%0 Journal Article
%T Heat-related morbidity and mortality in New England: evidence for local policy
%J Environmental research
%D 2017
%A Wellenius, Gregory A.
%A Eliot, Melissa N.
%A Bush, Kathleen F.
%A Holt, Dennis
%A Lincoln, Rebecca A.
%A Smith, Andrew E.
%A Gold, Julia
%V 156
%N 
%P 845-853
%X BACKGROUND: Heat-related morbidity and mortality is a recognized public health concern. However, public health officials need to base policy decisions on local evidence, which is often lacking for smaller communities. <br><br>OBJECTIVES: To evaluate the association between maximum daily heat index (HI) and morbidity and mortality in 15 New England communities (combined population: 2.7 million) in order to provide actionable evidence for local officials. <br><br>METHODS: We applied overdispersed Poisson nonlinear distributed lag models to evaluate the association between HI and daily (May-September) emergency department (ED) admissions and deaths in each of 15 study sites in New Hampshire, Maine, and Rhode Island, controlling for time trends, day of week, and federal holidays. Site-specific estimates were meta-analyzed to provide regional estimates. <br><br>RESULTS: Associations (sometimes non-linear) were observed between HI and each health outcome. For example, a day with a HI of 95°F vs. 75°F was associated with a cumulative 7.5% (95% confidence interval [CI]: 6.5%, 8.5%) and 5.1% (95% CI: 0.2%, 10.3%) higher rate of all-cause ED visits and deaths, respectively, with some evidence of regional heterogeneity. We estimate that in the study area, days with a HI≥95°F were associated with an annual average of 784 (95% CI: 658, 908) excess ED visits and 22 (95% CI: 3, 39) excess deaths. <br><br>CONCLUSIONS: Our results suggest the presence of adverse health impacts associated with HI below the current local guideline criteria of HI≥100°F used to issue heat advisories. We hypothesize that lowering this threshold may lead to substantially reduced heat-related morbidity and mortality in the study area.<br><br>Copyright © 2017 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>
%G en
%I Elsevier Publishing
%@ 0013-9351
%U http://dx.doi.org/10.1016/j.envres.2017.02.005