful integration of scientific knowledge into the development of location-specific strategies that recognize and address the limitations discussed herein.

Background:
The evidence that heat waves can result in both increased deaths and illness is substantial, and concern over this issue is rising because of climate change. Adverse health impacts from heat waves can be avoided, and epidemiologic studies have identified specific population and community characteristics that mark vulnerability to heat waves.

Objectives:
We situated vulnerability to heat in geographic space and identified potential areas for intervention and further research.

Methods:
We mapped and analyzed 10 vulnerability factors for heat-related morbidity/mortality in the United States: six demographic characteristics and two household air conditioning variables from the U.S. Census Bureau, vegetation cover from satellite images, and diabetes prevalence from a national survey. We performed a factor analysis of these 10 variables and assigned values of increasing vulnerability for the four resulting factors to each of 39,794 census tracts. We added the four factor scores to obtain a cumulative heat vulnerability index value.

Results:
Four factors explained > 75% of the total variance in the original 10 vulnerability variables: a) social/environmental vulnerability (combined education/poverty/race/green space), b) social isolation, c) air conditioning prevalence, and d) proportion elderly/diabetes. We found substantial spatial variability of heat vulnerability nationally, with generally higher vulnerability in the Northeast and Pacific Coast and the lowest in the Southeast. In urban areas, inner cities showed the highest vulnerability to heat.

Conclusions:
These methods provide a template for making local and regional heat vulnerability maps. After validation using health outcome data, interventions can be targeted at the most vulnerable populations.

The purpose of this project was to evaluate the State Bar of New Mexico's (SBNM) new podcast series, SBNM is Hear. The podcast was initially developed as a member outreach tool and a new platform for professional development and survey questions were developed to gauge the podcast’s effectiveness in these two areas. An electronic survey was deployed to active members of the SBNM through email. Respondents were asked questions regarding their demographics, whether they had listened to the series, and what content they would like to hear in the future. The survey resulted in 103 responses, of which 60% indicated that they had not listened to the podcast. The results showed that listenership was evenly divided between generations and that more females listened to at least one episode. The open-ended responses indicated that the two cohorts of respondents (listeners and non- listeners) viewed the podcast a potential connection to the New Mexico judiciary. Future recommendations include conducting an annual survey to continue to understand the effectiveness of the podcast and solicit feedback for continued growth and improvement

As the impact of technology on daily life continues to grow, online learning platforms for primary, secondary, post-secondary, and professional institutions find ways to:

1. Connect peers and instructors through digital communication.
2. Engage users more fully in learning.
3. Provide access to resources that enhance deep-impact education.

Online learning platforms, or learning management systems (LMS), are used to connect instructors and students through synchronous and asynchronous engagement tools, provide space for the transfer of resources and ideas, and track progress. However, these platforms were designed with more mainstream purposes - and more digitally savvy - users in mind.

Adult learning programs (with members ages 50+) currently have no online learning and sharing platform specifically designed to fit the needs and desires of their users. Despite the multitude of barriers to successful use, adult learning programs recognize the need to engage with members digitally and are seeking an online learning platform centered around their users.

This project, utilizing best practices in technical communication and mixed methods user experience research, broadens the boundaries of communication design by creating an online learning platform prototype specifically for adults ages 50+ through the lens of information design, content management, and user experience outcomes.

For more than 50 years, my aunt was a professional chef and baker who catered hundreds of events and owned a bakery before retiring. Her recipes have never been formally documented and are rarely shared because only she knows them. The purpose of the cooking website content strategy was to document five decades’ worth of my family’s recipes and write a cooking website content strategy report that will be used in the future to create the cooking website. Creating the website preserves the recipes and provides a resource that can be cited and referred to by future generations of my family. The cooking website applied project consists of a website content strategy report, including a social media strategy and website designs, documented recipes and oral histories, content audit, and content analysis.

This report aims to provide The Arts Partnership, an arts-based non-profit organization in the Fargo, ND-Moorhead, MN area, with recommendations on improving its “Connecting the Dots” weekly e-newsletter. The research was conducted using three separate channels – a quantitative survey of the current e-newsletter recipients, a qualitative coding exercise to uncover themes in each e-newsletter, and an analysis of the top-clicked links in each e-newsletter. The original research, combined with information gleaned from the literature review, results in seven recommendations The Arts Partnership can implement into its current program. These recommendations include reducing the amount of HTML in each e-newsletter to avoid SPAM traps, keeping the email as scannable as possible, maintaining its subscriber base to eliminate waste, ensuring its e-newsletters are mobile-responsive, improving the subject line of the e-newsletters, and finally, considering using a different email program that provides more features The Arts Partnership can use to continue to improve its newsletters.