title: Quantifying Vulnerability to Extreme Heat in Time Series Analyses: A Novel Approach Applied to Neighborhood Social Disparities under Climate Change.
abstract: OBJECTIVE
  We propose a novel approach to examine vulnerability in the relationship between heat and years of life lost and apply to neighborhood social disparities in Montreal and Paris.
  
  
  METHODS
  We used historical data from the summers of 1990 through 2007 for Montreal and from 2004 through 2009 for Paris to estimate daily years of life lost social disparities (DYLLD), summarizing social inequalities across groups. We used Generalized Linear Models to separately estimate relative risks (RR) for DYLLD in association with daily mean temperatures in both cities. We used 30 climate scenarios of daily mean temperature to estimate future temperature distributions (2021-2050). We performed random effect meta-analyses to assess the impact of climate change by climate scenario for each city and compared the impact of climate change for the two cities using a meta-regression analysis.
  
  
  RESULTS
  We show that an increase in ambient temperature leads to an increase in social disparities in daily years of life lost. The impact of climate change on DYLLD attributable to temperature was of 2.06 (95% CI: 1.90, 2.25) in Montreal and 1.77 (95% CI: 1.61, 1.94) in Paris. The city explained a difference of 0.31 (95% CI: 0.14, 0.49) on the impact of climate change.
  
  
  CONCLUSIONS
  We propose a new analytical approach for estimating vulnerability in the relationship between heat and health. Our results suggest that in Paris and Montreal, health disparities related to heat impacts exist today and will increase in the future.
authors.affiliation: Université de Montréal, DSEST, Montréal, QC H3T 1A8, Canada. tarik.benmarhnia@mcgill.ca.|EHESP School of Public Health, Rennes, Sorbonne-Paris Cité 35043, France. tarik.benmarhnia@mcgill.ca.|Institute for Health and Social Policy, McGill University, Montreal QC H3A 1A3, Canada. tarik.benmarhnia@mcgill.ca.
authors.forename: Tarik
authors.initials: T
authors.lastname: Benmarhnia
authors.affiliation: Consortium Ouranos, Montréal, Département Scénarios et Services Climatiques, Montréal, QC H3A 1B9, Canada. grenier.patrick@ouranos.ca.
authors.forename: Patrick
authors.initials: P
authors.lastname: Grenier
authors.affiliation: Institut National de Santé Publique du Québec, Montréal, QC H3A 1B9, Canada. allan.brand83@gmail.com.
authors.forename: Allan
authors.initials: A
authors.lastname: Brand
authors.affiliation: Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal, QC H2P 1E2, Canada. mfournie@santepub-mtl.qc.ca.
authors.forename: Michel
authors.initials: M
authors.lastname: Fournier
authors.affiliation: EHESP School of Public Health, Rennes, Sorbonne-Paris Cité 35043, France. severine.deguen@ehesp.fr.|INSERM U1085 (IRSET), Rennes 35042, France. severine.deguen@ehesp.fr.
authors.forename: Séverine
authors.initials: S
authors.lastname: Deguen
authors.affiliation: Université de Montréal, DSEST, Montréal, QC H3T 1A8, Canada. allan.brand83@gmail.com.|Institut National de Santé Publique du Québec, Montréal, QC H3A 1B9, Canada. allan.brand83@gmail.com.
authors.forename: Audrey
authors.initials: A
authors.lastname: Smargiassi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death / Q000639:trends; D002648:Child; D002675:Child, Preschool; D002947:Cities; D057231:Climate Change; D055874:Extreme Heat / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010297:Paris; D019057:Quality-Adjusted Life Years; D011792:Quebec; D012306:Risk; D012621:Seasons; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: climate change; climate models; population health; social health inequalities; temperature; time-series analyses; years of life lost