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Research Advance Publication

Environ Health Perspect; DOI:10.1289/ehp.1307496

Heat-Related Morbidity in Brisbane, Australia: Spatial Variation and Area-Level Predictors

David M. Hondula1,2 and Adrian G. Barnett
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1Center for Policy Informatics, Arizona State University, Phoenix, Arizona, USA; 2Department of Environmental Sciences, University of Virginia, Charlottesville, Virginia, USA; 3School of Public Health and Social Work & Institute for Heath and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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Citation: Hondula DM, Barnett AG. Heat-Related Morbidity in Brisbane, Australia: Spatial Variation and Area-Level Predictors. Environ Health Perspect;

Received: 10 August 2013
Accepted: 20 March 2014
Advance Publication: 30 April 2014

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Background: Extreme heat is a leading weather-related cause of illness and death in many locations across the globe including subtropical Australia. The possibility of increasingly frequent and severe heat waves warrants continued efforts to reduce this health burden, which could be accomplished by targeting intervention measures toward the most vulnerable communities.

Objectives: We sought to quantify spatial variability in heat-related morbidity in Brisbane, Australia, to highlight regions of the city with the greatest risk. We also aimed to find area-level social and environmental determinants of high risk within Brisbane.

Methods: We used a series of hierarchical Bayesian models to examine city-wide and intra-city associations between temperature and morbidity using a 2007–2011 time series of geographically-referenced hospital admissions data. The models accounted for long-term time trends, seasonality, and day of week and holiday effects.

Results: On average, a 10°C increase in daily maximum temperature during the summer was associated with a 7.2% increase in hospital admissions (95% CI: 4.7, 9.8%) on the following day. Positive statistically significant relationships between admissions and temperature were found for 16 of the city’s 158 areas; negative relationships were found for 5 areas. High-risk areas were associated with a lack of high income earners and higher population density.

Conclusions: Geographically targeted public health strategies for extreme heat may be effective in Brisbane, as morbidity risk was found to be spatially variable. Emergency responders, health officials, and city planners could focus on short- and long-term intervention measures that reach communities in the city with lower incomes and higher population densities, including reduction of urban heat island effects.

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