Heat-related morbidity in North Carolina: Who's at risk?

Heat waves affect human health through heat stress and exacerbate underlying conditions that can lead to an increase in morbidity and mortality. Many locations in the U.S. and elsewhere are expected to see an increase in the intensity, frequency, and duration of heat waves due to climate change. To affectively mitigate the adverse effects of heat waves, public health interventions must be able to target at-risk populations in a timely manner. Since heat stress can quickly become life-threatening, it is important to understand the environmental and societal risks that contribute to heat-related illness, as well as the populations that are most at risk, so that effective public health interventions can be established and implemented. Compared to heat-related mortality, relatively little is known about nonfatal heat-related illness. Moreover, few studies have examined heat-related illness across different levels of urbanization. Indeed, recent work in North Carolina reveals that a large number of heat-related deaths have occurred in rural areas, particularly among farm laborers. The objective of our work is to retrospectively assess the characteristics of nonfatal heat-related illness across North Carolina for a three year period (2006-2008) and the meteorological and societal factors that likely contributed to the pattern of heat-related illness across the state. To carry this out, we utilize a comprehensive database of emergency department (ED) admissions across the state of North Carolina: The North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT), maintained by the Department of Emergency Medicine at the University of North Carolina at Chapel Hill. Specifically, we seek to determine the empirical relationships between anomalously hot/humid weather and excess ED admissions, the primary health conditions (diagnoses) for admission, and the socio-demographic conditions of the at-risk populations across the state.