Using social security number to identify sub-populations vulnerable to the health impacts from extreme heat in Florida, U.S.

Abstract

BACKGROUND:

Some socioeconomically vulnerable groups may experience disproportionately higher risk of extreme heat illness than other groups, but no study has utilized the presence/absence of a social security number (SSN) as a proxy for vulnerable sub-populations.

METHODS:

This study focused on the warm season from 2008 to 2012 in Florida, U.S. With a total number of 8,256,171 individual level health outcomes, we devised separate case-crossover models for five heat-sensitive health outcomes (cardiovascular disease, dehydration, heat-related illness, renal disease, and respiratory disease), type of health care visit (emergency department (ED) and hospitalization), and patients reporting/not reporting an SSN. Each stratified model also considered potential effect modification by sex, age, or race/ethnicity.

RESULTS:

Mean temperature raised the odds of five heat-sensitive health outcomes with the highest odds ratios (ORs) for heat-related illness. Sex significantly modified heat exposure effects for dehydration ED visits (Males: 1.145, 95 % CI: 1.137-1.153; Females: 1.110, 95 % CI: 1.103-1.117) and hospitalization (Males: 1.116, 95 % CI: 1.110-1.121; Females: 1.100, 95 % CI: 1.095-1.105). Patients not reporting an SSN between 25 and 44 years (1.264, 95 % CI: 1.192-1.340) exhibited significantly higher dehydration ED ORs than those reporting an SSN (1.146, 95 % CI: 1.136-1.157). We also observed significantly higher ORs for cardiovascular disease hospitalization from the no SSN group (SSN: 1.089, 95 % CI: 1.088-1.090; no SSN: 1.100, 95 % CI: 1.091-1.110).

CONCLUSIONS:

This paper partially supports the idea that individuals without an SSN could experience higher risks of dehydration (for those 25-45 years), renal disease, and cardiovascular disease than those with an SSN.

• Authors: Jihoon Jung, Christopher K Uejio, Temilayo E Adeyeye, Kristina W Kintziger, Chris Duclos, Keshia Reid, Melissa Jordan, June T Spector, Tabassum Z Insaf
• Journal: Environmental research (Environ Res) Vol. 202 Pg. 111738 (11 2021) ISSN: 1096-0953 [Electronic] Netherlands
• PMID: 34331925 (Publication Type: Journal Article, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)
• Copyright: Copyright © 2021 Elsevier Inc. All rights reserved.

Topics

• Emergency Service, Hospital
• Extreme Heat (adverse effects)
• Female
• Florida (epidemiology)
• Heat Stress Disorders (epidemiology)
• Humans
• Male
• Social Security