ArticleEnvironmental health perspectives2014
Heat waves and health outcomes in Alabama (USA): the importance of heat wave definition.
Article in Environmental health perspectives, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 5 of them syntheses that pooled it.
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Who cites it
80 citing papers in PubMed, 5 syntheses or guidelines pooled it, 191 citations in OpenAlex.
- A systematic review and meta-analysis on heat thresholds for maternal health and birth outcomes.Nature communications · 2026Pooled it
- A Systematic Review of Heat Health Warning Systems: Enhancing the Framework Towards Effective Health Outcomes.Current environmental health reports · 2025Pooled it
- Heatwave and upper urinary tract stones morbidity: effect modification by heatwave definitions, disease subtypes, and vulnerable populations.Urolithiasis · 2024Pooled it
- Knowledge Gaps and Research Priorities on the Health Effects of Heatwaves: A Systematic Review of Reviews.International journal of environmental research and public health · 2022Pooled it
- Heat Exposure and Maternal Health in the Face of Climate Change.International journal of environmental research and public health · 2017Pooled it
- Temperature and heat-load exposure effects on preterm births: Insights from a population-based study using distributed lag non-linear models.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Heat Exposure Definitions in Temperature-Mortality Studies: Towards a Harmonisation Framework.Current environmental health reports · 2026Review
- Association between extreme heat exposure and risk of preterm birth and its effect modifiers: a systematic review and meta-analysis.Journal of exposure science & environmental epidemiology · 2026Article
- Development and external validation of a machine learning-based Cox model for predicting in-hospital survival in classic heatstroke: a multicenter retrospective study.Scientific reports · 2026Article
- Article
- Anthropogenic forcing drives equatorward migration of heatwave locations across continents.Nature communications · 2025Article
- Metrics of Urbanicity and Rurality in US-Based Epidemiologic Studies of Ambient Temperature and Health: A Scoping Review.Current environmental health reports · 2025Article
- Changing Degrees: a weight-of-evidence scoping review examining the impact of childhood exposures to climate change on educational outcomes.Environmental research · 2025Article
- Prenatal exposure to ambient temperature and preterm birth: a historical cohort.International journal of epidemiology · 2025Article
- Mental health disparities among maternal populations following heatwave exposure in North Carolina (2011-2019): a matched analysis.Lancet regional health. Americas · 2025Article
- Scoping review of climate drivers on maternal health: current evidence and clinical implications.AJOG global reports · 2025Review
- On adjustment for temperature in heat-wave epidemiology: a new method for estimating the health effects of heat waves.American journal of epidemiology · 2024Article
- Heat Index: An Alternative Indicator for Measuring the Impacts of Meteorological Factors on Diarrhoea in the Climate Change Era: A Time Series Study in Dhaka, Bangladesh.International journal of environmental research and public health · 2024Article
- Effect of heatwaves on mortality of Alzheimer's disease and other dementias among elderly aged 60 years and above in China, 2013-2020: a population-based study.The Lancet regional health. Western Pacific · 2024Article
- Identifying groups at-risk to extreme heat: Intersections of age, race/ethnicity, and socioeconomic status.Environment international · 2024Article
20 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundA deeper understanding of how heat wave definition affects the relationship between heat exposure and health, especially as a function of rurality, will be useful in developing effective heat wave warning systems.
objectiveWe compared the relationships between different heat wave index (HI) definitions and preterm birth (PTB) and nonaccidental death (NAD) across urban and rural areas.
methodsWe used a time-stratified case-crossover design to estimate associations of PTB and NAD with heat wave days (defined using 15 HIs) relative to non-heat wave control days in Alabama, USA (1990-2010). ZIP code-level HIs were derived using data from the North American Land Data Assimilation System. Associations with heat wave days defined using different HIs were compared by bootstrapping. We also examined interactions with rurality.
resultsAssociations varied depending on the HI used to define heat wave days. Heat waves defined as having at least 2 consecutive days with mean daily temperatures above the 98th percentile were associated with 32.4% (95% CI: 3.7, 69.1%) higher PTB, and heat waves defined as at least 2 consecutive days with mean daily temperatures above the 90th percentile were associated with 3.7% (95% CI: 1.1, 6.3%) higher NAD. Results suggest that significant positive associations were more common when relative-compared with absolute-HIs were used to define exposure. Both positive and negative associations were found in each rurality stratum. However, all stratum-specific significant associations were positive, and NAD associations with heat waves were consistently positive in urban strata but not in middle or rural strata.
conclusionsBased on our findings, we conclude that a relative mean-temperature-only heat wave definition may be the most effective metric for heat wave warning systems in Alabama.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.