@article{ref1,
title="Identifying heat-related deaths by using medical examiner and vital statistics data: surveillance analysis and descriptive epidemiology - Oklahoma, 1990-2011",
journal="Environmental research",
year="2016",
author="Johnson, Matthew G. and Brown, Sheryll and Archer, Pam and Wendelboe, Aaron and Magzamen, Sheryl and Bradley, Kristy K.",
volume="150",
number="",
pages="30-37",
abstract="OBJECTIVES: Approximately 660 deaths occur annually in the United States associated with excess natural heat. A record heat wave in Oklahoma during 2011 generated increased interest concerning heat-related mortality among public health preparedness partners. We aimed to improve surveillance for heat-related mortality and better characterize heat-related deaths in Oklahoma during 1990-2011, and to enhance public health messaging during future heat emergencies. <br><br>METHODS: Heat-related deaths were identified by querying vital statistics (VS) and medical examiner (ME) data during 1990-2011. Case inclusion criteria were developed by using heat-related International Classification of Diseases codes, cause-of-death nomenclature, and ME investigation narrative. We calculated sensitivity and predictive value positive (PVP) for heat-related mortality surveillance by using VS and ME data and performed a descriptive analysis. <br><br>RESULTS: During the study period, 364 confirmed and probable heat-related deaths were identified when utilizing both data sets. ME reports had 87% sensitivity and 74% PVP; VS reports had 80% sensitivity and 52% PVP. Compared to Oklahoma's general population, decedents were disproportionately male (67% vs. 49%), aged ≥65 years (46% vs. 14%), and unmarried (78% vs. 47%). Higher rates of heat-related mortality were observed among Blacks. Of 95 decedents with available information, 91 (96%) did not use air conditioning. <br><br>CONCLUSIONS: Linking ME and VS data sources together and using narrative description for case classification allows for improved case ascertainment and surveillance data quality. Males, Blacks, persons aged ≥65 years, unmarried persons, and those without air conditioning carry a disproportionate burden of the heat-related deaths in Oklahoma.<br><br>Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0013-9351",
doi="10.1016/j.envres.2016.05.035",
url="http://dx.doi.org/10.1016/j.envres.2016.05.035"
}