Air Conditioning in Nursing Homes and Mortality During Extreme Heat
Notice bibliographique
Résumé
Importance: Extreme heat poses a serious health risk to older adults because they are generally more susceptible to heat-related mortality. Many nursing homes in the US and elsewhere lack air conditioning (AC). Ecological studies have evaluated the protective role of AC against mortality on extreme heat days in prisons and large urban settings; however, the nursing home setting remains understudied. Objective: To assess mortality rates during extreme heat days in nursing homes with AC compared to those without AC. Design, Setting, and Participants: This was a case-crossover study conducted in Ontario, Canada, to determine the odds of mortality associated with extreme days separated for nursing homes with and without AC using conditional logistic regression. Nursing home residents who died during the warm months (June to September) from 2010 to 2023 were included. Data were analyzed from June 2024 to April 2025. Exposures: An extreme heat day was defined as any day in the ≥90th percentile of the heat index (ambient temperature and relative humidity) for any given nursing home location during the study period. Main Outcomes and Measures: All-cause mortality during extreme heat days, by AC status of nursing homes. Results: Of the 73 578 deaths of nursing home residents from 2010 to 2023, 40 255 residents (mean [SD] age, 86.8 [8.8] years; 65.6% women) died at 276 homes with AC and 33 323 residents (mean [SD] age, 87.2 [8.7] years; 64.8% women) at 339 homes without AC. Before the AC mandate was announced in July 2020, nursing homes without AC (55.1%) were predominantly investor owned (ie, for profit; standardized mean difference [SMD], 0.47), were built to older design standards (SMD, 0.57), and had more residents per room (SMD, 0.58) compared with nursing homes with AC. Overall, 4889 deaths (13.8%) in nursing homes without AC occurred on extreme heat days compared with 4611 deaths (12.1%) in those with AC. Extreme heat was associated with significantly increased odds of mortality in nursing homes without AC (odds ratio [OR], 1.11; 95% CI, 1.06-1.16) but not in those with AC (OR, 1.03; 95% CI, 0.98-1.07). Compared to nursing homes with AC, those without AC were associated with significantly higher relative odds of mortality on extreme heat days (relative OR, 1.08; 95% CI, 1.01-1.15). Lagged analyses suggest that the associated effects of extreme heat persisted for 3 days beyond the initial exposure. Conclusion and Relevance: In this case-crossover study, mortality was lower during extreme heat days in nursing homes with AC compared to those without AC. These findings suggest that AC provision in nursing homes and other congregate care settings may be important for preventing mortality among older adults during extreme heat days.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».