Graduate Thesis Or Dissertation
 

Mortality Associated with Short- and Long-Term Temperature Changes: A Global Evaluation within the Prospective Urban Rural Epidemiology Study

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  • The influence of increasing temperatures on human health has been widely established across multiple health disciplines. Short-term temperature changes are associated with an increased risk of hospitalization and death overall and in a variety of health conditions, such as cardiovascular disease. Even as humans can self-regulate heat stresses, the elderly, individuals with existing chronic disease, low-income individuals, individuals who work outside, and those residing in low-income countries and rural areas, may be at an increased risk of heat-related health events. Weather conditions, such as humidity, sun exposure, and wind speed, may modify this relationship, but the majority of heat-related health studies have not integrated these variables due to their limited availability from weather stations. Typically, weather data will be used from the nearest weather station, but this limits studies primarily to developed countries and urban areas. As new temperature products are publicly available from satellite and global temperature reanalysis products, this has opened the door for studies to be conducted outside these regions, although their uptake has been slow in climate-based health studies. Additionally, the use of administrative health records in previous temperature- based health studies has limited studies to developing countries (where these types of health data are available) and have limited the ability to detect who are most susceptible to heat-related health events (since administrative health records only contain basic demographic characteristics). As our climate becomes warmer and wetter, disproportionally affecting those in developing countries, there is a need for researchers to be able to accurately measure temperature data to study its health effects in these locations. It is critical to understand how both short- and long-term temperature changes impact the health of these individuals, including identifying who are the most susceptible and their resilience to acute temperature exposures and climate change. The first study of this dissertation validates the use of the global reanalysis product, the Global Land Data Assimilation System (GLDAS v2.1), in estimating daily temperature and heat indexes outside of mountainous regions using study sites from the global Prospective Urban Rural Epidemiology (PURE) study. We found the GLDAS v2.1 is a valid tool for assigning acute temperature exposures as moderate to high correlations between heat metrics. Additionally, we identified substantial differences in seasonal patterns and the number of extreme heat days across different climate zones. The second study evaluated the association between acute temperature exposure (air and wet-bulb globe temperatures) and mortality in the PURE study. We observed acute cold and hot temperatures increased the odds for all-cause and cardiovascular (CVD) mortality with higher odds using the wet-bulb temperature compared to air temperature alone. Adults from low- and middle-income countries, especially the poor from warm-temperate climates, were most susceptible to heat- related mortality. The third study evaluated the long-term temperature and temperature variability association with mortality in the PURE cohort. We found a significant increase in the risk of CVD mortality with increasing mean annual temperatures. Additionally, the rate of change in the baseline temperature variability in the ten and twenty years prior to study enrollment was associated with a significant increase in the risk of all-cause mortality in PURE communities. Results from these studies provide evidence that both short- and long- temperature affects adults in a variety of climate and socioeconomic settings. Publicly available datasets such as GLDAS can be used for global evaluations of climate- based health studies in regions without ground-based weather data. Additionally, the use of heat indexes compared to air temperature alone may be a better exposure metric when examining climate and health in a global context. Individuals with the highest odds of mortality with increasing temperatures were the ones with the least access to resources to mitigate short-term temperature changes. Overall, these results provide a foundation to study the susceptibility of short- and long-term heat exposure in global regions where the risk levels and susceptibility and protective factors are largely unknown.
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  • Pending Publication
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  • 2020-04-28 to 2021-05-29

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