The NYS HVI showed spatial variability in heat vulnerability across the state. Mapping the HVI allows quick identification of regions in NYS that could benefit from targeted interventions. The HVI will be used as a planning tool to help allocate appropriate adaptation measures like cooling centers and issue heat alerts to mitigate effects of heat in vulnerable areas.

Background: Although many climate-sensitive environmental exposures are related to mortality and morbidity, there is a paucity of estimates of the public health burden attributable to climate change.Objective: We estimated the excess current and future public health impacts related to respiratory hospitalizations attributable to extreme heat in summer in New York State (NYS) overall, its geographic regions, and across different demographic strata.Methods: On the basis of threshold temperature and percent risk changes identified from our study in NYS, we estimated recent and future attributable risks related to extreme heat due to climate change using the global climate model with various climate scenarios. We estimated effects of extreme high apparent temperature in summer on respiratory admissions, days hospitalized, direct hospitalization costs, and lost productivity from days hospitalized after adjusting for inflation.Results: The estimated respiratory disease burden attributable to extreme heat at baseline (1991–2004) in NYS was 100 hospital admissions, US$644,069 in direct hospitalization costs, and 616 days of hospitalization per year. Projections for 2080–2099 based on three different climate scenarios ranged from 206–607 excess hospital admissions, US$26–$76 million in hospitalization costs, and 1,299–3,744 days of hospitalization per year. Estimated impacts varied by geographic region and population demographics.Conclusions: We estimated that excess respiratory admissions in NYS due to excessive heat would be 2 to 6 times higher in 2080–2099 than in 1991–2004. When combined with other heat-associated diseases and mortality, the potential public health burden associated with global warming could be substantial.

It is known that extreme temperature and ambient air pollution are each independently associated with human health outcomes. However, findings from the few studies that have examined modified effects by seasons and the interaction between air pollution and temperature on health endpoints are inconsistent. This study examines the effects of short-term PM 2.5 (particulate matter less than or equal to 2.5 μm in aerodynamic diameter) on hospitalization for cardiovascular diseases (CVDs), its modifications by season and temperature, and whether these effects are heterogeneous across different regions in New York State (NYS). We used daily average temperature and PM 2.5 concentrations as exposure indicators and performed a time series analysis with a quasi-Poisson model, controlling for possible confounders, such as time-relevant variables and dew point, for CVDs in NYS, 1991NYS, -2006. Stratification parametric models were applied to evaluate the modifying effects by seasons and temperature. Across the whole year, a 10-μg/m 3 increment in PM 2.5 concentration accounted for a 1.37% increase in CVDs (95% confidence interval (CI): 0.90%, 1.84%) in New York City, Long Island & Hudson. The PM 2.5 effect was strongest in winter, with an additional 2.06% (95% CI: 1.33%, 2.80%) increase in CVDs observed per 10-μg/m 3 increment in PM 2.5 . Temperature modified the PM 2.5 effects on CVDs, and these modifications by temperature on PM 2.5 effects on CVDs were found at low temperature days. These associations were heterogeneous across four PM 2.5 concentration regions. PM 2.5 was positively associated with CVD hospitalizations. The short-term PM 2.5 effect varied with season and temperature levels, and stronger effects were observed in winter and at low temperature days.

Intervention strategies should monitor the first 6 mos after discharge from inpatient rehabilitation, during which the maximum level of functional improvement is expected. However, the individuals who have had a stroke had poor functional improvement at 1 yr (adjusted mean FIM score, 5.74) than those who have not had a stroke (adjusted mean FIM score, 6.56). The patients who have had a stroke required human supervision at 12 mos after rehabilitation. Therefore, long-term care needs should be monitored in the discharge plan.

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Background Limited epidemiologic research exists on the association between weather‐related extreme heat events (EHEs) and orofacial clefts (OFCs). We estimated the associations between maternal exposure to EHEs in the summer season and OFCs in offspring and investigated the potential modifying effect of body mass index on these associations. Methods We conducted a population‐based case–control study among mothers who participated in the National Birth Defects Prevention Study for whom at least 1 day of their first two post‐conception months occurred during summer. Cases were live‐born infants, stillbirths, and induced terminations with OFCs; controls were live‐born infants without major birth defects. We defined EHEs using the 95th and the 90th percentiles of the daily maximum universal apparent temperature distribution. We used unconditional logistic regression with Firth's penalized likelihood method to estimate adjusted odds ratios and 95% confidence intervals, controlling for maternal sociodemographic and anthropometric variables. Results We observed no association between maternal exposure to EHEs and OFCs overall, although prolonged duration of EHEs may increase the risk of OFCs in some study sites located in the Southeast climate region. Analyses by subtypes of OFCs revealed no associations with EHEs. Modifying effect by BMI was not observed. Conclusions We did not find a significantly increased risk of OFCs associated with maternal exposure to EHEs during the relevant window of embryogenesis. Future studies should account for maternal indoor and outdoor activities and for characteristics such as hydration and use of air conditioning that could modify the effect of EHEs on pregnant women.

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