SynthesisEnvironment international2021
Temporal changes in associations between high temperature and hospitalizations by greenspace: Analysis in the Medicare population in 40 U.S. northeast counties.
Synthesis in Environment international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Climate, Health, and Urban Green Infrastructure: The Evidence Base and Implications for Urban Policy and Spatial Planning.International journal of environmental research and public health · 2025Pooled it
- Urban heat island impacts on heat-related cardiovascular morbidity: A time series analysis of older adults in US metropolitan areas.Environment international · 2023Pooled it
- Heatwave Definition and Impact on Cardiovascular Health: A Systematic Review.Public health reviews · 2023Pooled it
- Separate and combined associations of heatwaves, air pollution, green spaces, and blue spaces with depressive symptoms: a national cohort study.Archives of public health = Archives belges de sante publique · 2026Article
- The effects of residential air conditioning and social vulnerability on heat-related hospitalizations in California.Environment international · 2025Article
- Extreme heat and hospital admissions in older adults: A small-area analysis in the Greater Boston metropolitan area.Environmental epidemiology (Philadelphia, Pa.) · 2025Article
- Association Between Residential Greenness and Risk of Stroke by Ecoregions: The REGARDS Study.Journal of the American Heart Association · 2025Article
- Effect Modifications of Overhead-View and Eye-Level Urban Greenery on Heat-Mortality Associations: Small-Area Analyses Using Case Time Series Design and Different Greenery Measurements.Environmental health perspectives · 2023Article
- A methodology for the public health surveillance and epidemiologic analysis of outdoor falls that require an emergency medical services response.Injury epidemiology · 2023Article
- Inequality in the availability of residential air conditioning across 115 US metropolitan areas.PNAS nexus · 2022Article
- Associations Between Residential Greenspace, Socioeconomic Status, and Stroke: A Matched Case-Control Study.Journal of patient-centered research and reviews · 2022Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
Although research indicates health and well-being benefits of greenspace, little is known regarding how greenspace may influence adaptation to health risks from heat, particularly how these risks change over time. Using daily hospitalization rates of Medicare beneficiaries ≥65 years for 2000-2016 in 40 U.S. Northeastern urban counties, we assessed how temperature-related hospitalizations from cardiovascular causes (CVD) and heat stroke (HS) changed over time. We analyzed effect modification of those temporal changes by Enhanced Vegetation Index (EVI), approximating greenspace. We used a two-stage analysis including a generalized additive model and meta-analysis. Results showed that relative risk (RR) (per 1 °C increase in lag0-3 temperature) for temperature-HS hospitalization was higher in counties with the lowest quartile EVI (RR = 2.7, 95% CI: 2.0, 3.4) compared to counties with the highest quartile EVI (RR = 0.40, 95% CI: 0.14, 1.13) in the early part of the study period (2000-2004). RR of HS decreased to 0.88 (95% CI: 0.31, 2.53) in 2013-2016 in counties with the lowest quartile EVI. RR for HS changed over time in counties in the highest quartile EVI, with RRs of 0.4 (95% CI: -0.7, 1.4) in 2000-2004 and 2.4 (95% CI: 1.6, 3.2) in 2013-2016. Findings suggest that adaptation to heat-health associations vary by greenness. Greenspace may help lower risks from heat but such health risks warrant continuous local efforts such as heat-health plans.
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Registered trials
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