title: Intra-urban vulnerability to heat-related mortality in New York City, 1997-2006.
abstract: The health impacts of exposure to summertime heat are a significant problem in New York City (NYC) and for many cities and are expected to increase with a warming climate. Most studies on heat-related mortality have examined risk factors at the municipal or regional scale and may have missed the intra-urban variation of vulnerability that might inform prevention strategies. We evaluated whether place-based characteristics (socioeconomic/demographic and health factors, as well as the built and biophysical environment) may be associated with greater risk of heat-related mortality for seniors during heat events in NYC. As a measure of relative vulnerability to heat, we used the natural cause mortality rate ratio among those aged 65 and over (MRR65+), comparing extremely hot days (maximum heat index 100°F+) to all warm season days, across 1997-2006 for NYC's 59 Community Districts and 42 United Hospital Fund neighborhoods. Significant positive associations were found between the MRR65+ and neighborhood-level characteristics: poverty, poor housing conditions, lower rates of access to air-conditioning, impervious land cover, surface temperatures aggregated to the area-level, and seniors' hypertension. Percent Black/African American and household poverty were strong negative predictors of seniors' air conditioning access in multivariate regression analysis.
authors.affiliation: Harvard University Graduate School of Design, Department of Urban Planning & Design, 48 Quincy Street, Cambridge, MA 02138, USA; Columbia University Graduate School of Architecture, Planning & Preservation, Urban Planning Program, 400 Avery Hall, 1172 Amsterdam Avenue, New York, NY 10027, USA. Electronic address: jkrosenthal@gsd.harvard.edu.
authors.forename: Joyce
authors.initials: J
authors.lastname: Klein Rosenthal
authors.affiliation: Columbia University Mailman School of Public Health, Department of Environmental Health Sciences, 722W. 168th St., New York, NY 10032, USA. Electronic address: plk3@columbia.edu.
authors.forename: Patrick L
authors.initials: PL
authors.lastname: Kinney
authors.affiliation: New York City Department of Health and Mental Hygiene, Bureau of Environmental, Surveillance and Policy, 120 Worth Street, New York, NY 10013, USA.
authors.forename: Kristina B
authors.initials: KB
authors.lastname: Metzger
mesh_terms: D000368:Aged; D016208:Databases, Factual; D005260:Female; D054624:Health Status Disparities; D006359:Heat Exhaustion / Q000401:mortality*; D006801:Humans; D008297:Male; D015233:Models, Statistical; D009026:Mortality / Q000639:trends*; D009519:New York City / Q000453:epidemiology; D035862:Vulnerable Populations
keywords: Health disparities; Heat-related mortality; Housing quality; Neighborhood characteristics; Vulnerability