title: A Case-Only Study of Vulnerability to Heat Wave-Related Mortality in New York City (2000-2011).
abstract: BACKGROUND
  As a result of climate change, the frequency of extreme temperature events is expected to increase, and such events are associated with increased morbidity and mortality. Vulnerability patterns, and corresponding adaptation strategies, are most usefully conceptualized at a local level.
  
  
  METHODS
  We used a case-only analysis to examine subject and neighborhood characteristics that modified the association between heat waves and mortality. All deaths of New York City residents from 2000 through 2011 were included in this analysis. Meteorological data were obtained from the National Climatic Data Center. Modifying characteristics were obtained from the death record and geographic data sets.
  
  
  RESULTS
  A total of 234,042 adult deaths occurred during the warm season of our study period. Compared with other warm-season days, deaths during heat waves were more likely to occur in black (non-Hispanic) individuals than other race/ethnicities [odds ratio (OR) = 1.08; 95% CI: 1.03, 1.12], more likely to occur at home than in institutions and hospital settings (OR = 1.11; 95% CI: 1.06, 1.16), and more likely among those living in census tracts that received greater public assistance (OR = 1.05; 95% CI: 1.01, 1.09). Finally, deaths during heat waves were more likely among residents in areas of the city with higher relative daytime summer surface temperature and less likely among residents living in areas with more green space.
  
  
  CONCLUSIONS
  Mortality during heat waves varies widely within a city. Understanding which individuals and neighborhoods are most vulnerable can help guide local preparedness efforts.
authors.affiliation: Department of Environmental and Occupational Health, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.
authors.forename: Jaime
authors.initials: J
authors.lastname: Madrigano
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ito
authors.forename: Sarah
authors.initials: S
authors.lastname: Johnson
authors.forename: Patrick L
authors.initials: PL
authors.lastname: Kinney
authors.forename: Thomas
authors.initials: T
authors.lastname: Matte
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009519:New York City / Q000453:epidemiology; D012111:Residence Characteristics; D012307:Risk Factors; D012621:Seasons; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data