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Estimating the number of excess deaths attributable to heat in 297 United States counties.

ABSTRACT: There is a well-established relationship between high ambient temperature and risk of death. However, the number of deaths attributable to heat each year in the United States remains incompletely quantified. Methods:We replicated the approach from a large, international study to estimate temperature-mortality associations in 297 United States counties and additionally calculated the number of deaths attributable to heat, a quantity of likely interest to policymakers and the public. Results:Across 297 counties representing 61.9% of the United States population in 2000, we estimate that an average of 5,608 (95% empirical confidence interval = 4,748, 6,291) deaths were attributable to heat annually, 1997-2006. Conclusions:Our results suggest that the number of deaths related to heat in the United States is substantially larger than previously reported.

SUBMITTER: Weinberger KR

PROVIDER: S-EPMC7289128 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Estimating the number of excess deaths attributable to heat in 297 United States counties.

Weinberger Kate R KR Harris Daniel D Spangler Keith R KR Zanobetti Antonella A Wellenius Gregory A GA

Environmental epidemiology (Philadelphia, Pa.) 20200423 3

There is a well-established relationship between high ambient temperature and risk of death. However, the number of deaths attributable to heat each year in the United States remains incompletely quantified.<h4>Methods</h4>We replicated the approach from a large, international study to estimate temperature-mortality associations in 297 United States counties and additionally calculated the number of deaths attributable to heat, a quantity of likely interest to policymakers and the public.<h4>Res ...[more]

PMID: 32613153

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Project description:BackgroundIn the United States, Coronavirus Disease 2019 (COVID-19) deaths are captured through the National Notifiable Disease Surveillance System and death certificates reported to the National Vital Statistics System (NVSS). However, not all COVID-19 deaths are recognized and reported because of limitations in testing, exacerbation of chronic health conditions that are listed as the cause of death, or delays in reporting. Estimating deaths may provide a more comprehensive understanding of total COVID-19-attributable deaths.MethodsWe estimated COVID-19 unrecognized attributable deaths, from March 2020-April 2021, using all-cause deaths reported to NVSS by week and six age groups (0-17, 18-49, 50-64, 65-74, 75-84, and ≥85 years) for 50 states, New York City, and the District of Columbia using a linear time series regression model. Reported COVID-19 deaths were subtracted from all-cause deaths before applying the model. Weekly expected deaths, assuming no SARS-CoV-2 circulation and predicted all-cause deaths using SARS-CoV-2 weekly percent positive as a covariate were modelled by age group and including state as a random intercept. COVID-19-attributable unrecognized deaths were calculated for each state and age group by subtracting the expected all-cause deaths from the predicted deaths.FindingsWe estimated that 766,611 deaths attributable to COVID-19 occurred in the United States from March 8, 2020-May 29, 2021. Of these, 184,477 (24%) deaths were not documented on death certificates. Eighty-two percent of unrecognized deaths were among persons aged ≥65 years; the proportion of unrecognized deaths were 0•24-0•31 times lower among those 0-17 years relative to all other age groups. More COVID-19-attributable deaths were not captured during the early months of the pandemic (March-May 2020) and during increases in SARS-CoV-2 activity (July 2020, November 2020-February 2021).InterpretationEstimating COVID-19-attributable unrecognized deaths provides a better understanding of the COVID-19 mortality burden and may better quantify the severity of the COVID-19 pandemic.FundingNone.

Dataset Information

Estimating the number of excess deaths attributable to heat in 297 United States counties.

Publications

Estimating the number of excess deaths attributable to heat in 297 United States counties.

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