Impact of heat on emergency hospital admission in Texas: geographic and racial/ethnic disparities,Journal of Exposure Science and Environmental Epidemiology

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Impact of heat on emergency hospital admission in Texas: geographic and racial/ethnic disparities
Journal of Exposure Science and Environmental Epidemiology ( IF 4.5 ) Pub Date : 2023-08-09 , DOI: 10.1038/s41370-023-00590-6
Chunyu Guo ₁ , Erjia Ge ₂ , Sungmin Lee ₃ , Yongmei Lu ₄ , Nick P Bassill ₅ , Nanhua Zhang _{6,

7} , Wei Zhang _{8,

9} , Yi Lu ₁₀ , Yuqing Hu ₁₁ , Jayajit Chakraborty ₁₂ , Rebecca T Emeny ₁₃ , Kai Zhang ₁₄

Affiliation

Department of Economics, School of Art and Science, University at Albany, State University of New York, Albany, NY, USA.
Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA.
Department of Geography and Environmental Studies, Texas State University, San Marcos, TX, USA.
Center of Excellence in Weather & Climate Analytics, University at Albany, State University of New York, Albany, NY, USA.
Division of Biostatistics & Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Department of Plants, Soils and Climate, Utah State University, Logan, UT, USA.
Ecology Center, Utah State University, Logan, UT, USA.
Department of Architecture and Civil Engineering, City University of Hong Kong, Hong Kong, Hong Kong.
Department of Architectural Engineering, The Pennsylvania State University, University Park, PA, USA.
Department of Sociology and Anthropology, University of Texas at El Paso, El Paso, TX, USA.
Department of Internal Medicine, Division of Molecular Medicine, Albuquerque, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA.

Background

Studies exploring the racial/ethnicity disparity of the impact of heat on hospital admission are notably limited, especially in Texas, a state with a diverse population and consistently ranking among the top ten U.S. states for heat-related deaths per capita from 2018 to 2020.

Objective

Our objective is to determine the correlation between elevated temperatures and emergency hospital admissions for various causes and age groups across 12 Metropolitan Statistical Areas(MSAs) in Texas. Additionally, we aim to investigate health inequalities in the five largest MSAs in Texas between 2004 and 2013.

Methods

We used MSA-level hospital admission and weather data to estimate the relationship between heat and emergency hospital admissions. We applied a Generalized Additive Model and random effects meta-analysis to calculate MSA-specific associations and overall correlation, repeating the analysis for age groups and specific causes of admission. We also investigated health disparities across racial and ethnic groups and performed a sensitivity analysis.

Results

The results showed that a 1 °C increase in temperature was associated with a 0.50% (95% CI [0.38%, 0.63%]) increase in all-cause emergency hospital admissions. Heat’s impact on hospital admissions varied among age groups and causes, with children under 6 years showing the highest effect estimate (0.64% (95% CI [0.32%,0.96%])). Statistically significant associations were found for Cardiovascular Diseases (0.27% (95% CI [0.07%,0.47%])), Ischemic Heart Diseases (0.53% (95% CI [0.15%,0.92%])), Pneumonia (0.70% (95% CI [0.25%,1.16%])), and Respiratory Diseases (0.67% (95% CI [0.18%,1.17%])). Health disparities were found among racial and ethnic groups in the five largest MSAs.

Impact statement

Studies exploring the impact of heat on hospital admission in Texas are notably limited. Our research provided a comprehensive examination of the connection between heat and emergency hospital admissions throughout Texas. Furthermore, we are the first to examine racial/ethnic disparities, identifying African American and Hispanic groups as disproportionately affected. These insights provide valuable insights for policymakers to allocate resources and implement strategies to mitigate the negative consequences of rising temperatures.

中文翻译：

高温对德克萨斯州急诊入院的影响：地理和种族/民族差异

背景

探索高温对入院影响的种族/族裔差异的研究明显有限，特别是在德克萨斯州，该州人口多元化，2018 年至 2020 年一直位居美国因高温导致人均死亡人数前十的州之列。

客观的

我们的目标是确定德克萨斯州 12 个大都市统计区 (MSA) 的高温与各种原因和年龄组的紧急住院之间的相关性。此外，我们的目标是调查 2004 年至 2013 年间德克萨斯州五个最大的 MSA 的健康不平等情况。

方法

我们使用 MSA 级别的入院和天气数据来估计高温与紧急入院之间的关系。我们应用广义加性模型和随机效应荟萃分析来计算 MSA 特定关联和总体相关性，并对年龄组和具体入院原因重复分析。我们还调查了不同种族和族裔群体的健康差异，并进行了敏感性分析。

结果

结果显示，体温每升高 1 °C，全因急诊入院率就会增加 0.50%（95% CI [0.38%, 0.63%]）。高温对入院的影响因年龄组和原因而异，其中 6 岁以下儿童的影响估计最高 (0.64% (95% CI [0.32%,0.96%]))。与心血管疾病 (0.27% (95% CI [0.07%,0.47%]))、缺血性心脏病 (0.53% (95% CI [0.15%,0.92%]))、肺炎 (0.70% (0.70% (0.70%, 95% CI [0.25%,1.16%]））和呼吸系统疾病（0.67%（95% CI [0.18%,1.17%]））。在五个最大的MSA中，种族和族裔群体之间存在健康差异。