ArticleEnvironmental epidemiology (Philadelphia, Pa.)2023
Does choice of outdoor heat metric affect heat-related epidemiologic analyses in the US Medicare population?
Article in Environmental epidemiology (Philadelphia, Pa.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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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
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Building the model: a review of input structures in extreme temperature-health.Environmental health : a global access science source · 2026Pooled 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
- Data Considerations for Estimating Ambient Heat Exposure for Environmental Epidemiological Studies.Current environmental health reports · 2026Review
- Independent and interactive effects of wet bulb globe temperature and air pollution exposures on suicide mortality.Environment international · 2026Article
- Heat Stress Metrics for US Census Tracts 1998-2020.Scientific data · 2026Article
- Excess risk of heat-related hospitalization associated with temperature and PMEnvironmental epidemiology (Philadelphia, Pa.) · 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
- Temperature and Emergency Department Visits: Present-Day Associations and Future Projections.Research square · 2025Article
- Impact of Daily Maximum Temperature on Emergency Department Arrivals and Acuity Levels.The western journal of emergency medicine · 2025Article
- Developing a Spatiotemporal Repository of Extreme Heat and Cold Exposure in the United States for Precision Public Health Research.Environmental science & technology · 2025Article
- Air Pollution and Temperature in Seizures and Epilepsy: A Scoping Review of Epidemiological Studies.Current environmental health reports · 2024Article
- Exposure to Ambient Heat and Risk of Spontaneous Abortion: A Case-Crossover Study.Epidemiology (Cambridge, Mass.) · 2024Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
Outdoor air temperature is associated with increased morbidity and mortality. Other thermal indices theoretically confer greater physiological relevance by incorporating additional meteorological variables. However, the optimal metric for predicting excess deaths or hospitalizations owing to extreme heat among US Medicare beneficiaries remains unknown. Methods: We calculated daily maximum, minimum, and mean outdoor air temperature (T), heat index (HI), wet-bulb globe temperature (WBGT), and Universal Thermal Climate Index (UTCI) for populous US counties and linked estimates with daily all-cause mortality and heat-related hospitalizations among Medicare beneficiaries (2006-2016). We fit distributed-lag nonlinear models for each metric and compared relative risks (RRs) at the 99th percentile. Results: Across all heat metrics, extreme heat was statistically significantly associated with elevated risks of morbidity and mortality. Associations were more pronounced for maximum daily values versus the corresponding minimum for the same metric. The starkest example was between HI Conclusion: Among Medicare beneficiaries in populous US counties, daily maximum and mean values of outdoor heat are associated with greater RRs of heat-related morbidity and all-cause mortality versus minimum values of the same metric. The choice of heat metric (e.g., temperature versus HI) does not appear to substantively affect risk calculations in this population.
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Registered trials
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