Impact of heat on emergency hospital admission in Texas: geographic and racial/ethnic disparities

Chunyu Guo; Erjia Ge; Sungmin Lee; Yongmei Lu; Nick P Bassill; Nanhua Zhang; Wei Zhang; Yi Lu; Yuqing Hu; Jayajit Chakraborty; Rebecca T Emeny; Kai Zhang

doi:10.1038/s41370-023-00590-6

Impact of heat on emergency hospital admission in Texas: geographic and racial/ethnic disparities

J Expo Sci Environ Epidemiol. 2023 Aug 9. doi: 10.1038/s41370-023-00590-6. Online ahead of print.

Authors

Chunyu Guo¹, Erjia Ge², Sungmin Lee³, Yongmei Lu⁴, Nick P Bassill⁵, Nanhua Zhang^{6

7}, Wei Zhang^{8

9}, Yi Lu¹⁰, Yuqing Hu¹¹, Jayajit Chakraborty¹², Rebecca T Emeny¹³, Kai Zhang¹⁴

Affiliations

¹ Department of Economics, School of Art and Science, University at Albany, State University of New York, Albany, NY, USA.
² Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
³ Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA.
⁴ Department of Geography and Environmental Studies, Texas State University, San Marcos, TX, USA.
⁵ Center of Excellence in Weather & Climate Analytics, University at Albany, State University of New York, Albany, NY, USA.
⁶ Division of Biostatistics & Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
⁷ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
⁸ Department of Plants, Soils and Climate, Utah State University, Logan, UT, USA.
⁹ Ecology Center, Utah State University, Logan, UT, USA.
¹⁰ Department of Architecture and Civil Engineering, City University of Hong Kong, Hong Kong, Hong Kong.
¹¹ Department of Architectural Engineering, The Pennsylvania State University, University Park, PA, USA.
¹² Department of Sociology and Anthropology, University of Texas at El Paso, El Paso, TX, USA.
¹³ Department of Internal Medicine, Division of Molecular Medicine, Albuquerque, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
¹⁴ Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA. kzhang9@albany.edu.

PMID: 37558698
DOI: 10.1038/s41370-023-00590-6

Abstract

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.

Keywords: Emergency Hospital Admission; Heat; Hot weather.

Publication types

Review