ArticleEnvironment international2021
Heat warnings, mortality, and hospital admissions among older adults in the United States.
Article in Environment international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 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
28 citing papers in PubMed, 2 syntheses or guidelines pooled 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
- Assessing the causal effects of a stochastic intervention in time series data: are heat alerts effective in preventing deaths and hospitalizations?Biostatistics (Oxford, England) · 2023Pooled it
- Data Considerations for Estimating Ambient Heat Exposure for Environmental Epidemiological Studies.Current environmental health reports · 2026Review
- Global Warming and the Elderly: A Socio-Ecological Framework.International journal of environmental research and public health · 2026Review
- Determining Location-Specific Thresholds for Heat Warning Systems to Mitigate Heatstroke Mortality in Japan.Environment & health (Washington, D.C.) · 2026Article
- Regular Medicaid Home Visits and Emergency Department Use Among Older Adults During Extreme Heat.JAMA network open · 2026Article
- Navigating the heat: implementation challenges and opportunities for heat alert communication and rural health data infrastructure.Frontiers in public health · 2026Article
- Climate resilience adaptation and psychiatric emergency services utilization during extreme heat in Boston, MA: a difference-in-differences analysis.Environment international · 2026Article
- The effectiveness of heat prevention plans in reducing heat-related mortality across Europe.Environmental research letters : ERL [Web site] · 2025Article
- Heat Wave Beliefs and Behaviors in Southern Spain.International journal of environmental research and public health · 2025Article
- Socioeconomic disparities in heat vulnerability among adults in Finland.Scientific reports · 2025Article
- Extreme heat and hospital admissions in older adults: A small-area analysis in the Greater Boston metropolitan area.Environmental epidemiology (Philadelphia, Pa.) · 2025Article
- Evaluation of community-based heat adaptation interventions: a systematic review.BMJ public health · 2025Article
- Daily heat and mortality among people experiencing homelessness in 2 urban US counties, 2015-2022.American journal of epidemiology · 2024Article
- Temporal changes in temperature-related mortality in relation to the establishment of the heat-health alert system in Victoria, Australia.International journal of biometeorology · 2024Article
- Beliefs and behaviors associated with the first named heat wave in Seville Spain 2022.Scientific reports · 2024Article
- Population Aging and Heat Exposure in the 21st Century: Which U.S. Regions Are at Greatest Risk and Why?The Gerontologist · 2024Article
- A newly proposed heatstroke-induced coagulopathy score in patients with heat illness: A multicenter retrospective study in China.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2024Article
- SHARE-ENV: A Data Set to Advance Our Knowledge of the Environment-Wellbeing Relationship.Environment & health (Washington, D.C.) · 2024Article
- The Double Burden: Climate Change Challenges for Health Systems.Environmental health insights · 2024Review
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundHeat warnings are issued in advance of forecast extreme heat events, yet little evidence is available regarding their effectiveness in reducing heat-related illness and death. We estimated the association of heat warnings and advisories (collectively, "alerts") issued by the United States National Weather Service with all-cause mortality and cause-specific hospitalizations among Medicare beneficiaries aged 65 years and older in 2,817 counties, 2006-2016.
methodsIn each county, we compared days with heat alerts to days without heat alerts, matched on daily maximum heat index and month. We used conditional Poisson regression models stratified on county, adjusting for year, day of week, federal holidays, and lagged daily maximum heat index.
resultsWe identified a matched non-heat alert day for 92,029 heat alert days in 2,817 counties, or 54.6% of all heat alert days during the study period. Contrary to expectations, heat alerts were not associated with lower risk of mortality (RR: 1.005 [95% CI: 0.997, 1.013]). However, heat alerts were associated with higher risk of hospitalization for fluid and electrolyte disorders (RR: 1.040 [95% CI: 1.015, 1.065]) and heat stroke (RR: 1.094 [95% CI: 1.038, 1.152]). Results were similar in sensitivity analyses additionally adjusting for same-day heat index, ozone, and PM
conclusionsOur results suggest that heat alerts are not associated with lower risk of mortality but may be associated with higher rates of hospitalization for fluid and electrolyte disorders and heat stroke, potentially suggesting that heat alerts lead more individuals to seek or access care.
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