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October 27, 1989, Vol 262, No. 16 >
ARTICLE | October 27, 1989

Geographic Distribution of Heat-Related Deaths Among Elderly Persons: Title and subTitle BreakUse of County-Level Dot Maps for Injury Surveillance and Epidemiologic Research FREE

Beverly F. Martinez, PhD; Joseph L. Annest, PhD; Edwin M. Kilbourne, MD; Marilyn L. Kirk; Kung-Jong Lui, PhD; Suzanne M. Smith, MD
[+] Author Affiliations

Reprint requests to Division of Injury Epidemiology and Control, Center for Environmental Health and Injury Control, Mailstop F-36, Centers for Disease Control, Atlanta, GA 30333 (Dr Annest).


JAMA. 1989;262(16):2246-2250. doi:10.1001/jama.1989.03430160068032
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References

Mapping is a useful tool for initiating data analysis of relatively infrequent injury events and can lead to interesting hypotheses that can then be tested in further epidemiologic studies. From national death certificate data for the years 1979 through 1985, we made dot maps of fatalities due to excessive heat (International Classification of Diseases code E900) among persons 65 years or older. The maps show clusterings of deaths, particularly in the central, south central, and southeastern sections of the United States, to an extent not fully explained by the population density or temperature extremes. The counties principally affected were highly urbanized and, for races other than white, were relatively poor. Our maps identify counties in which heat-related health problems in the elderly are particularly severe. Public health officials in high-risk areas should undertake heat-wave contingency planning and physicians practicing in such areas should familiarize themselves with the treatment of the spectrum of heat-related illnesses.

(JAMA. 1989;262:2246-2250)

REFERENCES

1 +
Thacker SB, Berkelman RL.  Public health surveillance in the United States . Epidemiol Rev. 1988;;10:164-190.
2 +
Mason TJ, McKay FW, Hoover R, Blot WJ, Fraumeni JF Jr. Atlas of Cancer Mortality for US Counties: 1950-1969. Washington, DC: Government Printing Office; 1975. Dept of Health, Education, and Welfare publication (NIH) 75-780.
3 +
Blot WJ, Fraumeni JF Jr, Mason TJ, Hoover RN.  Developing clues to environmental cancer . Environ Health Perspect. 1979;;32:53-58.
4 +
Pickle LW, Mason TJ, Howard N, Hoover R, Fraumeni JF Jr. Atlas of US Cancer Mortality Among Whites: 1950-1980. Washington, DC: Government Printing Office; 1987. Dept of Health and Human Services publication (NIH) 87-2900.
5 +
Tufte ER. The Visual Display of Quantitative Information . Cheshire, Conn: Graphics Press; 1983;.
6 +
Baker SP, Whitfield PA, O'Neill B.  Geographic variation in mortality for motor vehicle crashes . N Engl J Med. 1987;;316:1384-1387.
7 +
Baker SP, Whitfield RA, O'Neill B.  County mapping of injury mortality . J Trauma. 1988;; 28:741-745.
8 +
Jones TS, Liang AP, Kilbourne EM, et al.  Morbidity and mortality associated with the July 1980 heat wave in St Louis and Kansas City, Mo . JAMA. 1982;;247:3327-3331.
9 +
Centers for Disease Control.  Heatstroke: United States, 1980 . MMWR. 1981;;30:277-279.
10 +
Public Use Data Tape Documentation for the Compressed Mortality File, 1968-1985 . Washington, DC: National Center for Health Statistics; 1985;.
11 +
Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, Ninth Revision . Geneva, Switzerland: World Health Organization, 1977;;1.
12 +
Department of Commerce, Bureau of the Census. Chapter C, General social and economic characteristics. In: 1980 Census of the Population, Volume 1: Characteristics of the Population. Washington, DC: Government Printing Office; 1983.
13 +
Kilbourne EM, Choi K, Jones ST, Thacker SB, et al.  Risk factors for heatstroke . JAMA. 1982;;247:3332-3336.
14 +
Applegate WB, Runyan JW Jr, Brasfield L, Williams ML, Konigsberg C, Fouche C.  Analysis of the 1980 heat wave in Memphis . J Am Geriatr Soc. 1981;;29:337-342.
15 +
Clarke JF.  Some effects of the urban structure on heat mortality . Environ Res. 1972;;5:93-104.
16 +
Steadman RG.  A universal scale of apparent temperature . J Climate Applied Meteorol. 1984;; 23:1674-1687.
17 +
Dept of Commerce, National Oceanic and Atmospheric Administration, Environmental and Information Service. Local Climatological Data, Annual Summaries for 1980 . Asheville, NC: National Climatic Center; 1981;.
18 +
Kalkstein LS, Valimont KM.  An evaluation of summer discomfort in the United States using a relative climatological index . Bull Am Meteorol Soc. 1986;;67;842-848.
19 +
Knochel JP.  Environmental heat illness . Arch Intern Med. 1974;;133;841-864.
20 +
Graham BS, Lichtenstein MJ, Hinson JM, Theil GB.  Nonexertional heatstroke . Arch Intern Med. 1986;;146;87-90.
21 +
Vicario SJ, Okabajue R, Haltom T.  Rapid cooling in classic heatstroke . Am J Emerg Med. 1986;;4;394-398.
22 +
Centers for Disease Control.  Illness and death due to environmental heat—Georgia and St Louis, Missouri, 1983 . MMWR . 1984;;33;325-326.
23 +
Centers for Disease Control.  Heat-associated mortality—New York City . MMWR . 1984;;33;430-432.

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Interactive Graphics

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Thacker SB, Berkelman RL.  Public health surveillance in the United States . Epidemiol Rev. 1988;;10:164-190.
2 +
Mason TJ, McKay FW, Hoover R, Blot WJ, Fraumeni JF Jr. Atlas of Cancer Mortality for US Counties: 1950-1969. Washington, DC: Government Printing Office; 1975. Dept of Health, Education, and Welfare publication (NIH) 75-780.
3 +
Blot WJ, Fraumeni JF Jr, Mason TJ, Hoover RN.  Developing clues to environmental cancer . Environ Health Perspect. 1979;;32:53-58.
4 +
Pickle LW, Mason TJ, Howard N, Hoover R, Fraumeni JF Jr. Atlas of US Cancer Mortality Among Whites: 1950-1980. Washington, DC: Government Printing Office; 1987. Dept of Health and Human Services publication (NIH) 87-2900.
5 +
Tufte ER. The Visual Display of Quantitative Information . Cheshire, Conn: Graphics Press; 1983;.
6 +
Baker SP, Whitfield PA, O'Neill B.  Geographic variation in mortality for motor vehicle crashes . N Engl J Med. 1987;;316:1384-1387.
7 +
Baker SP, Whitfield RA, O'Neill B.  County mapping of injury mortality . J Trauma. 1988;; 28:741-745.
8 +
Jones TS, Liang AP, Kilbourne EM, et al.  Morbidity and mortality associated with the July 1980 heat wave in St Louis and Kansas City, Mo . JAMA. 1982;;247:3327-3331.
9 +
Centers for Disease Control.  Heatstroke: United States, 1980 . MMWR. 1981;;30:277-279.
10 +
Public Use Data Tape Documentation for the Compressed Mortality File, 1968-1985 . Washington, DC: National Center for Health Statistics; 1985;.
11 +
Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, Ninth Revision . Geneva, Switzerland: World Health Organization, 1977;;1.
12 +
Department of Commerce, Bureau of the Census. Chapter C, General social and economic characteristics. In: 1980 Census of the Population, Volume 1: Characteristics of the Population. Washington, DC: Government Printing Office; 1983.
13 +
Kilbourne EM, Choi K, Jones ST, Thacker SB, et al.  Risk factors for heatstroke . JAMA. 1982;;247:3332-3336.
14 +
Applegate WB, Runyan JW Jr, Brasfield L, Williams ML, Konigsberg C, Fouche C.  Analysis of the 1980 heat wave in Memphis . J Am Geriatr Soc. 1981;;29:337-342.
15 +
Clarke JF.  Some effects of the urban structure on heat mortality . Environ Res. 1972;;5:93-104.
16 +
Steadman RG.  A universal scale of apparent temperature . J Climate Applied Meteorol. 1984;; 23:1674-1687.
17 +
Dept of Commerce, National Oceanic and Atmospheric Administration, Environmental and Information Service. Local Climatological Data, Annual Summaries for 1980 . Asheville, NC: National Climatic Center; 1981;.
18 +
Kalkstein LS, Valimont KM.  An evaluation of summer discomfort in the United States using a relative climatological index . Bull Am Meteorol Soc. 1986;;67;842-848.
19 +
Knochel JP.  Environmental heat illness . Arch Intern Med. 1974;;133;841-864.
20 +
Graham BS, Lichtenstein MJ, Hinson JM, Theil GB.  Nonexertional heatstroke . Arch Intern Med. 1986;;146;87-90.
21 +
Vicario SJ, Okabajue R, Haltom T.  Rapid cooling in classic heatstroke . Am J Emerg Med. 1986;;4;394-398.
22 +
Centers for Disease Control.  Illness and death due to environmental heat—Georgia and St Louis, Missouri, 1983 . MMWR . 1984;;33;325-326.
23 +
Centers for Disease Control.  Heat-associated mortality—New York City . MMWR . 1984;;33;430-432.

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