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      Demandas al sector salud ante las manifestaciones del cambio climático en Jalisco Translated title: Demands to the health sector front the manifestations of climate change in Jalisco

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          Abstract

          Resumen El cambio climático ha detonado peligros para la salud que requieren determinarse y reconocerse en Jalisco. Un peligro confirmado son las temperaturas máximas extremas que lleva a un necesario diagnóstico de la vulnerabilidad y de riesgo como base para el diseño e implementación de medidas de adaptación ante manifestaciones actuales y futuras. Las demandas de atención del sector salud han aumentado a partir de verse incrementado el periodo de tiempo donde existe la probabilidad de presentarse temperaturas extremas y olas de calor pasando de dos meses considerado como normal, a cuatro meses en la actualidad con un incremento en mortalidad por enfermedades cardiovasculares y en morbilidad por infecciones gastrointestinales, de igual manera ha aumentado en dos meses la temperatura que favorece el incremento de la población de mosquitos transmisores de dengue. Lo anterior requiere de una respuesta del sector salud, no solo en la atención hospitalaria, sino en la prevención de la exposición a través de sistema de alerta temprana ante la presencia de peligro con una evaluación de dichas estrategias de comunicación para detener y revertir el incremento de daño a la salud de los habitantes de Jalisco, en particular las áreas urbanas de Tlaquepaque, Zapopan, Tonalá, Guadalajara y Puerto Vallarta que resultaron ser las más vulnerables al cambio climático en Jalisco.

          Translated abstract

          Abstract Climate change has triggered health hazards that need to be identified and recognized in Jalisco state. A confirmed threat is the extreme maximum temperatures that lead to a necessary diagnosis of vulnerability and risk as a basis for the design and implementation of adaptation measures to current and future manifestations. The demands of attention of the health sector have increased since the period of time where there is the probability of presenting extreme temperatures and heat waves has increased from two months considered as normal to four months at present with an increase in mortality due to cardiovascular diseases and morbidity due to gastrointestinal infections, likewise, the temperature has increased by two months which promotes the increase of the population of mosquitoes that transmit dengue fever. The above requires a response from the health sector, not only in hospital care, but also in the prevention of exposure through an early warning system in the presence of danger with an evaluation of such communication strategies to break and reverse the increase in damage to the health of the Jalisco state inhabitants, particularly the Tlaquepaque, Zapopan, Tonalá, Guadalajara and Puerto Vallarta urban areas which turned out to be the most vulnerable to climate change in Jalisco.

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          Most cited references47

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          Algorithms for enhancing public health utility of national causes-of-death data

          Background Coverage and quality of cause-of-death (CoD) data varies across countries and time. Valid, reliable, and comparable assessments of trends in causes of death from even the best systems are limited by three problems: a) changes in the International Statistical Classification of Diseases and Related Health Problems (ICD) over time; b) the use of tabulation lists where substantial detail on causes of death is lost; and c) many deaths assigned to causes that cannot or should not be considered underlying causes of death, often called garbage codes (GCs). The Global Burden of Disease Study and the World Health Organization have developed various methods to enhance comparability of CoD data. In this study, we attempt to build on these approaches to enhance the utility of national cause-of-death data for public health analysis. Methods Based on careful consideration of 4,434 country-years of CoD data from 145 countries from 1901 to 2008, encompassing 743 million deaths in ICD versions 1 to 10 as well as country-specific cause lists, we have developed a public health-oriented cause-of-death list. These 56 causes are organized hierarchically and encompass all deaths. Each cause has been mapped from ICD-6 to ICD-10 and, where possible, they have also been mapped to the International List of Causes of Death 1-5. We developed a typology of different classes of GCs. In each ICD revision, GCs have been identified. Target causes to which these GCs should be redistributed have been identified based on certification practice and/or pathophysiology. Proportionate redistribution, statistical models, and expert algorithms have been developed to redistribute GCs to target codes for each age-sex group. Results The fraction of all deaths assigned to GCs varies tremendously across countries and revisions of the ICD. In general, across all country-years of data available, GCs have declined from more than 43% in ICD-7 to 24% in ICD-10. In some regions, such as Australasia, GCs in 2005 are as low as 11%, while in some developing countries, such as Thailand, they are greater than 50%. Across different age groups, the composition of GCs varies tremendously - three classes of GCs steadily increase with age, but ambiguous codes within a particular disease chapter are also common for injuries at younger ages. The impact of redistribution is to change the number of deaths assigned to particular causes for a given age-sex group. These changes alter ranks across countries for any given year by a number of different causes, change time trends, and alter the rank order of causes within a country. Conclusions By mapping CoD through different ICD versions and redistributing GCs, we believe the public health utility of CoD data can be substantially enhanced, leading to an increased demand for higher quality CoD data from health sector decision-makers.
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            Extreme Temperatures and Mortality: Assessing Effect Modification by Personal Characteristics and Specific Cause of Death in a Multi-City Case-Only Analysis

            Background Extremes of temperature are associated with short-term increases in daily mortality. Objectives We set out to identify subpopulations and mortality causes with increased susceptibility to temperature extremes. Methods We conducted a case-only analysis using daily mortality and hourly weather data from 50 U.S. cities for the period 1989–2000, covering a total of 7,789,655 deaths. We used distributions of daily minimum and maximum temperature in each city to define extremely hot days (≥ 99th percentile) and extremely cold days (≤ 1st percentile), respectively. For each (hypothesized) effect modifier, a city-specific logistic regression model was fitted and an overall estimate calculated in a subsequent meta-analysis. Results Older subjects [odds ratio (OR) = 1.020; 95% confidence interval (CI), 1.005–1.034], diabetics (OR = 1.035; 95% CI, 1.010–1.062), blacks (OR = 1.037; 95% CI, 1.016–1.059), and those dying outside a hospital (OR = 1.066; 95% CI, 1.036–1.098) were more susceptible to extreme heat, with some differences observed between those dying from a cardiovascular disease and other decedents. Cardiovascular deaths (OR = 1.053; 95% CI, 1.036–1.070), and especially cardiac arrest deaths (OR =1.137; 95% CI, 1.051–1.230), showed a greater relative increase on extremely cold days, whereas the increase in heat-related mortality was marginally higher for those with coexisting atrial fibrillation (OR = 1.059; 95% CI, 0.996–1.125). Conclusions In this study we identified several subpopulations and mortality causes particularly susceptible to temperature extremes. This knowledge may contribute to establishing health programs that would better protect the vulnerable.
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              Heat-related deaths during the July 1995 heat wave in Chicago.

              During a record-setting heat wave in Chicago in July 1995, there were at least 700 excess deaths, most of which were classified as heat-related. We sought to determine who was at greatest risk for heat-related death. We conducted a case-control study in Chicago to identify risk factors associated with heat-related death and death from cardiovascular causes from July 14 through July 17, 1995. Beginning on July 21, we interviewed 339 relatives, neighbors, or friends of those who died and 339 controls matched to the case subjects according to neighborhood and age. The risk of heat-related death was increased for people with known medical problems who were confined to bed (odds ratio as compared with those who were not confined to bed, 5.5) or who were unable to care for themselves (odds ratio, 4.1). Also at increased risk were those who did not leave home each day (odds ratio, 6.7), who lived alone (odds ratio, 2.3), or who lived on the top floor of a building (odds ratio, 4.7). Having social contacts such as group activities or friends in the area was protective. In a multivariate analysis, the strongest risk factors for heat-related death were being confined to bed (odds ratio, 8.2) and living alone (odds ratio, 2.3); the risk of death was reduced for people with working air conditioners (odds ratio, 0.3) and those with access to transportation (odds ratio, 0.3). Deaths classified as due to cardiovascular causes had risk factors similar to those for heat-related death. In this study of the 1995 Chicago heat wave, those at greatest risk of dying from the heat were people with medical illnesses who were socially isolated and did not have access to air conditioning. In future heat emergencies, interventions directed to such persons should reduce deaths related to the heat.
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                Author and article information

                Journal
                revbio
                Revista bio ciencias
                Revista bio ciencias
                Universidad Autónoma de Nayarit (Tepic, Los Fresnos, Mexico )
                2007-3380
                2021
                : 8
                : e884
                Affiliations
                [1] Zapopan orgnameUniversidad de Guadalajara orgdiv1Instituto de Medio Ambiente y Comunidades Humanas orgdiv2Programa de Salud Ambiental Mexico
                Article
                S2007-33802021000100104 S2007-3380(21)00800000104
                10.15741/revbio.08.e884
                289887d5-da04-4911-ba21-7eeed260dfd3

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 10 February 2021
                : 02 December 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 48, Pages: 0
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                SciELO Mexico

                Categories
                Artículos originales

                Climate change adaptation,morbilidad,mortalidad,morbidity,vulnerabilidad,Adaptación al cambio climático,temperaturas extremas,mortality,temperature extremes,vulnerability

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