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2 results

  • Burnt by the sun: disaggregating temperature’s current and future impact on mortality in the Turkish context

  • Ilhan Can Özen
  • Journal:
    New Perspectives on Turkey / Volume 64 / May 2021
    Published online by Cambridge University Press:
    26 March 2021, pp. 81-116
    Print publication:
    May 2021

  • Our study plans to quantify the effect of higher temperatures on different critical Turkish health outcomes mainly to chart future developments and to identify locations in Turkey that may be potential vulnerable hotspots. The general structure of the temperature mortality function was estimated with different fixed-level effects, with a specific focus on the mortality effect of maximum apparent temperature. Regional models were fitted to pinpoint the thresholds where the temperature–mortality relation changes, thus investigating whether the thresholds are determined nationally or regionally. The future patterns were estimated by extrapolating from future temperature trends: analyzing possible future mortality trends under the restricting assumption of minimal acclimation. Using the fixed effect regression structure, social and developmental variables acting as heat effect modifiers were also identified. In the largest dataset, the initial fixed effect regression specification supports the hypothesis summarized by the U-shaped relationship between temperature and mortality. This is a first corroboration for Turkish climate and health research. In addition, intermediation effects were substantiated for the level of urbanization and population density, and the human development and health development within provinces. Regional heterogeneity is substantiated by the mortality–temperature relationship and the significant threshold deviations from the national average.

  • Characterizing the Impact of Extreme Heat on Mortality, Karachi, Pakistan, June 2015

  • Usman Ghumman, Jennifer Horney
  • Journal:
    Prehospital and Disaster Medicine / Volume 31 / Issue 3 / June 2016
    Published online by Cambridge University Press:
    05 April 2016, pp. 263-266
    Print publication:
    June 2016
  • Introduction

    Karachi, Pakistan was affected by a heat wave in June 2015 during the Muslim holy month of Ramadan. Many media reports attributed the excess deaths in part to the practice of daylight fasting during Ramadan. As much of the published research reports on heat-related mortality in Europe and the United States, an exploration of the effects of extreme heat on residents of a South Asian mega-city address a gap in current disaster research.

    Hypothesis/Problem

    This report investigated potential risk factors for excess mortality associated with the June 2015 heat wave in Karachi, Pakistan.

    Methods

    Data were obtained through manual review of death certificates at public hospitals and private clinics in Karachi, Pakistan, conducted from July 1 through July 31, 2015 by a trained physician. Demographic data for any deaths with a primary cause of death of heat-related illness were recorded in Microsoft Excel (Microsoft Corp.; Redmond, Washington USA). EpiSheet (2012; Rothman. Modern Epidemiology. Lippincott Williams & Wilkins; Philadelphia, Pennsylvania USA) was used to calculate risk differences (RD), rate ratios (RR), and 95% confidence intervals (95% CI).

    Results

    Overall, residents of Karachi were approximately 17 times as likely to die of a heat-related cause of death during June 2015 (RR=17.68; 95% CI, 13.87-22.53) when compared with the reference period of June 2014. Residents with a monthly income lower than 20,000 Pakistani Rupees (US $196; RD=0.03; 95% CI, 0.01-0.05) and those with less than a fifth grade education (RD=0.03; 95% CI, 0.00-0.05) were at significantly higher risk of death during the 2015 heat wave compared to the reference period.

    Conclusion

    Fasting during Ramadan was not a significant risk factor for mortality from heat-related causes during the Karachi heat wave of June 2015. A large number of excess deaths were reported across all demographic groups, which due to the burden of record keeping in an under-resourced health system during a public health emergency, are almost certainly an underestimate.

    GhummanU , HorneyJ . Characterizing the Impact of Extreme Heat on Mortality, Karachi, Pakistan, June 2015. Prehosp Disaster Med. 2016;31(3):263–266.