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Research Advance Publication

Environ Health Perspect; DOI:10.1289/ehp.1307392

Heat-Related Mortality and Adaptation to Heat in the United States

Jennifer F. Bobb,1 Roger D. Peng,2 Michelle L. Bell,3 and Francesca Dominici1
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1Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA; 2Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; 3School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA
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Citation: Bobb JF, Peng RD, Bell ML, Dominici F. Heat-Related Mortality and Adaptation to Heat in the United States. Environ Health Perspect;

Received: 18 July 2013
Accepted: 25 April 2014
Advance Publication: 29 April 2014

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Background: In a changing climate, increasing temperatures are anticipated to have profound health impacts. These impacts could be mitigated if individuals and communities adapt to changing exposures; however, little is known about the extent to which the population may be adapting.

Objective: To investigate the hypothesis that if adaptation is occurring, then heat-related mortality would be decreasing over time.

Methods: We used a national database of daily weather, air pollution, and age-stratified mortality rates for 105 US cities (covering 106 million people) during the summers 1987–2005. Time-varying coefficient regression models and Bayesian hierarchical models were used to estimate city-specific, regional, and national temporal trends in heat-related mortality, and to identify factors that explain variation across cities.

Results: On average across cities, the number of deaths (per 1000 deaths) attributable to each 10°F increase in same-day temperature decreased from 51 (95% posterior interval: 42–61) in 1987 to 19 (12–27) in 2005. This decline was largest among those 75 and older, in northern regions, and in cities with cooler climates. Though central air conditioning prevalence has increased, we did not find statistically significant evidence of larger temporal declines among cities with larger increases in prevalence.

Conclusions: The population has become more resilient to heat over time. Yet even with this increased resilience, substantial risks of heat-related mortality remain. Based on 2005 estimates, an increase in average temperatures by 5°F (central climate projection) would lead to an additional 1,907 deaths per summer across all cities.

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