Differential Effects of Temperature Extremes on Hospital Admission Rates for Respiratory Disease between Indigenous and Non-Indigenous Australians in the Northern Territory.

Donna Green,Hilary Bambrick,Peter Tait,Leanne Webb,Rosalie Schultz,Lisa Alexander,Andrew Pitman,James Goldie

doi:10.3390/ijerph121214988

Abstract

The health gap between Indigenous and non-Indigenous Australians may be exacerbated by climate change if temperature extremes have disproportionate adverse effects on Indigenous people. To explore this issue, we analysed the effect of temperature extremes on hospital admissions for respiratory diseases, stratified by age, Indigenous status and sex, for people living in two different climates zones in the Northern Territory during the period 1993–2011. We examined admissions for both acute and chronic respiratory diagnoses, controlling for day of the week and seasonality variables. Our analysis showed that: (1) overall, Indigenous hospital admission rates far exceeded non-Indigenous admission rates for acute and chronic diagnoses, and Top End climate zone admission rates exceeded Central Australia climate zone admission rates; (2) extreme cold and hot temperatures were associated with inconsistent changes in admission rates for acute respiratory disease in Indigenous and non-Indigenous children and older adults; and (3) no response to cold or hot temperature extremes was found for chronic respiratory diagnoses. These findings support our two hypotheses, that extreme hot and cold temperatures have a different effect on hospitalisations for respiratory disease between Indigenous and non-Indigenous people, and that these health risks vary between the different climate zones. We did not, however, find that there were differing responses to temperature extremes in the two populations, suggesting that any increased vulnerability to climate change in the Indigenous population of the Northern Territory arises from an increased underlying risk to respiratory disease and an already greater existing health burden.

Highlights

Humans can acclimatise to living in extreme temperatures
While many of these findings reflect well-known human health impact studies reported outside Australia [24], the disparity relating to Indigenous status has limited international precedent [25,26]
Age-adjusted admission rates were higher for the Indigenous populations in both climate regions regions examined andfor forboth both acute and chronic diagnoses examined and acute and chronic diagnoses (Figure 3).(Figure 3)

Summary

Introduction

Humans can acclimatise to living in extreme temperatures. From the Afar people who mine salt in the Danakil Depression, Ethiopia, where temperatures regularly exceed 50 ̋ C [1], to the YakutInt. Studies show that the impacts are not distributed with some subpopulations identified as vulnerable [21,22,23] While many of these findings reflect well-known human health impact studies reported outside Australia [24], the disparity relating to Indigenous status has limited international precedent [25,26]. Australia’s Indigenous and non-Indigenous populations [27] This assumption is supported by two quantitative studies that assessed temperature sensitivity among Indigenous people living in the Northern Territory [28,29]. The first study found that while hotter minimum temperatures were associated with an increased risk of hospitalisation for Indigenous people, overweight individuals and males generally, colder minimum temperatures were associated with an increased risk of hospitalisation for women. The second study analysed the link between climate extremes and cardiovascular disease in admissions to Northern Territory hospitals during

Methods

Results

Discussion

Conclusion