Area-level risk factors for heat-related illness in rural and urban locations across North Carolina,USA |
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| Institution: | 1. Institute of Health and Environment and Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, South Korea;2. Building 221, Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul 151-742, South Korea;3. School of Medicine, Samsung Medical Center, Department of Psychiatry, Gangnam-gu, Seoul 06351, South Korea;1. School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA;2. Urban Climate Research Center, Arizona State University, Tempe, AZ, USA;3. National Institute of Water and Atmospheric Research, Wellington, New Zealand;4. Union of Concerned Scientists, Washington, DC, USA;5. School of Environmental Sciences, University of Guelph, Guelph, ON, Canada;6. Department of Health Sciences and Department of Sociology and Anthropology, Northeastern University, Boston, MA, USA |
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| Abstract: | An improved understanding of heat vulnerable populations and locations is needed, especially in rural communities. The objective of this study was to identify area-level risk factors for heat-related illness (HRI) at the ZIP code level for urban and rural locations. We aggregated ZIP code-level emergency department visits into rural and urban locations based on population density. Area-level risk factors included previously established heat health risk factors (e.g. poverty, minority) and unexamined area-level risk factors common to rural locations (e.g. mobile homes, agriculture). Due to high spatial autocorrelation, a spatial error regression model was applied to identify risk factors with a significant relationship with HRI. Our results suggest that rural locations are also heat vulnerable, with greater rates of HRI compared to urban locations. Previously unexamined heat-health risk factors, including the number of mobile homes, non-citizens, and the labor-intensity of the agriculture, were all associated with increases of HRI in rural locations. In urban locations, previously established risk factors for heat-related mortality, such as decreased vegetation, living in poverty, and low education attainment were associated with increases in HRI. |
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| Keywords: | Heat Environmental health Area-level risk factors Geographic information systems Rural health Urban health |
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