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Extreme Heat May Affect Adults Aged 18–64 More Than the Elderly


Heat waves, which are the leading cause of weather-related deaths in the United States, are becoming more frequent, more intense, and longer-lasting as a result of climate change's continuing effects. As a result, the public is becoming more vulnerable to heat waves. Even though the negative health effects of heat have long been documented in the elderly, little is known about the potential consequences of heat exposure in young and middle-aged people.


Now, according to the findings of a new study led by researchers at Boston University School of Public Health (BUSPH), extreme heat-related complications appear to be more severe in younger and middle-aged adults in the United States than in elderly people.


In the study, which was published in The British Medical Journal, researchers looked into the relationship between extreme temperatures and visits to the emergency department (ED). According to the findings, days of extreme heat were associated with an increased risk of emergency department visits for any reason, heat-related illness, renal disease, and mental disorders in all adults, but the strongest association was found in adults ages 18 to 64 years old.


Prior research on the health effects of heat has primarily focused on the mortality or hospitalizations of seniors as the primary outcome measure. There has never been a comprehensive study of the effects of extreme heat on adults of all ages. This is also the first national study to examine emergency department visits as a proxy for the negative effects of heat on all adults.


According to Dr. Gregory Wellenius, associate professor of environmental health and director of BUSPH's Program on Climate and Health, "Many illnesses that result in emergency department visits do not necessitate hospitalization, particularly among the younger adult population." "We hoped to gain a more complete picture of the true burden of disease associated with days of extreme heat by examining emergency room visits," the researchers explained.


To quantify the risk of emergency department visits for any reason, as well as for specific conditions that may be associated with rising temperatures during the warm season, Wellenius and colleagues analyzed anonymous healthcare utilization claims data from 2010 to 2019. (between May and September).


The data was provided by OptumLabs, a collaborative research and innovation center that houses its core linked data assets in the OptumLabs Data Warehouse. OptumLabs is a collaborative research and innovation center that houses its core linked data assets in the OptumLabs Data Warehouse (OLDW). This database contains de-identified, longitudinal health information on more than 200 million commercial and Medicare Advantage enrollees and patients from across the United States, including medical and pharmacy claims, laboratory results, and enrollment records, as well as medical and pharmacy claims and enrollment records.


For the study, the researchers analyzed claims data from 74 million adults, including more than 22 million visits to the emergency department. When compared to days with cooler temperatures, they discovered that days with extreme heat (which varies by location but averages around 93 degrees Fahrenheit) were associated with a 66 percent increased risk of ED visits for heat-related illness and a 30 percent increased risk of renal disease. The risk of death from extreme heat, on the other hand, varied according to age. In people aged 45 to 54, a day of extreme heat was associated with a 10.3 percent increased risk of emergency department visits; however, in those over 75, the risk was only 3.6 percent higher.


According to Dr. Shengzhi Sun, a research scientist in the Department of Environmental Health at BUSPH and the study's lead author, "younger adults may be more susceptible to extreme heat exposure, particularly among workers who spend a significant amount of their time outdoors." Moreover, "younger adults may be unaware of the fact that they are at risk, as well, on hot days."


The findings also corroborated previous research that found that residents of counties in the United States with cooler warm-season temperatures still face an increased risk of heat-related complications. Compared to the warmer south east, days of extreme heat were associated with a 13 percent increase in the risk of emergency department visits in the northeastern region and a nearly ten percent increase in the Midwest and northwest regions.


"While extreme heat is dangerous to everyone's health, this study adds to the growing body of evidence that it is particularly dangerous in regions with cooler climates that may be less adapted to heat," says study co-author Dr. Kate Weinberger, an assistant professor at the University of British Columbia's School of Population and Public Health. "While extreme heat is dangerous to everyone's health, this study adds to the growing body of evidence that it is particularly dangerous in regions with cooler climates that may be less adapted to heat," It will be critical to implement heat adaptation measures in these regions as temperatures continue to rise as a result of climate change, according to the report.


A large number of heat-related complications can be avoided by altering public policy, the researchers argue, either by reducing exposure to heat or by improving people's susceptibility and adaptability to heat. However, they emphasize that effective policies will differ by region, state, and county.


Despite the fact that climate change is a global issue and that heat poses a threat to the health of everyone everywhere, the impacts are felt locally, and solutions must be tailored to local needs, according to Dr. Wellenius, citing geographic infrastructure, population vulnerability, and available resources as examples of this. As a result, because what works for heat wave preparedness in the Pacific Northwest is quite different from what works in the southeastern United States, solutions must be tailored to the specific requirements of the local community.


Doctor Francesca Dominici, the Clarence James Gamble Professor of Biostatistics at the Harvard T.H. Chan School of Public Health and co-director of the Harvard Data Science Initiative, says, "By examining emergency department visits for a variety of different reasons and across multiple age groups, we were able to accurately characterize the varying impact on health across different populations." An important goal of this research is to provide actionable information to clinicians and public health experts on how to prevent these emergency department visits while also considering the possibility of forecasting when these extreme heat events will occur.

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