title: Differential Effects of Temperature Extremes on Hospital Admission Rates for Respiratory Disease between Indigenous and Non-Indigenous Australians in the Northern Territory.
abstract: The health gap between Indigenous and non-Indigenous Australians may be exacerbated by climate change if temperature extremes have disproportionate adverse effects on Indigenous people. To explore this issue, we analysed the effect of temperature extremes on hospital admissions for respiratory diseases, stratified by age, Indigenous status and sex, for people living in two different climates zones in the Northern Territory during the period 1993-2011. We examined admissions for both acute and chronic respiratory diagnoses, controlling for day of the week and seasonality variables. Our analysis showed that: (1) overall, Indigenous hospital admission rates far exceeded non-Indigenous admission rates for acute and chronic diagnoses, and Top End climate zone admission rates exceeded Central Australia climate zone admission rates; (2) extreme cold and hot temperatures were associated with inconsistent changes in admission rates for acute respiratory disease in Indigenous and non-Indigenous children and older adults; and (3) no response to cold or hot temperature extremes was found for chronic respiratory diagnoses. These findings support our two hypotheses, that extreme hot and cold temperatures have a different effect on hospitalisations for respiratory disease between Indigenous and non-Indigenous people, and that these health risks vary between the different climate zones. We did not, however, find that there were differing responses to temperature extremes in the two populations, suggesting that any increased vulnerability to climate change in the Indigenous population of the Northern Territory arises from an increased underlying risk to respiratory disease and an already greater existing health burden.
authors.affiliation: Climate Change Research Centre, University of New South Wales, Sydney 2052, Australia. donna.green@unsw.edu.au.|ARC Centre of Excellence for Climate System Science, University of New South Wales, Sydney 2052, Australia. donna.green@unsw.edu.au.
authors.forename: Donna
authors.initials: D
authors.lastname: Green
authors.affiliation: Centre for Health Research, School of Medicine, Western Sydney University, Sydney 2150, Australia. H.Bambrick@westernsydney.edu.au.
authors.forename: Hilary
authors.initials: H
authors.lastname: Bambrick
authors.affiliation: Public Health Association of Australia, Canberra 2605, Australia. aspetert@bigpond.com.
authors.forename: Peter
authors.initials: P
authors.lastname: Tait
authors.affiliation: Climate Change Research Centre, University of New South Wales, Sydney 2052, Australia. j.goldie@unsw.edu.au.|ARC Centre of Excellence for Climate System Science, University of New South Wales, Sydney 2052, Australia. j.goldie@unsw.edu.au.
authors.forename: James
authors.initials: J
authors.lastname: Goldie
authors.affiliation: Climate Change Research Centre, University of New South Wales, Sydney 2052, Australia. r.schultz@student.unsw.edu.au.|ARC Centre of Excellence for Climate System Science, University of New South Wales, Sydney 2052, Australia. r.schultz@student.unsw.edu.au.
authors.forename: Rosalie
authors.initials: R
authors.lastname: Schultz
authors.affiliation: Climate Change Research Centre, University of New South Wales, Sydney 2052, Australia. Leanne.Webb@csiro.au.
authors.forename: Leanne
authors.initials: L
authors.lastname: Webb
authors.affiliation: Climate Change Research Centre, University of New South Wales, Sydney 2052, Australia. l.alexander@unsw.edu.au.|ARC Centre of Excellence for Climate System Science, University of New South Wales, Sydney 2052, Australia. l.alexander@unsw.edu.au.
authors.forename: Lisa
authors.initials: L
authors.lastname: Alexander
authors.affiliation: Climate Change Research Centre, University of New South Wales, Sydney 2052, Australia. a.pitman@unsw.edu.au.|ARC Centre of Excellence for Climate System Science, University of New South Wales, Sydney 2052, Australia. a.pitman@unsw.edu.au.
authors.forename: Andrew
authors.initials: A
authors.lastname: Pitman
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D057231:Climate Change; D003080:Cold Temperature / Q000009:adverse effects*; D005260:Female; D054624:Health Status Disparities; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015876:Northern Territory / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data*; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
keywords: Aboriginal Australia; climate change; climate zones; disproportionate impacts; indigenous health; respiratory health; temperature extremes