Background: As a result of climate change, the frequency of extreme temperature events is expected to increase, and such events are associated with increased morbidity and mortality. Vulnerability patterns, and corresponding adaptation strategies, are most usefully conceptualized at a local level.

Methods: We used a case-only analysis to examine subject and neighborhood characteristics that modified the association between heat waves and mortality. All deaths of New York City residents from 2000 through 2011 were included in this analysis. Meteorological data were obtained from the National Climatic Data Center. Modifying characteristics were obtained from the death record and geographic data sets.

Results: A total of 234,042 adult deaths occurred during the warm season of our study period. Compared with other warm-season days, deaths during heat waves were more likely to occur in black (non-Hispanic) individuals than other race/ethnicities [odds ratio (OR) = 1.08; 95% CI: 1.03, 1.12], more likely to occur at home than in institutions and hospital settings (OR = 1.11; 95% CI: 1.06, 1.16), and more likely among those living in census tracts that received greater public assistance (OR = 1.05; 95% CI: 1.01, 1.09). Finally, deaths during heat waves were more likely among residents in areas of the city with higher relative daytime summer surface temperature and less likely among residents living in areas with more green space.

Conclusion: Mortality during heat waves varies widely within a city. Understanding which individuals and neighborhoods are most vulnerable can help guide local preparedness efforts.

Citation: Madrigano J, Ito K, Johnson S, Kinney PL, Matte T. 2015. A case-only study of vulnerability to heat wave–related mortality in New York City (2000–2011). Environ Health Perspect 123:672–678;  http://dx.doi.org/10.1289/ehp.1408178

Address correspondence to J. Madrigano, Department of Environmental and Occupational Health, School of Public Health, Rutgers, The State University of New Jersey, 683 Hoes Lane West, Room 310, Piscataway, NJ 08854 USA. Telephone: (732) 235-4629. E-mail: [email protected]

We thank G. Pezeshski of the NYC Department of Health and Mental Hygiene, C. Rado of the NYC Department of City Planning, and Z. Ross for preparing data used in this analysis. We also thank J. Klein Rosenthal, of Harvard University Graduate School of Design for an earlier ecological analysis of the role of neighborhood characteristics and intra-urban risk of heat-related mortality in NYC.

This work was funded by National Oceanic and Atmospheric Administration grant NA04OAR4310185 and the Earth Institute Postdoctoral Fellows Program at Columbia University.

The authors declare they have no actual or potential competing financial interests.

Received: 26 January 2014 Accepted: 12 March 2015 Advance Publication: 17 March 2015 Final Publication: 1 July 2015

Note to readers with disabilities: EHP strives to ensure that all journal content is accessible to all readers. However, some figures and Supplemental Material published in EHP articles may not conform to 508 standards due to the complexity of the information being presented. If you need assistance accessing journal content, please contact [email protected] . Our staff will work with you to assess and meet your accessibility needs within 3 working days.

Note to readers with disabilities: EHP has provided a 508-conformant table of contents summarizing the Supplemental Material for this article (see below) so readers with disabilities may determine whether they wish to access the full, nonconformant Supplemental Material. If you need assistance accessing this or any other content on this site, please contact [email protected] . Our staff will work with you to assess and meet your accessibility needs within 3 working days.

Supplemental Table of Contents PDF (111 KB)