Changes in population susceptibility to heat and cold over time: assessing adaptation to climate change

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Abstract

Background

In the context of a warming climate and increasing urbanisation (with the associated urban heat island effect), interest in understanding temperature related health effects is growing. Previous reviews have examined how the temperature-mortality relationship varies by geographical location. There have been no reviews examining the empirical evidence for changes in population susceptibility to the effects of heat and/or cold over time. The objective of this paper is to review studies which have specifically examined variations in temperature related mortality risks over the 20 ^th and 21 ^st centuries and determine whether population adaptation to heat and/or cold has occurred.

Methods

We searched five electronic databases combining search terms for three main concepts: temperature, health outcomes and changes in vulnerability or adaptation. Studies included were those which quantified the risk of heat related mortality with changing ambient temperature in a specific location over time, or those which compared mortality outcomes between two different extreme temperature events (heatwaves) in one location.

Results

The electronic searches returned 9183 titles and abstracts, of which eleven studies examining the effects of ambient temperature over time were included and six studies comparing the effect of different heatwaves at discrete time points were included. Of the eleven papers that quantified the risk of, or absolute heat related mortality over time, ten found a decrease in susceptibility over time of which five found the decrease to be significant. The magnitude of the decrease varied by location. Only two studies attempted to quantitatively attribute changes in susceptibility to specific adaptive measures and found no significant association between the risk of heat related mortality and air conditioning prevalence within or between cities over time. Four of the six papers examining effects of heatwaves found a decrease in expected mortality in later years. Five studies examined the risk of cold. In contrast to the changes in heat related mortality observed, only one found a significant decrease in cold related mortality in later time periods.

Conclusions

There is evidence that across a number of different settings, population susceptibility to heat and heatwaves has been decreasing. These changes in heat related susceptibility have important implications for health impact assessments of future heat related risk. A similar decrease in cold related mortality was not shown. Adaptation to heat has implications for future planning, particularly in urban areas, with anticipated increases in temperature due to climate change.

Electronic supplementary material

The online version of this article (doi:10.1186/s12940-016-0102-7) contains supplementary material, which is available to authorized users.

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Most cited references 66

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Heat stress and public health: a critical review.

R. Sari Kovats, Shakoor Hajat (2008)

Heat is an environmental and occupational hazard. The prevention of deaths in the community caused by extreme high temperatures (heat waves) is now an issue of public health concern. The risk of heat-related mortality increases with natural aging, but persons with particular social and/or physical vulnerability are also at risk. Important differences in vulnerability exist between populations, depending on climate, culture, infrastructure (housing), and other factors. Public health measures include health promotion and heat wave warning systems, but the effectiveness of acute measures in response to heat waves has not yet been formally evaluated. Climate change will increase the frequency and the intensity of heat waves, and a range of measures, including improvements to housing, management of chronic diseases, and institutional care of the elderly and the vulnerable, will need to be developed to reduce health impacts.

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Heat Waves in the United States: Mortality Risk during Heat Waves and Effect Modification by Heat Wave Characteristics in 43 U.S. Communities

G Anderson, Michelle L. Bell (2010)

Background Devastating health effects from recent heat waves, and projected increases in frequency, duration, and severity of heat waves from climate change, highlight the importance of understanding health consequences of heat waves. Objectives We analyzed mortality risk for heat waves in 43 U.S. cities (1987–2005) and investigated how effects relate to heat waves’ intensity, duration, or timing in season. Methods Heat waves were defined as ≥ 2 days with temperature ≥ 95th percentile for the community for 1 May through 30 September. Heat waves were characterized by their intensity, duration, and timing in season. Within each community, we estimated mortality risk during each heat wave compared with non-heat wave days, controlling for potential confounders. We combined individual heat wave effect estimates using Bayesian hierarchical modeling to generate overall effects at the community, regional, and national levels. We estimated how heat wave mortality effects were modified by heat wave characteristics (intensity, duration, timing in season). Results Nationally, mortality increased 3.74% [95% posterior interval (PI), 2.29–5.22%] during heat waves compared with non-heat wave days. Heat wave mortality risk increased 2.49% for every 1°F increase in heat wave intensity and 0.38% for every 1-day increase in heat wave duration. Mortality increased 5.04% (95% PI, 3.06–7.06%) during the first heat wave of the summer versus 2.65% (95% PI, 1.14–4.18%) during later heat waves, compared with non-heat wave days. Heat wave mortality impacts and effect modification by heat wave characteristics were more pronounced in the Northeast and Midwest compared with the South. Conclusions We found higher mortality risk from heat waves that were more intense or longer, or those occurring earlier in summer. These findings have implications for decision makers and researchers estimating health effects from climate change.

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Emissions pathways, climate change, and impacts on California.

Katharine Hayhoe, Daniel Cayan, Christopher Field … (2004)

The magnitude of future climate change depends substantially on the greenhouse gas emission pathways we choose. Here we explore the implications of the highest and lowest Intergovernmental Panel on Climate Change emissions pathways for climate change and associated impacts in California. Based on climate projections from two state-of-the-art climate models with low and medium sensitivity (Parallel Climate Model and Hadley Centre Climate Model, version 3, respectively), we find that annual temperature increases nearly double from the lower B1 to the higher A1fi emissions scenario before 2100. Three of four simulations also show greater increases in summer temperatures as compared with winter. Extreme heat and the associated impacts on a range of temperature-sensitive sectors are substantially greater under the higher emissions scenario, with some interscenario differences apparent before midcentury. By the end of the century under the B1 scenario, heatwaves and extreme heat in Los Angeles quadruple in frequency while heat-related mortality increases two to three times; alpine/subalpine forests are reduced by 50-75%; and Sierra snowpack is reduced 30-70%. Under A1fi, heatwaves in Los Angeles are six to eight times more frequent, with heat-related excess mortality increasing five to seven times; alpine/subalpine forests are reduced by 75-90%; and snowpack declines 73-90%, with cascading impacts on runoff and streamflow that, combined with projected modest declines in winter precipitation, could fundamentally disrupt California's water rights system. Although interscenario differences in climate impacts and costs of adaptation emerge mainly in the second half of the century, they are strongly dependent on emissions from preceding decades.

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Author and article information

Contributors

Katherine Arbuthnott: Katherine.arbuthnott@lshtm.ac.uk

Shakoor Hajat: Shakoor.hajat@lshtm.ac.uk

Clare Heaviside: Clare.heaviside@phe.gov.uk

Sotiris Vardoulakis: Sotiris.vardoulakis@phe.gov.uk

Conference

Journal ID (nlm-ta): Environ Health

Journal ID (iso-abbrev): Environ Health

Title: Environmental Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1476-069X

Publication date (Electronic): 8 March 2016

Publication date PMC-release: 8 March 2016

Publication date Collection: 2016

Volume: 15

Issue : Suppl 1 Issue sponsor : Publication of this supplement has not been supported by sponsorship. Information about the source of funding for publication charges can be found in the individual articles. The articles have been through the journal's standard peer review process for supplements. Supplement Editor competing interests: PW has received research funding to his employing institution from the Natural Environment Research Council, the Wellcome Trust, the European Commission and the National Institute for Health Research on projects relating to sustainability and health in relation to the built environment. SV is the Head of the Environmental Change Department of Public Health England. Four papers (Arbuthnott et al., Salmond et al., Heaviside et al., Woods et al) in this supplement have been co-authored by SV or members of SV's Department. Peer-review of these papers was supervised by another guest editor, Prof Keith Dear, who made editorial decisions. SV is a member of the stakeholder committee for the UCL Complex Built Environment Systems (CBES) Group, which submitted one of the papers recommended for publication (Macmillan et al.). The paper was independently peer-reviewed by an external reviewer as well as by another guest editor (Paul Wilkinson). SV holds honorary academic affiliations with the London School of Hygiene and Tropical Medicine, the University of Birmingham, and Exeter University. SV has received research funding to their employing institution (PHE) from the European Commission and the National Institute for Health Research on projects relating to urban environmental health and sustainability. KD declares no competing interests.

Electronic Location Identifier: 33

Affiliations

[ ]Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London,, WC1H 9SH UK

[ ]Environmental Change Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot, OX11 0RQ UK

Article

Publisher ID: 102

DOI: 10.1186/s12940-016-0102-7

PMC ID: 4895245

PubMed ID: 26961541

SO-VID: 746e4c94-4234-4a8e-ac85-4327e506c517

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Conference name: The 11th International Conference on Urban Health

Conference location: Manchester, UK

Conference date: 06/03/2014

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ScienceOpen disciplines: Public health

Keywords: climate change,adaptation,temperature,heat,cold,heatwave,mortality,health

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ScienceOpen disciplines: Public health

Keywords: climate change, adaptation, temperature, heat, cold, heatwave, mortality, health

Changes in population susceptibility to heat and cold over time: assessing adaptation to climate change

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Climate Change: Open Access

Most cited references 66

Heat stress and public health: a critical review.

Heat Waves in the United States: Mortality Risk during Heat Waves and Effect Modification by Heat Wave Characteristics in 43 U.S. Communities

Emissions pathways, climate change, and impacts on California.

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