Mortality during a Large-Scale Heat Wave by Place, Demographic Group, Internal and External Causes of Death, and Building Climate Zone
Abstract
:1. Introduction
2. Materials and Methods
2.1. Mortality Data Source
2.2. Definitions of Heat Wave Deaths and Expected Deaths
2.3. Statistical Analysis: Relative Risk and Excess Deaths
2.4. Definitions of Subgroups and Temperature Data
3. Results
3.1. Place of Death
3.2. Demographics
3.3. Internal and External Causes of Death
3.4. Geography
4. Discussion
Other Considerations and Limitations
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
Abbreviations
AC | Air conditioning |
API | Asian/Hawaiian/Pacific Islanders |
CI | Confidence interval |
RR | Relative risk |
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Place of Death | Heat Wave Deaths a | Reference Day Deaths/2 b | RR (CI) | Excess Deaths c |
---|---|---|---|---|
All deaths | 11,727 | 11,144 | 1.05 (1.03–1.08) | 582 |
Inside hospital d | 4933 | 4820 | 1.02 (0.99–1.06) | 113 |
Outside hospital | 6670 | 6197 | 1.08 (1.05–1.11) | 473 |
Decedent‘s home | 3646 | 3262 | 1.12 (1.07–1.16) | 384 |
Hospice or nursing home | 2218 | 2156 | 1.03 (0.98–1.08) | 62 |
Other | 806 | 779 | 1.04 (0.95–1.13) | 27 |
Unknown | 124 | 127 | 0.97 (0.79–1.21) | −3 |
Underlying Cause of Death (ICD-10 Codes) | Total Mortality | At-Home Mortality | ||||||
---|---|---|---|---|---|---|---|---|
Heat Wave a | Reference/2 b | Relative Risk (CI) | Excess Deaths | Heat Wave | Reference/2 | Relative Risk (CI) | Excess Deaths | |
Internal causes (A00–R94) | 10,575 | 10,167 | 1.04 (1.02–1.07) * | 408 | 3382 | 3053 | 1.11 (1.06–1.16) * | 330 |
Mental/nervous system (F00–H95) | 935 | 841 | 1.11 (1.03–1.20) * | 94 | 259 | 212 | 1.22 (1.05–1.43) * | 47 |
Endocrine Disease (E00–88) | 483 | 448 | 1.08 (0.97–1.20) | 35 | 163 | 119 | 1.38 (1.13–1.68) * | 45 |
Respiratory system (J00–99) | 1042 | 973 | 1.07 (0.99–1.16) | 69 | 243 | 217 | 1.12 (0.95–1.31) | 26 |
Other internal diseases (L00–R99) | 515 | 488 | 1.06 (0.95–1.17) | 27 | 88 | 77 | 1.14 (0.87–1.48) | 11 |
Cardiovascular (I00–99) | 4169 | 4014 | 1.04 (1.00–1.08) | 155 | 1292 | 1095 | 1.18 (1.10–1.26) * | 198 |
Digestive system (K00–92) | 443 | 434 | 1.02 (0.91–1.14) | 9 | 67 | 71 | 0.94 (0.70–1.25) | −5 |
Neoplasms (C00–D48) | 2769 | 2739 | 1.01 (0.97–1.06) | 30 | 1249 | 1231 | 1.01 (0.95–1.09) | 18 |
Infectious and parasitic (A00–B99) | 219 | 230 | 0.95 (0.81–1.12) | −11 | 21 | 29 | 0.71 (0.43–1.17) | −9 |
External causes (V01–Y89.9) | 1152 | 977 | 1.18 (1.10–1.27) * | 175 | 264 | 210 | 1.26 (1.08–1.47) * | 54 |
External causes, excluding X30 | 1053 | 971 | 1.09 (1.01–1.17) * | 83 | 221 | 209 | 1.05 (0.90–1.24) | 12 |
Related to extreme heat (X30) | 99 | 7 | 15.2 (8.54–27.1) * | 92 | 43 | 1 | 86.0 (11.8–624.5) * | 43 |
Accidental drowning (W65–74) | 57 | 43 | 1.33 (0.95–1.85) | 14 | 8 | 1 | 8.00 (1.70–37.67) * | 7 |
Accidental poisoning (X40–49) | 182 | 145 | 1.26 (1.04–1.51) * | 37 | 88 | 69 | 1.28 (0.98–1.67) | 19 |
Homicide (X85–Y09, Y87.1) | 170 | 145 | 1.17 (0.97–1.42) | 25 | 16 | 18 | 0.89 (0.49–1.60) | −2 |
Falls (W00–19) | 91 | 83 | 1.09 (0.84–1.41) | 8 | 5 | 7 | 0.67 (0.24–1.83) | −3 |
Transport accidents (V01–99, Y85) | 292 | 278 | 1.05 (0.91–1.21) | 14 | 1 | 1 | 0.67 (0.07–6.41) | −1 |
Other external c | 92 | 91 | 1.01 (0.79–1.30) | 1 | 12 | 16 | 0.75 (0.39–1.46) | −4 |
Suicide (X60–84, Y87.0) | 169 | 185 | 0.91 (0.76–1.10) | −16 | 91 | 97 | 0.94 (0.73–1.21) | −6 |
Climate Zone | Representative City/Climate Type a | Total Mortality | At-Home Mortality | ADAT during Peak Heat Wave b °F (°C) | Peak Heat Wave ADAT Differential (°F) c | % AC Ownership d | ||
---|---|---|---|---|---|---|---|---|
Relative Risk (CI) | Excess Deaths | Relative Risk (CI) | Excess Deaths | |||||
1 | Arcata/coastal | 1.19 (0.89–1.59) | 12 | 1.58 (1.01–2.48) * | 13 | 81 (27) | 23 | 4% |
4 | Sunnyvale/coastal interior | 1.14 (1.02–1.26) * | 65 | 1.22 (1.01–1.46) * | 32 | 82 (28) | 17 | 48% |
2 | Santa Rosa/coastal interior | 1.14 (1.00–1.29) | 45 | 1.10 (0.89–1.36) | 13 | 85 (29) | 10 | 43% |
11 | Red Bluff/N Central Valley | 1.12 (1.00–1.26) | 50 | 1.18 (0.97–1.44) | 24 | 87 (31) | 14 | 89% |
13 | Fresno/S Central Valley | 1.11 (1.02–1.22) * | 74 | 1.43 (1.21–1.68) * | 75 | 88 (31) | 13 | 89% |
9 | Pasadena/coastal interior | 1.10 (1.04–1.17) * | 168 | 1.20 (1.08–1.34) * | 86 | 84 (29) | 15 | 76% |
n/a e | n/a | 1.10 (0.98–1.23) | 42 | 1.32 (0.92–1.91) | 12 | n/a | n/a | n/a |
6 | Los Angeles/coastal | 1.06 (0.98–1.15) | 51 | 1.10 (0.95–1.27) | 26 | 74 (23) | 11 | 31% |
8 | El Toro/coastal | 1.05 (0.98–1.13) | 61 | 1.19 (1.05–1.36) * | 58 | 79 (26) | 11 | 55% |
14 | China Lake/desert | 1.05 (0.91–1.21) | 14 | 0.98 (0.77–1.24) | −2 | 85 (29) | 10 | 88% |
10 | Riverside/coastal interior | 1.03 (0.96–1.11) | 39 | 0.97 (0.86–1.10) | -11 | 84 (29) | 13 | 87% |
12 | Sacramento/Central Valley | 1.02 (0.96–1.08) | 27 | 1.11 (0.99–1.25) | 48 | 88 (31) | 19 | 86% |
15 | El Centro/desert | 1.02 (0.87–1.20) | 6 | 0.98 (0.75–1.29) | −2 | 94 (34) | 8 | 97% |
3 | Oakland/coastal | 0.99 (0.92–1.06) | −11 | 1.06 (0.93–1.21) | 21 | 72 (22) | 14 | 11% |
7 | San Diego/coastal | 0.97 (0.88–1.07) | −20 | 0.97 (0.81–1.15) | −7 | 78 (26) | 12 | 32% |
5 | Santa Maria/coastal | 0.90 (0.72–1.11) | −14 | 0.98 (0.68–1.40) | −1 | 76 (24) | 15 | 15% |
16 | Mount Shasta/mountainous | 0.90 (0.76–1.06) | −24 | 1.00 (0.76–1.31) | 0 | 78 (26) | 13 | 56% |
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Joe, L.; Hoshiko, S.; Dobraca, D.; Jackson, R.; Smorodinsky, S.; Smith, D.; Harnly, M. Mortality during a Large-Scale Heat Wave by Place, Demographic Group, Internal and External Causes of Death, and Building Climate Zone. Int. J. Environ. Res. Public Health 2016, 13, 299. https://doi.org/10.3390/ijerph13030299
Joe L, Hoshiko S, Dobraca D, Jackson R, Smorodinsky S, Smith D, Harnly M. Mortality during a Large-Scale Heat Wave by Place, Demographic Group, Internal and External Causes of Death, and Building Climate Zone. International Journal of Environmental Research and Public Health. 2016; 13(3):299. https://doi.org/10.3390/ijerph13030299
Chicago/Turabian StyleJoe, Lauren, Sumi Hoshiko, Dina Dobraca, Rebecca Jackson, Svetlana Smorodinsky, Daniel Smith, and Martha Harnly. 2016. "Mortality during a Large-Scale Heat Wave by Place, Demographic Group, Internal and External Causes of Death, and Building Climate Zone" International Journal of Environmental Research and Public Health 13, no. 3: 299. https://doi.org/10.3390/ijerph13030299