Heat-related emergency hospitalizations for respiratory diseases in the medicare population

G. Brooke Anderson, Francesca Dominici, Yun Wang, Meredith C. McCormack, Michelle L. Bell, Roger D. Peng

Research output: Contribution to journalArticlepeer-review


Rationale: The heat-related risk of hospitalization for respiratory diseases among the elderly has not been quantified in the United States on a national scale. With climate change predictions of more frequent and more intense heat waves, it is of paramount importance to quantify the health risks related to heat, especially for themost vulnerable. Objectives: To estimate the risk of hospitalization for respiratory diseases associated with outdoor heat in the U.S. elderly. Methods: An observational study of approximately 12.5 million Medicare beneficiaries in 213 United States counties, January 1, 1999 to December 31, 2008. We estimate a national average relative risk of hospitalization for each 10°F (5.6°C) increase in daily outdoor temperature using Bayesian hierarchical models. Measurements and Main Results: We obtained daily county-level rates of Medicare emergency respiratory hospitalizations (International Classification of Diseases, Ninth Revision, 464-466, 480-487, 490-492) in 213 U.S. counties from 1999 through 2008. Overall, each 10°F increase in daily temperature was associated with a 4.3% increase in same-day emergency hospitalizations for respiratory diseases (95% posterior interval, 3.8, 4.8%). Counties' relative risks were significantly higher in counties with cooler average summer temperatures. Conclusions: We found strong evidence of an association between outdoor heat and respiratory hospitalizations in the largest population of elderly studied to date. Given projections of increasing temperatures from climate change and the increasing global prevalence of chronic pulmonary disease, the relationship between heat and respiratory morbidity is a growing concern.

Original languageEnglish (US)
Pages (from-to)1098-1103
Number of pages6
JournalAmerican journal of respiratory and critical care medicine
Issue number10
StatePublished - May 15 2013


  • Chronic obstructive pulmonary disease
  • Hospitalization
  • Hot temperature
  • Respiratory tract infections
  • Weather

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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