The impact of extreme heat on morbidity in Milwaukee, Wisconsin

Given predictions of increased intensity and frequency of heat waves, it is important to study the effect of high temperatures on human mortality and morbidity. Many studies focus on heat wave-related mortality; however, heat-related morbidity is often overlooked. The goals of this study are to examine the historical observed relationship between temperature and morbidity (illness), and explore the extent to which observed historical relationships could be used to generate future projections of morbidity under climate change. We collected meteorological, air pollution, and hospital admissions data in Milwaukee, Wisconsin, for the years 1989-2005, and employed a generalized additive model (GAM) to quantify the relationship between morbidity (as measured by hospital admissions) and high temperatures with adjustment for the effects of potential confounders. We also estimated temperature threshold values for different causes of hospital admissions and then quantified the associated percent increase of admissions per degree above the threshold. Finally, the future impact of higher temperatures on admissions for the years 2059-2075 was examined. Our results show that five causes of admission (endocrine, genitourinary, renal, accidental, and self-harm) and three age groups (15-64, 75-84, > 85 years) were affected by high temperatures. Future projections indicate a larger number of days above the current temperature threshold leading to an increase in admissions. Our results indicate that climate change may increase heat-related hospital admissions in the US urban mid-West and that health systems should include heat wave planning.