title: Current and Projected Heat-Related Morbidity and Mortality in Rhode Island.
abstract: BACKGROUND
  Climate change is expected to cause increases in heat-related mortality, especially among the elderly and very young. However, additional studies are needed to clarify the effects of heat on morbidity across all age groups and across a wider range of temperatures.
  
  
  OBJECTIVE
  We aimed to estimate the impact of current and projected future temperatures on morbidity and mortality in Rhode Island.
  
  
  METHODS
  We used Poisson regression models to estimate the association between daily maximum temperature and rates of all-cause and heat-related emergency department (ED) admissions and all-cause mortality. We then used downscaled Coupled Model Intercomparison Project Phase 5 (CMIP5; a standardized set of climate change model simulations) projections to estimate the excess morbidity and mortality that would be observed if this population were exposed to the temperatures projected for 2046-2053 and 2092-2099 under two representative concentration pathways (RCP): RCP 8.5 and 4.5.
  
  
  RESULTS
  Between 2005 and 2012, an increase in maximum daily temperature from 75 to 85°F was associated with 1.3% and 23.9% higher rates of all-cause and heat-related ED visits, respectively. The corresponding effect estimate for all-cause mortality from 1999 through 2011 was 4.0%. The association with all-cause ED admissions was strongest for those < 18 or ≥ 65 years of age, whereas the association with heat-related ED admissions was most pronounced among 18- to 64-year-olds. If this Rhode Island population were exposed to temperatures projected under RCP 8.5 for 2092-2099, we estimate that there would be 1.2% (range, 0.6-1.6%) and 24.4% (range, 6.9-41.8%) more all-cause and heat-related ED admissions, respectively, and 1.6% (range, 0.8-2.1%) more deaths annually between April and October.
  
  
  CONCLUSIONS
  With all other factors held constant, our findings suggest that the current population of Rhode Island would experience substantially higher morbidity and mortality if maximum daily temperatures increase further as projected.
  
  
  BACKGROUND
  Kingsley SL, Eliot MN, Gold J, Vanderslice RR, Wellenius GA. 2016. Current and projected heat-related morbidity and mortality in Rhode Island. Environ Health Perspect 124:460-467; http://dx.doi.org/10.1289/ehp.1408826.
authors.affiliation: Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Kingsley
authors.forename: Melissa N
authors.initials: MN
authors.lastname: Eliot
authors.forename: Julia
authors.initials: J
authors.lastname: Gold
authors.forename: Robert R
authors.initials: RR
authors.lastname: Vanderslice
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Wellenius
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D057231:Climate Change; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D018882:Heat Stress Disorders / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D012237:Rhode Island / Q000453:epidemiology