Effects of Extreme Temperature on Aging Populations in the United States: AGeographically Granular Assessment of Present and Future Impacts by Race and Ethnicity - PROJECT SUMMARY The overall objective of the proposed research is to estimate the present and future burden of extreme temperature in a geographically detailed manner for the US. Extreme temperature risk will be assessed on a 4x4 km grid for the contiguous US and roll into socio-demographic and -economic information available on the census tract and county level. The main emphasis lies in understanding how risk increases across the lifespan and quantifying the expected impact in aging populations. Understanding how extreme temperature effects are modified by other factors such as socio-demographic or socio-economic characteristics, pre-existing health conditions, and air pollution etc. is another key aim of the proposed work. In a previous study, the PI estimated that approximately 124,000 (95% UI: 105,000-145,000) deaths in the US in 2019 occurred due to exposure to non-optimal temperature. This renders temperature the leading environmental risk factor in North America, currently contributing to more deaths than air pollution. Cold exposure, in particular, adds to this high burden, but substantial heat-related effects occur in states such as Arizona, Texas, or Louisiana. With temperatures rising, the significance of heat-related deaths is likely to increase. In addition, population aging in the US, with the population aged 65 years and above expected to double by 2060, is potentially aggravating the impact of extreme temperature. While several studies have assessed temperature impacts on all-cause or broad categories of disease, there is no systematic assessment of the impact of extreme temperature on cause- specific mortality or of the role of risk modification, especially by age. Furthermore, most related studies have conducted risk assessment in select locations, mostly individual cities, but spatially detailed continuous assessments across regions are lacking. Here, we suggest research that is driven by three hypotheses and centered around three aligning research aims. In Aim 1, we will derive all-cause and cause-specific risk functions for extreme high and low temperature across the lifespan and estimate county-specific burden. In Aim 2, we will project future impacts of extreme temperature-related disease using climate and population change scenarios. Finally, in Aim 3 we will assess the risk reduction potential associated with interventions to reduce temperature- health risk and provide regional risk reduction guidance. Detailed estimates allow identifying priority areas and target specific population and patient groups. The proposed work draws from the extensive data and infrastructure available at IHME and builds upon work previously conducted within the Global Burden of Disease study. Results will be published in scientific journals and via an online visualization tool, allowing the scientific community, as well as non-technical audiences, the media, and policy- and decision-makers to view and utilize the results. To ensure effective communication and policy translation of results, the research team is supported by a policy advisory panel and the IHME Global Impact group.
