Spatiotemporal analysis of heat and heat wave effects on elderly mortality in Texas, 2006-2011.
Heat and heat waves have been linked to the increased risk of deaths, hospital admissions, and emergency visits.



This study presents a spatiotemporal analysis of heat and heat wave effects on elderly mortality (≥65years) in Texas.



We compiled a six-year daily weather and mortality counts dataset from 254 counties in Texas during 2006-2011. Heat index (HI), a combination of temperature and relative humidity, was used as the exposure metric in this study. Associations between daily all-cause elderly mortality and daily maximum HI and heat waves (≥2days of county-specific daily maximum HI>95th percentiles) were examined using a quasi-Poisson regression. A Markov random field smoother was included in the model to account for spatial autocorrelations and spatial heterogeneity. The model also controlled for long-term trend and seasonality in mortality, and the effects of day of the week.



On average, the lag effect of heat on elderly mortality risk lasted up to 10days, and the cumulative heat effects started to increase rapidly when daily maximum HI exceeded the 90th percentile in Texas. Elderly living in Northwest Texas and parts of West Texas were at greater risk of elderly mortality attributable to heat waves, and the highest relative risk for elderly mortality occurred in El Paso County (4.70, 95% Confidence Interval=4.33, 5.10).



Our study indicates strong geographical variations of heat wave effects on elderly mortality risk in Texas.
Department of Biostatistics, The University of Texas School of Public Health at San Antonio Regional Campus, San Antonio, TX, USA; Research to Advance Community Health Center, The University of Texas Health Science Center at San Antonio Regional Campus, San Antonio, TX, USA.
Lung-Chang
LC
Chien
Division of Epidemiology and Biostatistics, School of Public Health, The University of Queensland, Brisbane, Australia.
Yuming
Y
Guo
Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas School of Public Health, Houston, TX, USA; Southwest Center for Occupational and Environmental Health, School of Public Health, University of Texas Health Science Center at Houston, TX, USA. Electronic address: kai.zhang@uth.tmc.edu.
Kai
K
Zhang
D000368:Aged; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005260:Female; D006358:Hot Temperature; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends*; D062211:Spatio-Temporal Analysis; D013781:Texas; D014887:Weather
Distributed lagged nonlinear model; Heat index; Mortality; Spatial heterogeneity