Journal
ENVIRONMENTAL RESEARCH
Volume 136, Issue -, Pages 449-461Publisher
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.envres.2014.08.042
Keywords
Heat wave; Mortality; Vulnerability; Green space; Socio-demographic
Funding
- University of Michigan Center for Occupational Health and Safety Engineering (National Institute for Occupational Safety and Health (NIOSH)) [2T42OH008455]
- National Institute on Aging Interdisciplinary Research Training in Health and Aging [T32AG027708]
- University of Michigan Rackham Student Research Grants
- Environmental Protection Agency Science to Achieve Results (EPA STAR) grant [R83275201]
- National Institute of Environmental Health Sciences (NIEHS) grant [R21ES020156]
- Graham Environmental Sustainability Institute Dow Postdoctoral Fellowship
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Objectives: We examined how individual and area socio-demographic characteristics independently modified the extreme heat (EH)-mortality association among elderly residents of 8 Michigan cities, May-September, 1990-2007. Methods: In a time-stratified case-crossover design, we regressed cause-specific mortality against EH (indicator for 4-day mean, minimum, maximum or apparent temperature above 97th or 99th percentiles). We examined effect modification with interactions between EH and personal marital status, age, race, sex and education and ZIP-code percent non-green space (National Land Cover Dataset), age, race, income, education, living alone, and housing age (U.S. Census). Results: In models including multiple effect modifiers, the odds of cardiovascular mortality during EH (99th percentile threshold) vs. non-EH were higher among non-married individuals (1.21, 95% CI=1.14-1.28 vs. 0.98, 95% CI = 0.90-1.07 among married individuals) and individuals in ZIP codes with high (91%) non-green space (1.17, 95% CI = 1.06-1.29 vs. 0.98, 95% CI = 0.89-1.07 among individuals in ZIP codes with low (39%) non-green space). Results suggested that housing age may also be an effect modifier. For the EH-respiratory mortality association, the results were inconsistent between temperature metrics and percentile thresholds of EH but largely insignificant. Conclusions: Green space, housing and social isolation may independently enhance elderly peoples' heat-related cardiovascular mortality vulnerability. Local adaptation efforts should target areas and populations at greater risk. (C) 2014 Elsevier Inc. All rights reserved.
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