EXCESS MORTALITY ATTRIBUTABLE TO EXTREME HEAT IN NEW YORK CITY, 1997-2013

Extreme heat event excess mortality has been estimated statistically to assess impacts, evaluate heat emergency response, and project climate change risks. We estimated annual excess non-external-cause deaths associated with extreme heat events in New York City (NYC). Extreme heat events were defined as days meeting current National Weather Service forecast criteria for issuing heat advisories in NYC based on observed maximum daily heat index values from LaGuardia Airport. Outcomes were daily non-external-cause death counts for NYC residents from May through September from 1997 to 2013 (n=337,162). The cumulative relative risk (CRR) of death associated with extreme heat events was estimated in a Poisson time-series model for each year using an unconstrained distributed lag for days 0-3 accommodating over dispersion, and adjusting for within-season trends and day of week. Attributable death counts were computed by year based on individual year CRRs. The pooled CRR per extreme heat event day was 1.11 (95%CI 1.08-1.14). The estimated annual excess non-external-cause deaths attributable to heat waves ranged from -14 to 358, with a median of 121. Point estimates of heat wave-attributable deaths were greater than 0 in all years but one and were correlated with the number of heat wave days (r=0.81). Average excess non-external-cause deaths associated with extreme heat events were nearly 11-fold greater than hyperthermia deaths. Estimated extreme heat event-associated excess deaths may be a useful indicator of the impact of extreme heat events, but single-year estimates are currently too imprecise to identify short-term changes in risk.