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Neighborhood Effects on Heat Deaths: Social and Environmental Predictors of Vulnerability in Maricopa County, Arizona

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      Background: Most heat-related deaths occur in cities, and future trends in global climate change and urbanization may amplify this trend. Understanding how neighborhoods affect heat mortality fills an important gap between studies of individual susceptibility to heat and broadly comparative studies of temperature–mortality relationships in cities.Objectives: We estimated neighborhood effects of population characteristics and built and natural environments on deaths due to heat exposure in Maricopa County, Arizona (2000–2008).Methods: We used 2000 U.S. Census data and remotely sensed vegetation and land surface temperature to construct indicators of neighborhood vulnerability and a geographic information system to map vulnerability and residential addresses of persons who died from heat exposure in 2,081 census block groups. Binary logistic regression and spatial analysis were used to associate deaths with neighborhoods.Results: Neighborhood scores on three factors—socioeconomic vulnerability, elderly/isolation, and unvegetated area—varied widely throughout the study area. The preferred model (based on fit and parsimony) for predicting the odds of one or more deaths from heat exposure within a census block group included the first two factors and surface temperature in residential neighborhoods, holding population size constant. Spatial analysis identified clusters of neighborhoods with the highest heat vulnerability scores. A large proportion of deaths occurred among people, including homeless persons, who lived in the inner cores of the largest cities and along an industrial corridor.Conclusions: Place-based indicators of vulnerability complement analyses of person-level heat risk factors. Surface temperature might be used in Maricopa County to identify the most heat-vulnerable neighborhoods, but more attention to the socioecological complexities of climate adaptation is needed.

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          Climate change and human health: present and future risks.

          There is near unanimous scientific consensus that greenhouse gas emissions generated by human activity will change Earth's climate. The recent (globally averaged) warming by 0.5 degrees C is partly attributable to such anthropogenic emissions. Climate change will affect human health in many ways-mostly adversely. Here, we summarise the epidemiological evidence of how climate variations and trends affect various health outcomes. We assess the little evidence there is that recent global warming has already affected some health outcomes. We review the published estimates of future health effects of climate change over coming decades. Research so far has mostly focused on thermal stress, extreme weather events, and infectious diseases, with some attention to estimates of future regional food yields and hunger prevalence. An emerging broader approach addresses a wider spectrum of health risks due to the social, demographic, and economic disruptions of climate change. Evidence and anticipation of adverse health effects will strengthen the case for pre-emptive policies, and will also guide priorities for planned adaptive strategies.

            Author and article information

            [1 ]School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA
            [2 ]Science Applications Research and Development, Jacobs/Engineering Science and Contract Group, NASA Johnson Space Center, Houston, Texas, USA
            [3 ]Department of Biomedical Informatics, Arizona State University, Scottsdale, Arizona, USA
            Author notes
            Address correspondence to S. Harlan, School of Human Evolution and Social Change, Arizona State University, Tempe, AZ 85284-2402 USA. Telephone: (480) 727-6780. E-mail: sharon.harlan@
            Environ Health Perspect
            Environ. Health Perspect
            Environmental Health Perspectives
            National Institute of Environmental Health Sciences
            16 November 2012
            February 2013
            : 121
            : 2
            : 197-204

            This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, properly cited.


            Public health

            vulnerability, remote sensing, neighborhoods, heat mortality, gis, climate


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