ArticleProceedings of the National Academy of Sciences of the United States of America2019
Assessment of extreme heat and hospitalizations to inform early warning systems.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 4 of them syntheses that pooled it.
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Who cites it
53 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- The impact of climate change on airborne and droplet-borne diseases and hospital response measures.Frontiers in public health · 2026Pooled it
- A Systematic Review of Heat Health Warning Systems: Enhancing the Framework Towards Effective Health Outcomes.Current environmental health reports · 2025Pooled it
- Thermal indices for assessing the impact of outdoor thermal environments on human health: a systematic review of epidemiological studies.International journal of biometeorology · 2025Pooled it
- A State of the Science Review of Wildfire-Specific Fine Particulate Matter Data Sources, Methods, and Models.Environmental health perspectives · 2025Pooled it
- HeatRisk and air quality risk recommendations: A narrative review and action algorithm for the care of people at risk for and living with cardiovascular disease.American journal of preventive cardiology · 2027Review
- Extreme Heat and Emergency Health Impacts in the US (2018-2025).International journal of environmental research and public health · 2026Article
- Climate Change and Heat-related Illness in Older Adults: Implications for Emergency Medicine.The western journal of emergency medicine · 2026Review
- Article
- Quantifying the financial burden of heat-related hospital admissions in Switzerland under a changing climate: A scalable analytical framework.BMC global and public health · 2026Article
- A climate region classification for California's warm season: apparent temperature clustering to support heat-health epidemiology.International journal of biometeorology · 2026Article
- Selected Impacts of Urban Heat Islands on Emergency Medical Services Utilization in Rhode Island.The western journal of emergency medicine · 2026Article
- Extreme Urban Heat and Emergency Department Visits in Older Adults.JAMA network open · 2026Article
- A healthy cities agenda for extreme heat adaptation in urban settings.Bulletin of the World Health Organization · 2026Article
- Evaluation of heat warning thresholds with multiple lagged and cumulative health impacts based on a 20-year population database.Scientific reports · 2026Article
- Emerging heat stress patterns across India under future climate scenarios.Scientific reports · 2026Article
- Determining Location-Specific Thresholds for Heat Warning Systems to Mitigate Heatstroke Mortality in Japan.Environment & health (Washington, D.C.) · 2026Article
- Heat-health warning systems for outdoor workers: recent advances, implementation gaps, and future priorities.Frontiers in public health · 2026Review
- Temporal trends and disparities in heat-related cardiovascular mortality in the United States (1999-2024): a CDC WONDER analysis.Frontiers in cardiovascular medicine · 2026Article
- Risk of hospitalization and mortality across US climate regions following extreme heat exposure in patients with end-stage kidney disease (ESKD) receiving in-center hemodialysis: a space-time-stratified case-crossover analysis.Environmental health : a global access science source · 2025Article
- Sometimes missing the heat: the risk of underestimating extreme heat days with daily maximum heat index approximation.International journal of biometeorology · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
Heat early warning systems and action plans use temperature thresholds to trigger warnings and risk communication. In this study, we conduct multistate analyses, exploring associations between heat and all-cause and cause-specific hospitalizations, to inform the design and development of heat-health early warning systems. We used a two-stage analysis to estimate heat-health risk relationships between heat index and hospitalizations in 1,617 counties in the United States for 2003-2012. The first stage involved a county-level time series quasi-Poisson regression, using a distributed lag nonlinear model, to estimate heat-health associations. The second stage involved a multivariate random-effects meta-analysis to pool county-specific exposure-response associations across larger geographic scales, such as by state or climate region. Using results from this two-stage analysis, we identified heat index ranges that correspond with significant heat-attributable burden. We then compared those with the National Oceanic and Atmospheric Administration National Weather Service (NWS) heat alert criteria used during the same time period. Associations between heat index and cause-specific hospitalizations vary widely by geography and health outcome. Heat-attributable burden starts to occur at moderately hot heat index values, which in some regions are below the alert ranges used by the NWS during the study time period. Locally specific health evidence can beneficially inform and calibrate heat alert criteria. A synchronization of health findings with traditional weather forecasting efforts could be critical in the development of effective heat-health early warning systems.
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