Heat/mortality sensitivities in Los Angeles during winter: a unique phenomenon in the United States.

BACKGROUND: Extreme heat is often associated with elevated levels of human mortality, particularly across the mid-latitudes. Los Angeles, CA exhibits a unique, highly variable winter climate, with brief periods of intense heat caused by downsloping winds commonly known as Santa Ana winds. The goal is to determine if Los Angeles County is susceptible to heat-related mortality during the winter season. This is the first study to specifically evaluate heat-related mortality during the winter for a U.S. city. METHODS: Utilizing the Spatial Synoptic Classification system in Los Angeles County from 1979 through 2010, we first relate daily human mortality to synoptic air mass type during the winter season (December, January, February) using Welch's t-tests. However, this methodology is only somewhat effective at controlling for important inter- and intra-annual trends in human mortality unrelated to heat such as influenza outbreaks. As a result, we use distributed lag nonlinear modeling (DLNM) to evaluate if the relative risk of human mortality increases during higher temperatures in Los Angeles, as the DLNM is more effective at controlling for variability at multiple temporal scales within the human mortality dataset. RESULTS: Significantly higher human mortality is uncovered in winter when dry tropical air is present in Los Angeles, particularly among those 65 years and older (p < 0.001). The DLNM reveals the relative risk of human mortality increases when above average temperatures are present. Results are especially pronounced for maximum and mean temperatures, along with total mortality and those 65 + . CONCLUSIONS: The discovery of heat-related mortality in winter is a unique finding in the United States, and we recommend stakeholders consider warning and intervention techniques to mitigate the role of winter heat on human health in the County.

Where are weather-suicide associations valid? An examination of nine US counties with varying seasonality.

There has been much research on the associations between weather variables and suicide rates. However, the state of understanding has remained rather stagnant due to many contradictory findings. The purpose of this project is to examine a larger database of suicides that includes a longer and more recent period of record (1975-2010) across numerous locations in the USA. In all, we examine nine total counties (and the primary city associated with them) with a special effort made to compare locations with varying degrees of temperature seasonality: Cook (Chicago), Fulton (Atlanta), King (Seattle), Los Angeles (Los Angeles), Maricopa (Phoenix), Miami-Dade (Miami), Philadelphia (Philadelphia), Salt Lake (Salt Lake City), and St. Louis (St. Louis). We first examine the unique seasonal cycle in suicides evident in each locale and then use distributed lag nonlinear modeling (DLNM) to relate the suicide data to daily surface temperatures. Results suggest that a late spring/summer peak generally exists in suicide rates, and above average temperatures are associated with increased suicide risk in almost all study counties. Further, it appears that these associations can be found in both mid-latitude and sub-tropical climate types.

The urban heat island and its impact on heat waves and human health in Shanghai.

With global warming forecast to continue into the foreseeable future, heat waves are very likely to increase in both frequency and intensity. In urban regions, these future heat waves will be exacerbated by the urban heat island effect, and will have the potential to negatively influence the health and welfare of urban residents. In order to investigate the health effects of the urban heat island (UHI) in Shanghai, China, 30 years of meteorological records (1975-2004) were examined for 11 first- and second-order weather stations in and around Shanghai. Additionally, automatic weather observation data recorded in recent years as well as daily all-cause summer mortality counts in 11 urban, suburban, and exurban regions (1998-2004) in Shanghai have been used. The results show that different sites (city center or surroundings) have experienced different degrees of warming as a result of increasing urbanization. In turn, this has resulted in a more extensive urban heat island effect, causing additional hot days and heat waves in urban regions compared to rural locales. An examination of summer mortality rates in and around Shanghai yields heightened heat-related mortality in urban regions, and we conclude that the UHI is directly responsible, acting to worsen the adverse health effects from exposure to extreme thermal conditions.

The social impacts of the heat-health watch/warning system in Phoenix, Arizona: assessing the perceived risk and response of the public.

Heat is the leading weather-related killer in the United States. Although previous research suggests that social influences affect human responses to natural disaster warnings, no studies have examined the social impacts of heat or heat warnings on a population. Here, 201 surveys were distributed in Metropolitan Phoenix to determine the social impacts of the heat warning system, or more specifically, to gauge risk perception and warning response. Consistent with previous research, increased risk perception of heat results in increased response to a warning. Different social factors such as sex, race, age, and income all play an important role in determining whether or not people will respond to a warning. In particular, there is a strong sense of perceived risk to the heat among Hispanics which translates to increased response when heat warnings are issued. Based on these findings, suggestions are presented to help improve the Phoenix Heat Warning System.

Regional similarities in seasonal mortality across the United States: an examination of 28 metropolitan statistical areas.

Human mortality exhibits a strong seasonal pattern with deaths in winter far exceeding those in the summer. While the pattern itself is clear, there have been very few studies examining whether the magnitude or timing of seasonal mortality varies considerably across space. Thus, the goal of this study is to conduct a comprehensive geographic analysis of seasonal mortality across the United States and to uncover systematic regional differences in such mortality. Unique seasonal mortality curves were created for 28 metropolitan statistical areas across the United States, and the amplitude and timing of mortality peaks were determined. The findings here indicate that the seasonality of mortality exhibits strong spatial variation with the largest seasonal mortality amplitudes found in the southwestern United States and the smallest in the North, along with South Florida. In addition, there were strong intra-regional similarities that exist among the examined cities, implying that environmental factors are more important than social factors in determining seasonal mortality response. This work begins to fill a large gap within the scientific literature concerning the geographic variation and underlying causes of seasonal mortality across the United States.

Heat wave impacts on mortality in Shanghai, 1998 and 2003.

A variety of research has linked extreme heat to heightened levels of daily mortality and, not surprisingly, heat waves both in 1998 and in 2003 all led to elevated mortality in Shanghai, China. While the heat waves in the two years were similar in meteorological character, elevated mortality was much more pronounced during the 1998 event, but it remains unclear why the human response was so varied. In order to explain the differences in human mortality between the two years' heat waves, and to better understand how heat impacts human health, we examine a wide range of meteorological, pollution, and social variables in Shanghai during the summers (15 June to 15 September) of 1998 and 2003. Thus, the goal of this study is to determine what was responsible for the varying human health response during the two heat events. A multivariate analysis is used to investigate the relationships between mortality and heat wave intensity, duration, and timing within the summer season, along with levels of air pollution. It was found that for heat waves in both summers, mortality was strongly associated with the duration of the heat wave. In addition, while slightly higher than average, the air pollution levels for the two heat waves were similar and cannot fully explain the observed differences in human mortality. Finally, since the meteorological conditions and pollution levels for the two heat waves were alike, we conclude that improvements in living conditions in Shanghai, such as increased use of air conditioning, larger living areas, and increased urban green space, along with higher levels of heat awareness and the implementation of a heat warning system, were responsible for the lower levels of human mortality in 2003 compared to 1998.