Temperature and Mortality in New York City: Past, Present and Future

The complex interplay between climate change, demographics and socioeconomic conditions is transforming the global environmental health landscape. In the aftermath of recent heat waves around the world, especially the 2003 heat wave in Europe, heat is being recognized as an emerging public health issue worldwide, particularly in urban areas. This work explores the historical and future heat-related mortality in New York City, from the beginning of the 20th until the end of the 21st century. New York City is among the largest cities in the world and has been a thriving metropolis over the entire period covered by this study. The unique makeup of the city makes it particularly suitable for studying the impacts of heat over an extended period of time. The presented work encompasses multiple domains of knowledge and illustrates the necessity for applying highly interdisciplinary approaches in addressing the emerging challenges of our time. The background chapter provides an overview of methodological approaches and findings from previous studies with direct relevance to the specific aims of this work. Chapter I is focused on characterizing the impacts of heat on daily mortality since 1900. Here, heat effects are presented in a historical context and changes over time are analyzed and discussed. Chapter II provides a comparative assessment of recent historical and heat impacts until 2100 in New York City, Boston and Philadelphia. This analysis illustrates the differences and similarities between heat impacts in New York City and the other two major urban areas in the U.S. Northeast. Chapter III provides a more comprehensive assessment of future heat-related mortality in New York City under a number of adaptation, climate change and demographic scenarios. The concluding chapter presents a summary of findings and recommendations for future research

The 1918 influenza pandemic in New York City: age-specific timing, mortality, and transmission dynamics

Background: The 1918 influenza pandemic caused disproportionately high mortality among certain age groups. The mechanisms underlying these differences are not fully understood. Objectives: To explore the dynamics of the 1918 pandemic and to identify potential age-specific transmission patterns. Methods: We examined 1915–1923 daily mortality data in New York City (NYC) and estimated the outbreak duration and initial effective reproductive number (Re) for each 1-year age cohort. Results: Four pandemic waves occurred from February 1918 to April 1920. The fractional mortality increase (i.e. ratio of excess mortality to baseline mortality) was highest among teenagers during the first wave. This peak shifted to 25- to 29-year-olds in subsequent waves. The distribution of age-specific mortality during the last three waves was strongly correlated (r = 0·94 and 0·86). With each wave, the pandemic appeared to spread with a comparable early growth rate but then attenuate with varying rates. For the entire population, Re estimates made assuming 2-day serial interval were 1·74 (1·27), 1·74 (1·43), 1·66 (1·25), and 1·86 (1·37), respectively, during the first week (first 3 weeks) of each wave. Using age-specific mortality, the average Re estimates over the first week of each wave were 1·62 (95% CI: 1·55–1·68), 1·68 (1·65–1·72), 1·67 (1·61–1·73), and 1·69 (1·63–1·74), respectively; Re was not significantly different either among age cohorts or between waves. Conclusions: The pandemic generally caused higher mortality among young adults and might have spread mainly among school-aged children during the first wave. We propose mechanisms to explain the timing and transmission dynamics of the four NYC pandemic waves

Economic Burden of Hospitalizations for Heat-Related Illnesses in the United States, 2001–2010

Understanding how heat waves affect morbidity and mortality, as well as the associated economic costs, is essential for characterizing the human health impacts of extreme heat under a changing climate. Only a handful of studies have examined healthcare costs associated with exposures to high temperatures. This research explores costs associated with hospitalizations for heat-related illness (HRI) in the United States using the 2001 to 2010 Nationwide Inpatient Sample (NIS). Descriptive statistics of patient data for HRI hospitalizations were examined and costs of hospitalizations were reported using the all-payer inpatient cost-to-charge ratio. Costs were examined using a log-gamma model with patient and hospital characteristics included as fixed effects. Adjusted mean costs were then compared across racial groups. The mean costs of HRI hospitalizations were higher among racial/ethnic minorities compared to Whites, who accounted for almost 65% of all HRI hospitalizations. Observed differences in costs based on income, insurance, and gender were also significant. These results suggest that these populations are suffering disproportionately from health inequity, thus, they could shoulder greater disease and financial burdens due to climate change. These findings may have important implications in understanding the economic impact public health planning and interventions will have on preventing hospitalizations related to extreme heat. Keywords: climate change; health equity; heat-related illness; hospitalizations; economic cost; racial disparitie

Schools and Terrorism: Global Trends, Impacts, and Lessons for Resilience

This study characterizes trends in the frequency and characteristics of terrorist attacks in child-serving educational institutions around the world, examining the specific vulnerabilies of children and schools with regard to terrorist violence, as well as the various impacts that violence has on children, communities, and societies. Following the analysis of available data on terrorist attacks against educational institutions, vulnerabilities, and impacts, the study concludes with a discussion of what still needs to be understood in the intersection of child vulnerability and terrorism, and provides recommendations for improving resilience to terrorist attacks against child-serving educational institutions. One would like to think that certain truths or values would be universally understood as rules of engagement, formally declared or otherwise. The sanctity of children's well-being should be unquestioned, regardless of the issues at stake in the larger conflict. Sadly, history shows that this understanding is neither universally shared nor uniformly valued. —Irwin Redlener, Americans at Risk, 2007 Since the violent attack on School Number One in Beslan, Russia in 2004, the perceived threat of massive terror attacks targeting schoolchildren has loomed in the public consciousness. In recent years, attacks against educational institutions worldwide have increasingly been reported and documented. The kidnapping of 276 schoolgirls by Boko Haram in Nigeria and the massacre of at least 150 students and staff in a Peshawar school by the Pakistani Taliban in 2014 are still fresh in the minds of the public. These attacks serve as reminders of the vulnerability that children in schools face, being “soft targets” whose symbolic value has the capacity of invoking mayhem at the largest possible scale. They also demonstrate the urgency with which this emerging trend in violence must be systemically recorded, analyzed, and mitigated. The following article will discuss the vulnerability of children with regard to terrorist violence, exploring the literature on what makes children and educational institutions particularly desirable targets. Trends in the frequency and characteristics of terrorist attacks against child-serving educational institutions around the world will be examined, paying particular attention to potential school level and gendered disparities. Finally, a critical analysis on what can be learned from the available data and what still needs to be researched in the nexus of child vulnerability and terrorism will be provided

Acts of terrorism and mass violence targeting schools : Analysis and implications for preparedness in the USA

To enhance the preparedness of US schools to acts of terrorism and mass violence, the landscape of threats against schools must first be understood. This includes exploring the global trends of acts of terrorism against schools, as well as looking specifically at the history of terrorism and acts of mass violence against schools domestically. This paper conducts a review of two databases in order to look at the trends in acts of terrorism and mass violence carried out against schools, and provides recommendations for domestic school preparedness based on this information

Climate Change and Health on the U.S. Gulf Coast: Public Health Adaptation is Needed to Address Future Risks

The impacts of climate change on human health have been documented globally and in the United States. Numerous studies project greater morbidity and mortality as a result of extreme weather events and other climate-sensitive hazards. Public health impacts on the U.S. Gulf Coast may be severe as the region is expected to experience increases in extreme temperatures, sea level rise, and possibly fewer but more intense hurricanes. Through myriad pathways, climate change is likely to make the Gulf Coast less hospitable and more dangerous for its residents, and may prompt substantial migration from and into the region. Public health impacts may be further exacerbated by the concentration of people and infrastructure, as well as the region’s coastal geography. Vulnerable populations, including the very young, elderly, and socioeconomically disadvantaged may face particularly high threats to their health and well-being. This paper provides an overview of potential public health impacts of climate variability and change on the Gulf Coast, with a focus on the region’s unique vulnerabilities, and outlines recommendations for improving the region’s ability to minimize the impacts of climate-sensitive hazards. Public health adaptation aimed at improving individual, public health system, and infrastructure resilience is urgently needed to meet the challenges climate change may pose to the Gulf Coast in the coming decades

Projected Heat-Related Mortality in the U.S. Urban Northeast

Increased heat-related mortality is projected to be among the major impacts of climate change on human health, and the United States urban Northeast region is likely to be particularly vulnerable. In support of regional adaptation planning, quantitative information is needed on potential future health responses at the urban and regional scales. Here, we present future projections of heat-related mortality in Boston, New York and Philadelphia utilizing downscaled next-generation climate models and Representative Concentration Pathways (RCPs) developed in support of the Intergovernmental Panel on Climate Change (IPCC)’s Fifth Assessment Report (AR5). Our analyses reveal that heat-related mortality rates per 100,000 of population during the baseline period between 1985 and 2006 were highest in Philadelphia followed by New York City and Boston. However, projected heat-related mortality rates in the 2020s, 2050s and 2080s were highest in New York City followed by Philadelphia and Boston. This study may be of value in developing strategies for reducing the future impacts of heat and building climate change resilience in the urban Northeast region

Particulate matter pollution in African cities

Abstract: Rapid urban population growth, air pollution emissions, and changing patterns of disease in African cities may increase the burden of air pollution-related morbidity and mortality in coming decades. Yet, air monitoring is limited across the continent and many countries lack air quality standards. This paper focuses on particulate matter (PM) pollution, one of the most relevant and widely used indicators of urban air quality. We provide an overview of published PM monitoring studies in Africa, outline major themes, point out data gaps, and discuss strategies for addressing particulate air pollution in rapidly growing African cities. Our review reveals that, although few studies have reported annual mean levels of coarse and fine particles, collective evidence from short- and long-term air monitoring studies across urban Africa demonstrates that pollution levels often exceed international guidelines. Furthermore, pollution levels may be rising as a result of increased motor vehicle traffic building on already high background concentrations of PM in many locations due to climatic and geographic conditions. Biomass burning and industrial activities, often located in cities, further exacerbate levels of PM. Despite the health risks this situation presents, air quality programs, particularly in sub-Saharan Africa, have been stalled or discontinued in recent years. Implementation of systematic PM data collection would enable air pollution-related health impact assessments, the development of strategies to reduce the air pollution health burden, and facilitate urban planning and transportation policy as it relates to air quality and health. Keywords Urban air quality, Environmental health, Particulate matter, PM10, PM2.5, Afric

Heat-Related Mortality in a Warming Climate: Projections for 12 U.S. Cities

Heat is among the deadliest weather-related phenomena in the United States, and the number of heat-related deaths may increase under a changing climate, particularly in urban areas. Regional adaptation planning is unfortunately often limited by the lack of quantitative information on potential future health responses. This study presents an assessment of the future impacts of climate change on heat-related mortality in 12 cities using 16 global climate models, driven by two scenarios of greenhouse gas emissions. Although the magnitude of the projected heat effects was found to differ across time, cities, climate models and greenhouse pollution emissions scenarios, climate change was projected to result in increases in heat-related fatalities over time throughout the 21st century in all of the 12 cities included in this study. The increase was more substantial under the high emission pathway, highlighting the potential benefits to public health of reducing greenhouse gas emissions. Nearly 200,000 heat-related deaths are projected to occur in the 12 cities by the end of the century due to climate warming, over 22,000 of which could be avoided if we follow a low GHG emission pathway. The presented estimates can be of value to local decision makers and stakeholders interested in developing strategies to reduce these impacts and building climate change resilience

Children in Disasters: Do Americans Feel Prepared? A National Survey

This study was led by the National Center for Disaster Preparedness (NCDP) at Columbia University’s Earth Institute on behalf of the Resilient Children/Resilient Communities (RCRC) Initiative, in partnership with Save the Children with funding from GSK.The purpose of the study was to learn more about people’s opinions and attitudes toward disaster preparedness with a focus on children in disasters.The national survey of American households was conducted in December 2015. Eligible participants were 18 years of age or older, and included participants, with or without children, in their household. Many of the families surveyed had children in a K-12 school or in daycare