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Assessing Adaptation Strategies for Extreme Heat: A Public Health Evaluation of Cooling Centers in Maricopa County, Arizona

Description

Preventing heat-associated morbidity and mortality is a public health priority in Maricopa County, Arizona (United States). The objective of this project was to evaluate Maricopa County cooling centers and gain insight into their capacity to provide relief for the public

Preventing heat-associated morbidity and mortality is a public health priority in Maricopa County, Arizona (United States). The objective of this project was to evaluate Maricopa County cooling centers and gain insight into their capacity to provide relief for the public during extreme heat events. During the summer of 2014, 53 cooling centers were evaluated to assess facility and visitor characteristics. Maricopa County staff collected data by directly observing daily operations and by surveying managers and visitors. The cooling centers in Maricopa County were often housed within community, senior, or religious centers, which offered various services for at least 1500 individuals daily. Many visitors were unemployed and/or homeless. Many learned about a cooling center by word of mouth or by having seen the cooling center’s location. The cooling centers provide a valuable service and reach some of the region’s most vulnerable populations. This project is among the first to systematically evaluate cooling centers from a public health perspective and provides helpful insight to community leaders who are implementing or improving their own network of cooling centers.

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Date Created
2016-09-23

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Heat-Associated Deaths in Maricopa County: AZ Final Report for 2014

Description

Mortality from environmental heat is a significant public health problem in Maricopa County, especially because it is largely preventable. Maricopa County has conducted heat surveillance since 2006. Each year, the enhanced heat surveillance season usually begins in May and ends

Mortality from environmental heat is a significant public health problem in Maricopa County, especially because it is largely preventable. Maricopa County has conducted heat surveillance since 2006. Each year, the enhanced heat surveillance season usually begins in May and ends in October. The main goals of heat surveillance are to identify the demographic characteristics of heat-associated deaths (e.g., age and gender) and the risk factors for mortality (e.g., homelessness). Sharing this information helps community stakeholders to design interventions in an effort to prevent heat-associated deaths among vulnerable populations.

The two main sources of data for heat surveillance are: preliminary reports of death (PRODs) from the Office of the Medical Examiner (OME) and death certificates from the MCDPH Office of Vital Registration.

Heat-associated deaths are classified as heat-caused or heat related. Heat-caused deaths are those in which environmental heat was directly involved in the sequence of conditions causing deaths. Heat-related deaths are those in which environmental heat contributed to the deaths but was not in the sequence of conditions causing these deaths. For more information on how heat-associated deaths are classified, see the definitions in Appendix. For more information on MCDPH’s surveillance system, see Background and Methodology.

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Date Created
2015

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Seasonal Hydroclimatic Impacts of Sun Corridor Expansion

Description

Conversion of natural to urban land forms imparts influence on local and regional hydroclimate via modification of the surface energy and water balance, and consideration of such effects due to rapidly expanding megapolitan areas is necessary in light of the

Conversion of natural to urban land forms imparts influence on local and regional hydroclimate via modification of the surface energy and water balance, and consideration of such effects due to rapidly expanding megapolitan areas is necessary in light of the growing global share of urban inhabitants. Based on a suite of ensemble-based, multi-year simulations using the Weather Research and Forecasting (WRF) model, we quantify seasonally varying hydroclimatic impacts of the most rapidly expanding megapolitan area in the US: Arizona's Sun Corridor, centered upon the Greater Phoenix metropolitan area. Using a scenario-based urban expansion approach that accounts for the full range of Sun Corridor growth uncertainty through 2050, we show that built environment induced warming for the maximum development scenario is greatest during the summer season (regionally averaged warming over AZ exceeds 1 °C).

Warming remains significant during the spring and fall seasons (regionally averaged warming over AZ approaches 0.9 °C during both seasons), and is least during the winter season (regionally averaged warming over AZ of 0.5 °C). Impacts from a minimum expansion scenario are reduced, with regionally averaged warming ranging between 0.1 and 0.3 °C for all seasons except winter, when no warming impacts are diagnosed. Integration of highly reflective cool roofs within the built environment, increasingly recognized as a cost-effective option intended to offset the warming influence of urban complexes, reduces urban-induced warming considerably. However, impacts on the hydrologic cycle are aggravated via enhanced evapotranspiration reduction, leading to a 4% total accumulated precipitation decrease relative to the non-adaptive maximum expansion scenario. Our results highlight potentially unintended consequences of this adaptation approach within rapidly expanding megapolitan areas, and emphasize the need for undeniably sustainable development paths that account for hydrologic impacts in addition to continued focus on mean temperature effects.

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Date Created
2012-09-07

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Heat-Related Deaths in Hot Cities: Estimates of Human Tolerance to High Temperature Thresholds

Description

In this study we characterized the relationship between temperature and mortality in central Arizona desert cities that have an extremely hot climate. Relationships between daily maximum apparent temperature (ATmax) and mortality for eight condition-specific causes and all-cause deaths were modeled

In this study we characterized the relationship between temperature and mortality in central Arizona desert cities that have an extremely hot climate. Relationships between daily maximum apparent temperature (ATmax) and mortality for eight condition-specific causes and all-cause deaths were modeled for all residents and separately for males and females ages <65 and ≥65 during the months May–October for years 2000–2008. The most robust relationship was between ATmax on day of death and mortality from direct exposure to high environmental heat. For this condition-specific cause of death, the heat thresholds in all gender and age groups (ATmax = 90–97 °F; 32.2‒36.1 °C) were below local median seasonal temperatures in the study period (ATmax = 99.5 °F; 37.5 °C). Heat threshold was defined as ATmax at which the mortality ratio begins an exponential upward trend. Thresholds were identified in younger and older females for cardiac disease/stroke mortality (ATmax = 106 and 108 °F; 41.1 and 42.2 °C) with a one-day lag. Thresholds were also identified for mortality from respiratory diseases in older people (ATmax = 109 °F; 42.8 °C) and for all-cause mortality in females (ATmax = 107 °F; 41.7 °C) and males <65 years (ATmax = 102 °F; 38.9 °C). Heat-related mortality in a region that has already made some adaptations to predictable periods of extremely high temperatures suggests that more extensive and targeted heat-adaptation plans for climate change are needed in cities worldwide.

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Created

Date Created
2014-05-20

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Urban Adaptation Can Roll Back Warming of Emerging Megapolitan Regions

Description

Modeling results incorporating several distinct urban expansion futures for the United States in 2100 show that, in the absence of any adaptive urban design, megapolitan expansion, alone and separate from greenhouse gas-induced forcing, can be expected to raise near-surface temperatures

Modeling results incorporating several distinct urban expansion futures for the United States in 2100 show that, in the absence of any adaptive urban design, megapolitan expansion, alone and separate from greenhouse gas-induced forcing, can be expected to raise near-surface temperatures 1–2 °C not just at the scale of individual cities but over large regional swaths of the country. This warming is a significant fraction of the 21st century greenhouse gas-induced climate change simulated by global climate models. Using a suite of regional climate simulations, we assessed the efficacy of commonly proposed urban adaptation strategies, such as green, cool roof, and hybrid approaches, to ameliorate the warming. Our results quantify how judicious choices in urban planning and design cannot only counteract the climatological impacts of the urban expansion itself but also, can, in fact, even offset a significant percentage of future greenhouse warming over large scales. Our results also reveal tradeoffs among different adaptation options for some regions, showing the need for geographically appropriate strategies rather than one size fits all solutions.

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Created

Date Created
2014-02-25

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Improving Heat-Related Health Outcomes in an Urban Environment With Science-Based Policy

Description

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

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.

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Created

Date Created
2016-10-12

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Mapping Community Determinants of Heat Vulnerability

Description

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

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.

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Created

Date Created
2009-11-01

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Heat Death Associations With the Built Environment, Social Vulnerability, and Their Interactions With Rising Temperature

Description

In an extreme heat event, people can go to air-conditioned public facilities if residential air-conditioning is not available. Residences that heat slowly may also mitigate health effects, particularly in neighborhoods with social vulnerability. We explored the contributions of social vulnerability

In an extreme heat event, people can go to air-conditioned public facilities if residential air-conditioning is not available. Residences that heat slowly may also mitigate health effects, particularly in neighborhoods with social vulnerability. We explored the contributions of social vulnerability and these infrastructures to heat mortality in Maricopa County and whether these relationships are sensitive to temperature. Using Poisson regression modeling with heat-related mortality as the outcome, we assessed the interaction of increasing temperature with social vulnerability, access to publicly available air conditioned space, home air conditioning and the thermal properties of residences. As temperatures increase, mortality from heat-related illness increases less in census tracts with more publicly accessible cooled spaces. Mortality from all internal causes of death did not have this association. Building thermal protection was not associated with mortality. Social vulnerability was still associated with mortality after adjusting for the infrastructure variables. To reduce heat-related mortality, the use of public cooled spaces might be expanded to target the most vulnerable.

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Created

Date Created
2016-08-03

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Neighborhood Effects on Heat Deaths: Social and Environmental Predictors of Vulnerability in Maricopa County, Arizona

Description

Objectives: We estimated neighborhood effects of population characteristics and built and natural environments on deaths due to heat exposure in Maricopa County, Arizona (2000–2008).

Methods: We used 2000 U.S. Census data and remotely sensed vegetation and land surface temperature to construct

Objectives: We estimated neighborhood effects of population characteristics and built and natural environments on deaths due to heat exposure in Maricopa County, Arizona (2000–2008).

Methods: We used 2000 U.S. Census data and remotely sensed vegetation and land surface temperature to construct indicators of neighborhood vulnerability and a geographic information system to map vulnerability and residential addresses of persons who died from heat exposure in 2,081 census block groups. Binary logistic regression and spatial analysis were used to associate deaths with neighborhoods.

Results: Neighborhood scores on three factors—socioeconomic vulnerability, elderly/isolation, and unvegetated area—varied widely throughout the study area. The preferred model (based on fit and parsimony) for predicting the odds of one or more deaths from heat exposure within a census block group included the first two factors and surface temperature in residential neighborhoods, holding population size constant. Spatial analysis identified clusters of neighborhoods with the highest heat vulnerability scores. A large proportion of deaths occurred among people, including homeless persons, who lived in the inner cores of the largest cities and along an industrial corridor.

Conclusions: Place-based indicators of vulnerability complement analyses of person-level heat risk factors. Surface temperature might be used in Maricopa County to identify the most heat-vulnerable neighborhoods, but more attention to the socioecological complexities of climate adaptation is needed.

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Created

Date Created
2013-02-01

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Multiple Trigger Points for Quantifying Heat-Health Impacts: New Evidence from a Hot Climate

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

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.

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Created

Date Created
2016-02-01