Background: A record-breaking 645 heat-related deaths and an unprecedented 54 days above 110°F were recorded in 2023 in Maricopa County, Arizona. To address increasing heat-related health risks, the Maricopa County Department of Public Health (MCDPH) conducted a survey at heat relief sites during August 1–September 15, which included questions regarding perceptions of health risks during extreme summer heat.

Objectives: Assess perceptions of health risks during extreme heat and identify potential disparities in risk perception among different demographic groups.

Methods: Analysis of 944 survey responses in SAS EG 8.2 using odds ratios to compare perceived health risk during extreme heat (yes/no) to awareness of excessive heat warnings (EHWs), demographic characteristics, and heat relief site usage.

Results: Awareness of EHWs quadrupled likelihood of (95% CI: 2.9, 5.5) perceived health risk due to extreme heat. People experiencing homelessness (PEH) and people who use drugs were 2.5 (95% CI: 1.9, 3.3) and 2.0 (95% CI: 1.3, 3.1) times more likely to perceive health risk due to heat, respectively. Homeowners were approximately half as likely (95% CI: 0.3, 0.8) to indicate perceived health risk compared with renters. First time visitors at heat relief sites were about half as likely (95% CI: 0.4, 0.8) to report perceived health risk compared with repeat visitors.

Conclusion: These findings highlight the importance of EHWs and targeted interventions, particularly for vulnerable populations such as PEH and those who use drugs. Education tailored to homeowners and community engagement at heat relief sites may enhance awareness and mitigate heat-related health risks.

Background

Tick abundance is a measure for assessing potential disease exposure; climate may impact tick abundance, although understudied in the Midwest. Excessive cold snaps and lack of insulating snow cover may increase tick mortality.

Objectives

To assess the association between cold snaps and snow depth on tick abundance.

Methods

Using Metropolitan Mosquito Control District (MMCD) and Minnesota Department of Natural Resources (MN-DNR) data (2014-22), we employed a generalized linear mixed-effects model assessing tick abundance by the number of days per month <0°F, average snow depth, and interaction between these variables; year and drought were adjusted for, and county was a repeated measure.

Results

Among Ixodes scapularis ticks, increased cold snap days were associated with higher tick abundance; increased snow depth with lower tick abundance, most prominent at the beginning of the winter season. Significant interaction between cold snaps and snow depth occurred in the first and last months of the season (December and March; p= 0.0084 and 0.0304). Among Dermacentor variabilis ticks, the trends are more prominent. Interaction between snow depth and cold snaps are seen at the beginning of the winter season. Additional snow depth in January is associated with lower tick abundance by cold snap days, but higher tick abundance if in December.

Conclusion

The influence of cold snaps and low snow depth on tick abundance is more nuanced than traditionally understood. Climate appears most impactful at the beginning and end of the winter season, with D. variabilis more affected than I. scapularis.

Background

The San Diego County region has seen rising temperatures due to climate change, evidenced by an increased number, intensity, and duration of excessive heat events. Even in coastal areas, surveillance of weather and risk of heat illness and injury is critical.

Objectives

Examine trends in excessive heat events and heat illness/injury in San Diego County.

Methods

Daily pre-hospital surveillance of heat-related illness and injury by the County of San Diego Emergency Medical Services occurred during heat events when the National Weather Service evaluated heat risk and issued excessive heat warnings and heat advisories. Annual death, emergency department, and hospital data from the California Department of Public Health were analyzed at the county level. Heat illness or injury is defined by the Centers for Disease Control and Prevention (CDC), including any mention of heat illness or injury from May through September, excluding mention of non-natural heat exposure.

Results

Eight heat events occurred in 2022, with the earliest occurring in February, before the typical heat season, and the longest lasting 11 days. Annual surveillance, from 2006 through 2021, showed an upward trend in emergency department and hospital visits among residents experiencing heat illness/injury. Between 1991 and 2021, there were 85 heat illness/injury deaths among San Diego County residents (average three per year). In 2021, there were eight deaths, the highest number of deaths from heat illness/injury since 1991.

Conclusion

As temperatures increase, the County of San Diego’s focus is on preventing adverse health effects in an equitable manner for all residents.

Introduction. Global warming significantly impacts various health concerns, posing a considerable threat to public well-being. Our study is to explore the correlation between the Heat Vulnerability Index (HVI) and the severity of acute ischemic stroke (AIS).

Method. We conducted a retrospective study involving consecutive patients admitted for acute ischemic stroke (AIS) at a comprehensive stroke center in NYC between 2012 and 2021. Demographic, socioeconomic, and clinical data were extracted from electronic health records. The Heat Vulnerability Index (HVI) was categorized as high (levels 4-5) or low (levels 1-3). Trend analysis, chi-square tests, t-tests were conducted to assess associations. Multivariable logistic regression analyses were performed to further explore these relationships.

Results. Out of the 3,429 recorded AIS episodes, 32.8% occurred in areas classified as having a high HVI score (4-5), while 25.3% exhibited high stroke severity with a National Institutes of Health Stroke Scale (NIHSS) score of 10 or higher. Through various multivariable regression models, high HVI emerged as a statistically significant factor for increased stroke severity. In the final multivariable regression model with stepwise selection, high HVI remained significant, showing an odds ratio (OR) of 1.36 with a 95% confidence interval (CI) of [1.15-1.61] after adjustment for patient factors and comorbidities.

Conclusion. The correlation between HVI and heightened stroke severity highlights the significance of directing policy interventions towards socioeconomically disadvantaged neighborhoods. This underscores the need for targeted efforts aimed at reducing vulnerability to environmental factors and improving access to healthcare resources in underserved areas.