Abstract
Heat waves (HWs) have killed more people in Australia than all other natural hazards combined. Climate change is expected to increase the frequency, duration, and intensity of HWs and leads to a doubling of heat-related deaths over the next 40 years. Despite being a significant public health issue, HWs do not attract the same level of attention from researchers, policy makers, and emergency management agencies compared to other natural hazards. The purpose of the study was to identify risk factors that might lead to population vulnerability to HW in Western Australia (WA). HW vulnerability and resilience among the population of the state of WA were investigated by using time series analysis. The health impacts of HWs were assessed by comparing the associations between hospital emergency department (ED) presentations, hospital admissions and mortality data, and intensities of HW. Risk factors including age, gender, socioeconomic status (SES), remoteness, and geographical locations were examined to determine whether certain population groups were more at risk of adverse health impacts due to extreme heat. We found that hospital admissions due to heat-related conditions and kidney diseases, and overall ED attendances, were sensitive indicators of HW. Children aged 14 years or less and those aged 60 years or over were identified as the most vulnerable populations to HWs as shown in ED attendance data. Females had more ED attendances and hospital admissions due to kidney diseases; while males had more heat-related hospital admissions than females. There were significant dose–response relationships between HW intensity and SES, remoteness, and health service usage. The more disadvantaged and remotely located the population, the higher the health service usage during HWs. Our study also found that some population groups and locations were resilient to extreme heat. We produced a mapping tool, which indicated geographic areas throughout WA with various vulnerability and resilience levels to HW. The findings from this study will allow local government, community service organizations, and agencies in health, housing, and education to better identify and understand the degree of vulnerability to HW throughout the state, better target preparatory strategies, and allocate limited resources to those most in need.
Highlights
A heat wave (HW) is a prolonged period of excessively hot weather
Results related to emergency department (ED) attendances and hospitalizations due to heat and kidney diseases are presented here, as measures in other datasets were not identified as having significant association with the excess heat factor (EHF)
Outcomes from this study indicated that the heat-related hospitalizations and overall ED presentations were the two most sensitive measures for assessing the impact of HW on health services
Summary
A heat wave (HW) is a prolonged period of excessively hot weather. Heat waves have caused more deaths in Australia since European settlement than all other natural hazards combined, and are predicted to increase in frequency, duration, and intensity, with a doubling of the number of HW-related deaths in the 40 years [1, 2]. A recent study conducted in Western Australia (WA) found that the excess heat factor (EHF) metric was the best HW indicator among the three metrics examined to predict greatest health service demand [3]. There has been little verification of whether a particular population group is at higher risk or even resilient to HWs, acclimatization, individual susceptibility, and community and geographical characteristics all affect heat-related effects on mortality and morbidity [2, 4,5,6,7]. Young children and the elderly are commonly identified at high risk of morbidity and mortality during the period of HWs [8,9,10,11], whereas people with renal, respiratory, and cardiovascular conditions are susceptible to heat due to hyperthermia and dehydration [12,13,14]. There have only been a limited number of studies examining the geographical variation and effects of socioeconomic status (SES) on people’s response to HW
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