title: Heat Death Associations with the built environment, social vulnerability and their interactions with rising temperature.
abstract: In an extreme heat event, people can go to air-conditioned public facilities if residential air-conditioning is not available. Residences that heat slowly may also mitigate health effects, particularly in neighborhoods with social vulnerability. We explored the contributions of social vulnerability and these infrastructures to heat mortality in Maricopa County and whether these relationships are sensitive to temperature. Using Poisson regression modeling with heat-related mortality as the outcome, we assessed the interaction of increasing temperature with social vulnerability, access to publicly available air conditioned space, home air conditioning and the thermal properties of residences. As temperatures increase, mortality from heat-related illness increases less in census tracts with more publicly accessible cooled spaces. Mortality from all internal causes of death did not have this association. Building thermal protection was not associated with mortality. Social vulnerability was still associated with mortality after adjusting for the infrastructure variables. To reduce heat-related mortality, the use of public cooled spaces might be expanded to target the most vulnerable.
authors: Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 911 Broxton Plaza, Los Angeles, CA 90095-1736, USA; Center for Public Health and Disasters, UCLA-Fielding School of Public Health, 650 Young Drive South, Los Angeles, CA 90095-1772, USA. Electronic address: deisenman@mednet.ucla.edu.
authors: David P
authors: DP
authors: Eisenman
authors: Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 911 Broxton Plaza, Los Angeles, CA 90095-1736, USA.
authors: Holly
authors: H
authors: Wilhalme
authors: Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 911 Broxton Plaza, Los Angeles, CA 90095-1736, USA.
authors: Chi-Hong
authors: CH
authors: Tseng
authors: Civil, Environmental, and Sustainable Engineering, 660 S College Ave, Tempe, AZ 85287, USA.
authors: Mikhail
authors: M
authors: Chester
authors: California Department of Public Health, Environmental Health Investigations Branch, 580 Marina Bay Parkway, Building P-3, Richmond, CA 94804-6403, USA.
authors: Paul
authors: P
authors: English
authors: Institute of the Environment, UCLA, Life Sciences 5362, Los Angeles, CA 90095, USA.
authors: Stephanie
authors: S
authors: Pincetl
authors: Civil, Environmental, and Sustainable Engineering, 660 S College Ave, Tempe, AZ 85287, USA.
authors: Andrew
authors: A
authors: Fraser
authors: Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 911 Broxton Plaza, Los Angeles, CA 90095-1736, USA.
authors: Sitaram
authors: S
authors: Vangala
authors: Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 911 Broxton Plaza, Los Angeles, CA 90095-1736, USA.
authors: Satvinder K
authors: SK
authors: Dhaliwal
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D000389:Air Conditioning; D001130:Arizona / Q000453:epidemiology; D002423:Cause of Death; D005160:Facility Design and Construction / Q000379:methods; D005260:Female; D018882:Heat Stress Disorders / Q000401:mortality* / Q000517:prevention & control; D006358:Hot Temperature / Q000009:adverse effects*; D006798:Housing; D006801:Humans; D008297:Male; D008875:Middle Aged; D025341:Principal Component Analysis; D012307:Risk Factors; D017678:Sex Distribution; D035862:Vulnerable Populations