The impact of extreme heat on morbidity in Milwaukee, Wisconsin

Abstract

Given predictions of increased intensity and frequency of heat waves, it is important to study the effect of high temperatures on human mortality and morbidity. Many studies focus on heat wave-related mortality; however, heat-related morbidity is often overlooked. The goals of this study are to examine the historical observed relationship between temperature and morbidity (illness), and explore the extent to which observed historical relationships could be used to generate future projections of morbidity under climate change. We collected meteorological, air pollution, and hospital admissions data in Milwaukee, Wisconsin, for the years 1989–2005, and employed a generalized additive model (GAM) to quantify the relationship between morbidity (as measured by hospital admissions) and high temperatures with adjustment for the effects of potential confounders. We also estimated temperature threshold values for different causes of hospital admissions and then quantified the associated percent increase of admissions per degree above the threshold. Finally, the future impact of higher temperatures on admissions for the years 2059–2075 was examined. Our results show that five causes of admission (endocrine, genitourinary, renal, accidental, and self-harm) and three age groups (15–64, 75–84, >85 years) were affected by high temperatures. Future projections indicate a larger number of days above the current temperature threshold leading to an increase in admissions. Our results indicate that climate change may increase heat-related hospital admissions in the US urban mid-West and that health systems should include heat wave planning.

This is a preview of subscription content, log in to check access.

References

  1. Confalonieri U et al (2007) Human health. In: Parry M et al (eds) Climate change 2007: impacts, adaptation and vulnerability. Contribution of working group II to the fourth assessment report of the intergovernmental panel on climate change. Cambridge University Press, Cambridge, pp 391–431

    Google Scholar 

  2. Curriero FC, Heiner KS, Samet JM, Zeger SL, Strug L, Patz JA (2002) Temperature and mortality in 11 cities of the eastern United States. Am J Epidemiol 155:80–87

    Article  Google Scholar 

  3. Dominici F, Samet JM, Zeger SL (2000) Combining evidence on air pollution and daily mortality from the twenty largest US cities: a hierarchical modeling strategy (with discussion). J R Stat Soc Ser A 163:263–302

    Article  Google Scholar 

  4. Duffy PB et al (2003) High resolution simulations of global climate, part 1: present climate. Clim Dyn 21:371–390

    Article  Google Scholar 

  5. Foster KG, Ellis FP, Doré C, Exton-Smith AN, Weiner JS (1976) Sweat responses in the aged. Age Ageing 5:91–101

    Article  Google Scholar 

  6. GFDL GAMDT (The GFDL Global Model Development Team) (2004) The new GFDL global atmospheric and land model AM2-LM2: evaluation with prescribed SST simulations. J Climate 17:4641–4673

    Article  Google Scholar 

  7. Govindasamy B, Duffy PB, Coquard J (2003) High resolution simulations of global climate, part 2: effects of increases greenhouse gases. Clim Dyn 21:391–404

    Article  Google Scholar 

  8. Hajat S, Armstrong B, Gouveia N, Wilkinson P (2004) Comparison of mortality displacement of heat-related deaths in Delhi, Sao Paulo and London. Epidemiology 15:S94–S94

    Article  Google Scholar 

  9. Hajat S, Kovats RS, Lachowycz K (2007) Heat-related and cold-related deaths in England and Wales: who is at risk? Occup Environ Med 64:93–100

    Article  Google Scholar 

  10. Hansen AL, Bi P, Ryan P, Nitschke M, Pisaniello D, Tucker G (2008a) The effect of heat waves on hospital admissions for renal disease in a temperate city of Australia. Int J Epidemiol 37:1359–1365

    Article  Google Scholar 

  11. Hansen A, Bi P, Nitschke M, Ryan P, Pisaniello D, Tucker G (2008b) The effect of heat waves on mental health in a temperate Australian city. Environ Health Perspect 116:1369–1375

    Article  Google Scholar 

  12. Hayhoe K, Cayan D, Field CB et al (2004) Emissions pathways, climate change, and impacts on California. Proc Natl Acad Sci U S A 101:12422–12427

    Article  Google Scholar 

  13. Hayhoe K, Sheridan S, Kalkstein L, Greene S (2010) Climate change, heat waves, and mortality projections for Chicago. J Great Lakes Res 36:65–73

    Article  Google Scholar 

  14. Jones TS, Liang AP, Kilbourne EM, Griffin MR, Patriarca PA, Fite Wassilak SG, Mullan RJ, Herrick RF, Donnell HD, Choi K, Thacker SB (1982) Morbidity and mortality associated with the July 1980 heat wave in St. Louis and Kansas City, MO. JAMA 247:3327–3331

    Article  Google Scholar 

  15. Kalkstein LS, Davis RE (1989) Weather and human mortality: and evaluation of demographic and interregional responses in the United States. Ann Assoc Am Geogr 79:44–64

    Article  Google Scholar 

  16. Kalkstein LS, Greene JS (1997) An evaluation of climate/mortality relationships in large U.S. cities and the possible impacts of climate change. Environ Health Perspect 105:84–93

    Article  Google Scholar 

  17. Keatinge WR, Donaldson GC, Cordioli EA, Martinelli M, Kunst AE, Mackenbach JP, Nayha S, Vuori I (2000) Heat related mortality in warm and cold regions of Europe: observational study. Br Med J 321:670–673

    Article  Google Scholar 

  18. Kilbourne EM (1999) The spectrum of illness during heat waves. Am J Prev Med 16:359–360

    Article  Google Scholar 

  19. Knowlton K, Rotkin-Ellman M, King G, Margolis HG, Smith D, Solomon G, Trent R, English P (2009) The 2006 California heat wave: impacts on hospitalizations and emergency department visits. Environ Health Perspect 117:61–67

    Google Scholar 

  20. Kovats RS, Ebi KL (2006) Heatwaves and public health in Europe. Eur J Public Health 16:592–599

    Article  Google Scholar 

  21. Kovats RS, Hajat S, Wilkinson P (2004) Contrasting patterns of mortality and hospital admissions during hot weather and heat waves in Greater London, UK. Occup Environ Med 61:893–898

    Article  Google Scholar 

  22. McGeehin MA, Mirabelli M (2001) The potential impacts of climate variability and change on temperature-related morbidity and mortality in the United States. Environ Health Perspect 109:185–189

    Article  Google Scholar 

  23. Mearns LO, Gutowski W, Jones R, Leung R, McGinnis S, Nunes A, Qian Y (2009) The North American Regional Climate Change Assessment Program: an overview. EOS 90(36):311–312

    Article  Google Scholar 

  24. Mearns LO, Hulme M, Carter TR, Leemans R, Lal M, Whetton P (2001) Climate scenario development (Chapter 13). In: Houghton JT et al (eds) Climate change 2001: the scientific basis. Contribut ion of working goup I to the third assessment report of the IPCC. Cambridge University Press, Cambridge, pp 583–638

    Google Scholar 

  25. Meehl GA, Tebaldi C (2004) More intense, more frequent, and longer lasting heat waves in the 21st century. Science 305:994–997

    Article  Google Scholar 

  26. Meehl G et al (2007) Global climate projections. In: Solomon et al (eds) Climate change 2007: the physical science basis. Contribution of Working Group I to the Fourth Assessment Report of the Intergovenmental Panel on Climate Change. Cambridge University Press, Cambridge, pp 747–845

    Google Scholar 

  27. Michelozzi P et al (2009) High temperature and hospitalizations for cardiovascular and respiratory causes in 12 European Cities. Am J Respir Crit Care Med 179:383–389

    Article  Google Scholar 

  28. Nakićenović N et al (2000) Special report on emissions scenarios. Cambridge University Press, Cambridge

    Google Scholar 

  29. Nitschke M, Tucker GR, Bi P (2007) Morbidity and mortality during heatwaves in metropolitan Adelaide. Med J Aust 187:662–665

    Google Scholar 

  30. O’Neill MS, Zanobetti A, Schwartz J (2003) Modifiers of the temperature and mortality association in seven US cities. Am J Epidemiol 157:1074–1082

    Article  Google Scholar 

  31. Page LA, Hajat S, Kovats RS (2007) Relationship between daily suicide counts and temperature in England and Wales. Br J Psychiatry 191:106–112

    Article  Google Scholar 

  32. Peng R, Bell M (2010) Spatial misalignment in time series studies of air pollution and health data. This paper considers the point data of air pollution and area average of health data. Tech Report

  33. Robine J, Cheung S, Le Roy S, Van Oyen H, Griffiths C, Michel JP, Herrmann F (2008) Death toll exceeded 70,000 in Europe during the summer of 2003. C R Biologies 331:171–178

    Article  Google Scholar 

  34. Ruppert D, Wand MP, Carroll R J (2003) Semiparametric regression. Cambridge University Press, UK

    Google Scholar 

  35. Schwartz J (2001) Is there harvesting in the association of airborne particles with daily deaths and hospital admissions? Epidemiology 12:55–61

    Article  Google Scholar 

  36. Schwartz J, Samet JM, Patz JA (2004) Hospital admissions for heart disease: the effects of temperature and humidity. Epidemiology (Cambridge, MA) 15:755–761

    Article  Google Scholar 

  37. Semenza JC, Rubin CH, Falter KH, Selanikio JD, Flanders WD, Howe HL, Wilhelm JL (1996) Heat-related deaths during the July 1995 heat wave in Chicago. New Engl J Med 335:84–90

    Article  Google Scholar 

  38. Semenza JC, McCullough JE, Flanders WD, McGeehin MA, Lumpkin JR (1999) Excess hospital admissions during the July 1995 heat wave in Chicago. Am J Prev Med 16:269–277

    Article  Google Scholar 

  39. Wheeler M (1976) Heat stroke in the elderly. Med Clin North Am 60:1289–1296

    Google Scholar 

  40. Zanobetti A, Wand MP, Schwartz J, Ryan LM (2000) Generalized additive distributed lag models. Biostatistics 1:279–292

    Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Bo Li.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Li, B., Sain, S., Mearns, L.O. et al. The impact of extreme heat on morbidity in Milwaukee, Wisconsin. Climatic Change 110, 959–976 (2012). https://doi.org/10.1007/s10584-011-0120-y

Download citation

Keywords

  • Heat Wave
  • Generalize Additive Model
  • Geophysical Fluid Dynamics Laboratory
  • Future Temperature
  • North American Regional Climate Change Assessment Program