Seizing the policy opportunities for health- and equity-improving energy decisions.

The Inflation Reduction Act (IRA), together with other US federal policies, offers a unique window of opportunity to promote health and equity goals through clean energy investments. Seizing these near-term opportunities to realize sizable synergies requires strategic actions from federal, state, and local actors.

Fire Smoke Elevated the Carbonaceous PM Concentration and Mortality Burden in the Contiguous U.S. and Southern Canada.

Despite emerging evidence on the health impacts of fine particulate matter (PM) from wildland fire smoke, the specific effects of PM composition on health outcomes remain uncertain. We developed a three-level, chemical transport model-based framework to estimate daily full-coverage concentrations of smoke-derived carbonaceous PM, specifically organic carbon (OC) and elemental carbon (EC), at a 1 × 1 km spatial resolution from 2002 to 2019 across the contiguous U.S.

Case-crossover assessment of the modifying effects of home medication use on acute kidney-related morbidity due to elevated ambient heat exposure in Atlanta, GA, from 2013 to 2019.

Background: Elevated ambient temperatures increase the risk for acute kidney-related morbidity, and medication use may increase vulnerability to heat exposure. This study examines whether medication use, and combination medication use (ie, polypharmacy), modifies the risk for temperature-related volume depletion (VD) and acute kidney injury (AKI).

Methods: This study uses patient-level emergency department (ED) visit data from four Atlanta-area hospitals during the warm season from 2013 to 2019.

Assessment of human exposure to uncommon industrial toxicants in Glynn County, Georgia.

Coastal Glynn County, Georgia, is home to four hazardous sites on the United States EPA's National Priorities List. Toxicants of concern include mercury, the pesticide toxaphene, and Aroclor 1268, a mixture of highly chlorinated polychlorinated biphenyls (PCBs); these toxicants are known to persist in the local environment and/or regional aquatic life, including local seafood. At the invitation of, and in partnership with, local community leaders and environmental groups, we conducted a human exposure study in Glynn County.

Associations Between Temperature and Location of Injury or Condition Among Heat-Related Emergency Department Visits.

High ambient temperature poses significant health risk globally. However, the relative importance of different exposure pathways leading to health risks remains unclear. For 9 US states during 2016-2018, ED visit records for heat exhaustion and heat stroke (HEAT), fluid and electrolyte imbalance (FEI), volume depletion (VD), and acute kidney injury (AKI) were identified via diagnosis codes.

Modeling Time-varying Dispersion to Improve Estimation of the Short-term Health Effect of Environmental Exposure in a Time-series Design.

Background: Time-series models for count outcomes are routinely used to estimate short-term health effects of environmental exposures. The dispersion parameter is universally assumed to be constant over the study period.

Objective: The aim is to examine whether dispersion depends on time-varying covariates in a case study of emergency department visits in Atlanta during 1999-2009 and to evaluate approaches for addressing time-varying dispersion.

Estimating the Association Between Outdoor Temperature and Acute Kidney Injury Using Alternative Case Definitions.

Objective: This study aimed to improve estimates of the association between acute kidney injury (AKI) and ambient heat exposure through better case ascertainment and by isolating community-acquired AKI.

Methods: We conducted a case-crossover study using data on AKI-related emergency department (ED) visits in Atlanta. Daymet meteorology was used to assess exposure.

Wildfires are associated with increased emergency department visits for anxiety disorders in the western United States.

As wildfires increasingly impact the global economy and public health, understanding their effects is crucial. Particularly, the relationship between wildfires and anxiety disorders remains unclear. In this study, we explore this association by analyzing 1,897,865 emergency department visits for anxiety disorders in the western United States.

Temporal change in minimum mortality temperature under changing climate: A multicountry multicommunity observational study spanning 1986-2015.

Background: The minimum mortality temperature (MMT) or MMT percentile (MMTP) is an indicator of population susceptibility to nonoptimum temperatures. MMT and MMTP change over time; however, the changing directions show region-wide heterogeneity. We examined the heterogeneity of temporal changes in MMT and MMTP across multiple communities and in multiple countries.

Temperature-mortality associations by age and cause: a multi-country multi-city study.

Background: Heterogeneity in temperature-mortality relationships across locations may partly result from differences in the demographic structure of populations and their cause-specific vulnerabilities. Here we conduct the largest epidemiological study to date on the association between ambient temperature and mortality by age and cause using data from 532 cities in 33 countries.

Methods: We collected daily temperature and mortality data from each country.

Association between precipitation and mortality due to diarrheal diseases by climate zone: A multi-country modeling study.

Background: Precipitation could affect the transmission of diarrheal diseases. The diverse precipitation patterns across different climates might influence the degree of diarrheal risk from precipitation. This study determined the associations between precipitation and diarrheal mortality in tropical, temperate, and arid climate regions.

Association between outdoor temperature and fatal police shootings in the United States, 2015-2021.

Background: Here, we investigate the association between outdoor temperature and fatal police shootings in the United States between 2015 and 2021.

Methods: We conducted a time-stratified case-crossover study. Data on fatal police shootings were from the Washington Post's Fatal Force database and temperature data were from Daymet.

Associations of pollen and cardiovascular disease morbidity in Atlanta during 1993-2018.

Background: Pollen exposure is associated with substantial respiratory morbidity, but its potential impact on cardiovascular disease (CVD) remains less understood. This study aimed to investigate the associations between daily levels of 13 pollen types and emergency department (ED) visits for eight CVD outcomes over a 26-year period in Atlanta, GA.

Methods: We acquired pollen data from Atlanta Allergy & Asthma, a nationally certified pollen counting station, and ED visit data from individual hospitals and the Georgia Hospital Association.

Ozone-related acute excess mortality projected to increase in the absence of climate and air quality controls consistent with the Paris Agreement.

Short-term exposure to ground-level ozone in cities is associated with increased mortality and is expected to worsen with climate and emission changes. However, no study has yet comprehensively assessed future ozone-related acute mortality across diverse geographic areas, various climate scenarios, and using CMIP6 multi-model ensembles, limiting our knowledge on future changes in global ozone-related acute mortality and our ability to design targeted health policies. Here, we combine CMIP6 simulations and epidemiological data from 406 cities in 20 countries or regions.

Impact of population aging on future temperature-related mortality at different global warming levels.

Older adults are generally amongst the most vulnerable to heat and cold. While temperature-related health impacts are projected to increase with global warming, the influence of population aging on these trends remains unclear. Here we show that at 1.

Assessment of census-tract level socioeconomic position as a modifier of the relationship between short-term PM exposure and cardiovascular emergency department visits in Missouri.

Introduction: Ambient particulate matter ≤ 2.5 µm in aerodynamic diameter (PM) exposure elevates the risk for cardiovascular disease morbidity (CVDM). The aim of this study is to characterise which area-level measures of socioeconomic position (SEP) modify the relationship between PM exposure and CVDM in Missouri at the census-tract (CT) level.

Time-series analysis of temperature variability and cardiovascular emergency department visits in Atlanta over a 27-year period.

Background: Short-term temperature variability, defined as the temperature range occurring within a short time span at a given location, appears to be increasing with climate change. Such variation in temperature may influence acute health outcomes, especially cardiovascular diseases (CVD). Most research on temperature variability has focused on the impact of within-day diurnal temperature range, but temperature variability over a period of a few days may also be health-relevant through its impact on thermoregulation and autonomic cardiac functioning.

Identifying heat thresholds for South Africa towards the development of a heat-health warning system.

Exposure to heatwaves may result in adverse human health impacts. Heat alerts in South Africa are currently based on defined temperature-fixed threshold values for large towns and cities. However, heat-health warning systems (HHWS) should incorporate metrics that have been shown to be effective predictors of negative heat-related health outcomes.

Heat Exposure among Adult Women in Rural Tamil Nadu, India.

Exposure to heat is associated with a substantial burden of disease and is an emerging issue in the context of climate change. Heat is of particular concern in India, which is one of the world's hottest countries and also most populous, where relatively little is known about personal heat exposure, particularly in rural areas. Here, we leverage data collected as part of a randomized controlled trial to describe personal temperature exposures of adult women (40-79 years of age) in rural Tamil Nadu.