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Vulnerability to Heat-related Mortality: A Systematic Review, Meta-analysis, and Meta-regression Analysis

Abstract : BACKGROUND: Addressing vulnerability to heat-related mortality is a necessary step in the development of policies dictated by heat action plans. We aimed to provide a systematic assessment of the epidemiologic evidence regarding vulnerability to heat-related mortality. METHODS: Studies assessing the association between high ambient temperature or heat waves and mortality among different subgroups and published between January 1980 and August 2014 were selected. Estimates of association for all the included subgroups were extracted. We assessed the presence of heterogeneous effects between subgroups conducting Cochran Q tests. We conducted random effect meta-analyses of ratios of relative risks (RRR) for high ambient temperature studies. We performed random effects meta-regression analyses to investigate factors associated with the magnitude of the RRR. RESULTS: Sixty-one studies were included. Using the Cochran Q test, we consistently found evidence of vulnerability for the elderly ages \textgreater85 years. We found a pooled RRR of 0.99 (95% confidence interval [CI] = 0.97, 1.01) for male sex, 1.02 (95% CI = 1.01, 1.03) for age \textgreater65 years, 1.04 (95% CI = 1.02, 1.07) for age \textgreater75 years, 1.03 (95% CI = 1.01, 1.05) for low individual socioeconomic status (SES), and 1.01 (95% CI = 0.99, 1.02) for low ecologic SES. CONCLUSIONS: We found strongest evidence of heat-related vulnerability for the elderly ages \textgreater65 and \textgreater75 years and low SES groups (at the individual level). Studies are needed to clarify if other subgroups (e.g., children, people living alone) are also vulnerable to heat to inform public health programs
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Submitted on : Thursday, January 28, 2016 - 11:43:36 AM
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Tarik Benmarhnia, Séverine Deguen, Jay S. Kaufman, Audrey Smargiassi. Vulnerability to Heat-related Mortality: A Systematic Review, Meta-analysis, and Meta-regression Analysis. Epidemiology, Lippincott, Williams & Wilkins, 2015, 26 (6), pp.781-793. ⟨10.1097/EDE.0000000000000375⟩. ⟨hal-01197347⟩



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