Heat-Related Hospital Admissions Among the Elderly: Community, Socio-economic and Medical Determinants of Vulnerability and Economic Impacts

Principal Investigator

Marie O'Neill

Co-Investigators

Helen Levy, Antonella Zanobetti, Daniel Schrag, Daniel Brown, Melissa Stults

Funding Sources

Environmental Protection Agency (EPA)

About this Project

We will quantify impacts of climate change on health by assessing which individual and community characteristics reflect special vulnerability, in a study of heat and hospital admissions among the elderly in U.S. cities. In cooperation with ICLEI's Cities for Climate Protection Campaign, representing 157 cities in the U.S., results will be disseminated to inform development of preventive programs.

Study Objectives: 1) a. Determine whether excess hospital admissions occur among elderly people during hot weather in 34 U.S. cities, from cardiovascular, respiratory, diabetes and heat-related causes; b. Assess whether vulnerability to heat-associated hospital admission differs, according to co-morbid conditions (diabetes; cardiovascular, respiratory, renal disease; overall frailty), individual characteristics (race, gender, age, use of public vs. private hospital), and city-wide characteristics (percent poverty, percent with college education, percent of non-white population, air conditioning (AC) prevalence, percent green space, housing characteristics, air pollution concentrations, weather variability, city preventive programs); 2) Quantify the economic impact of these admissions under different climate change scenarios and adaptive/mitigative strategies, addressing equity concerns; and 3) Disseminate results to city officials in order to foster and inform preventive actions and policies.

The study objectives will be accomplished by: 1) Analyzing data on Medicare hospital admissions in 34 U.S. cities from 1985-2003, combined with environmental data and city-wide characteristics; 2) Estimating costs of admissions using the Medicare billing data, and predicting how potential climate change, and societal activities to reduce heat exposure, may affect these costs in the future; and 3) Incorporating results into a software planning module for use by local governments and holding a workshop with local officials to discuss results and preventive strategies.