It’s not the heat, it’s the vulnerability: attribution of the 2016 spike in heat-associated deaths in Maricopa County, Arizona

Putnam, Hana; Hondula, David M.; Urban, Aleš; Berisha, Vjollca; Iñiguez, Paul; Roach, Matthew

doi:10.1088/1748-9326/aadb44

Cited by 44 publications

(26 citation statements)

References 45 publications

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“…Heat stress occurs when households are unable to afford or access energy to cool their homes. The health effects from this type of energy insecurity, such as increased morbidity and mortality rates, are most often seen during heatwaves when excess heat from outside conditions creates heat stress (135,141,142). Cardiovascular issues such as heat strokes, hypertension, and heart attack, dehydration, hyperthermia, and nervous system morbidities are examples of health impacts that occur under heat stress (69,135,143).…”

Section: Heat Stress and Forbearancementioning

confidence: 99%

“…Other health effects include a higher likelihood of acute renal failure (42) and increased sleep disturbances as a result of the extreme heat in inadequately cooled homes, which can exacerbate mental health conditions triggered by the stress of energy insecurity (53,57). This increase in morbidity and mortality is motivated by other social determinants of health that predict energy insecurity (142).…”

Section: Heat Stress and Forbearancementioning

confidence: 99%

“…Severe weather events will lead to acute energy insecurity such as power outages that can affect anyone. More frequent heatwaves will significantly increase energy demand, the need for expanded energy systems, dependence on household air conditioning for entire populations (45,93,141,142,159). Power outages from heatwaves and storms can put anyone at risk of medical difficulties.…”

Section: Climate Change and Energy Insecuritymentioning

confidence: 99%

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Energy, Poverty, and Health in Climate Change: A Comprehensive Review of an Emerging Literature

Jessel

Sawyer

Hernández

2019

Front. Public Health

198

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Household energy is increasingly vital for maintaining good health. Unaffordable and inadequate household energy presents adverse consequences that are amplified by poverty and a changing climate. To date, the connections between energy, socioeconomic disadvantage, and well-being are generally underappreciated, and household energy connection with climate change is under-researched. Building on the energy insecurity framework, this review explores literature related to household energy, poverty, and health in order to highlight the disproportionate burdens borne by vulnerable populations in adequately meeting household energy needs. This paper is based on a comprehensive review of books, peer-reviewed articles, and reports published between 1990 and 2019, identified via databases including JSTOR and PubMed. A total of 406 publications were selected as having potential for full review, 203 received full review, and 162 were included in this paper on the basis of set inclusion criteria. From the literature review, we created an original heuristic model that describes energy insecurity as either acute or chronic, and we further explore the mediators and pathways that link energy insecurity to health. In the discussion, we posit that the extant literature does not sufficiently consider that vulnerable communities often experience energy insecurity bundled with other hardships. We also discuss energy, poverty, and health through the lens of climate change, making the criticism that most research on household energy does not consider climate change. This evidence is important for enhancing research in this field and developing programmatic and policy interventions as they pertain to energy access, affordability, and health, with special emphasis on vulnerable populations, climate change, and social inequality.

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Section: Heat Stress and Forbearancementioning

confidence: 99%

Section: Heat Stress and Forbearancementioning

confidence: 99%

Section: Climate Change and Energy Insecuritymentioning

confidence: 99%

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Energy, Poverty, and Health in Climate Change: A Comprehensive Review of an Emerging Literature

Jessel

Sawyer

Hernández

2019

Front. Public Health

198

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“…On the one hand, some scholars use morbidity and mortality data to build multiple models between temperature and heat-associated deaths to assess the population health vulnerability risk caused by extreme heat [10][11][12][13]. Some studies found that extreme heat is only a trigger, the differences in demographic characteristics are a direct factor in mortality [14]. Therefore, the assessment results of these studies mainly reflect the risk differences of different social groups.…”

mentioning

confidence: 99%

Assessing Urban Risk to Extreme Heat in China

Huang

Guo

et al. 2020

Sustainability

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Many cities are experiencing persistent risk in China due to frequent extreme weather events. Some extreme weather events, such as extreme heat hazard, have seriously threatened human health and socio-economic development in cities. There is an urgent need to measure the degree of extreme heat risk and identify cites with the highest levels of extreme heat risk. In this study, we presented a risk assessment framework of extreme heat and considered risk as a combination of hazard, exposure, and vulnerability. Based on these three dimensions, we selected relevant variables from historical meteorological data (1960–2016) and socioeconomic statistics in 2016, establishing an indicator system of extreme heat risk evaluation. Finally, we developed an extreme heat risk index to quantify the levels of extreme heat risk of 296 prefecture-level cities in China and revealed the spatial pattern of extreme heat risk in China in 2016 and their dominant factors. The results show that (1) cities with high levels of extreme heat hazard are mainly located in the south of China, especially in the southeast of China; (2) the spatial distribution of the extreme heat risk index shows obvious agglomeration characteristics; (3) the spatial distribution of the extreme heat risk is still mostly controlled by natural geographical conditions such as climate and topography; (4) among the four types of hazard-dominated, exposure-dominated, vulnerability-dominated, and low risk cities, the number of vulnerability-dominated cities is the largest. The results of this study can provide support for the risk management of extreme heat disasters and the formation of targeted countermeasures in China.

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“…Regional studies have demonstrated associations between heatassociated mortality and contextual factors, such as weather and temperature, neighborhood socioeconomic status, social isolation, and land cover. [8][9][10][11] MCDPH's heat-associated death surveillance system provides a valuable complement to these place-based analyses with detailed data on the demographic characteristics of decedents and circumstances of death. We describe findings of the Maricopa County heatassociated death surveillance system in the 11-year period (2006-2016) since its implementation to understand the circumstances of heat-associated deaths and compare these results with the findings of studies and projects that occurred during the same period.…”

mentioning

confidence: 99%

Heat-Associated Mortality in a Hot Climate

et al. 2020

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Objectives Maricopa County, Arizona (2017 population about 4.3 million), is located in the Sonoran Desert. In 2005, the Maricopa County Department of Public Health (MCDPH) established a heat-associated mortality surveillance system that captures data on circumstances of death for Maricopa County residents and visitors. We analyzed 2006-2016 surveillance system data to understand the characteristics and circumstances of heat-associated deaths. Methods We classified heat-associated deaths based on International Classification of Diseases, Tenth Revision codes (X30, T67.X, and P81.0) and phrases (heat exposure, environ, exhaustion, sun, heat stress, heat stroke, or hyperthermia) in part I or part II of the death certificate. We summarized data on decedents’ demographic characteristics, years lived in Arizona, location of death (indoors vs outdoors), presence and functionality of air conditioning, and whether the decedent had been homeless. We examined significant associations between variables by using the Pearson χ2 tests and logistic regression. Results During 2006-2016, MCDPH recorded data on 920 heat-associated deaths, 912 of which included location of injury. Of 565 (62%) heat-associated deaths that occurred outdoors, 458 (81%) were among male decedents and 243 (43%) were among decedents aged 20-49. Of 347 (38%) heat-associated deaths that occurred indoors, 201 (58%) were among decedents aged ≥65. Non-Arizona residents were 5 times as likely as Arizona residents to have a heat-associated death outdoors ( P < .001). Of 727 decedents with data on duration of Arizona residency, 438 (60%) had resided in Arizona ≥20 years. Conclusions Ongoing evaluation of interventions that target populations at risk for both outdoor and indoor heat-associated deaths can further inform refinement of the surveillance system and identify best practices to prevent heat-associated deaths.

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It’s not the heat, it’s the vulnerability: attribution of the 2016 spike in heat-associated deaths in Maricopa County, Arizona

Cited by 44 publications

References 45 publications

Energy, Poverty, and Health in Climate Change: A Comprehensive Review of an Emerging Literature

Energy, Poverty, and Health in Climate Change: A Comprehensive Review of an Emerging Literature

Assessing Urban Risk to Extreme Heat in China

Heat-Associated Mortality in a Hot Climate

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