Temporal changes in associations between high temperature and hospitalizations by greenspace: Analysis in the Medicare population in 40 U.S. northeast counties.
Adaptation
Climate change
Greenspace
Heat
Hospitalization
Temperature
Journal
Environment international
ISSN: 1873-6750
Titre abrégé: Environ Int
Pays: Netherlands
ID NLM: 7807270
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
08
01
2021
revised:
18
05
2021
accepted:
23
06
2021
pubmed:
5
7
2021
medline:
3
9
2021
entrez:
4
7
2021
Statut:
ppublish
Résumé
Although research indicates health and well-being benefits of greenspace, little is known regarding how greenspace may influence adaptation to health risks from heat, particularly how these risks change over time. Using daily hospitalization rates of Medicare beneficiaries ≥65 years for 2000-2016 in 40 U.S. Northeastern urban counties, we assessed how temperature-related hospitalizations from cardiovascular causes (CVD) and heat stroke (HS) changed over time. We analyzed effect modification of those temporal changes by Enhanced Vegetation Index (EVI), approximating greenspace. We used a two-stage analysis including a generalized additive model and meta-analysis. Results showed that relative risk (RR) (per 1 °C increase in lag0-3 temperature) for temperature-HS hospitalization was higher in counties with the lowest quartile EVI (RR = 2.7, 95% CI: 2.0, 3.4) compared to counties with the highest quartile EVI (RR = 0.40, 95% CI: 0.14, 1.13) in the early part of the study period (2000-2004). RR of HS decreased to 0.88 (95% CI: 0.31, 2.53) in 2013-2016 in counties with the lowest quartile EVI. RR for HS changed over time in counties in the highest quartile EVI, with RRs of 0.4 (95% CI: -0.7, 1.4) in 2000-2004 and 2.4 (95% CI: 1.6, 3.2) in 2013-2016. Findings suggest that adaptation to heat-health associations vary by greenness. Greenspace may help lower risks from heat but such health risks warrant continuous local efforts such as heat-health plans.
Identifiants
pubmed: 34218185
pii: S0160-4120(21)00362-7
doi: 10.1016/j.envint.2021.106737
pmc: PMC8380720
mid: NIHMS1722949
pii:
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
106737Subventions
Organisme : NIMHD NIH HHS
ID : R01 MD012769
Pays : United States
Organisme : EPA
ID : R835871
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Informations de copyright
Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.
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