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Record W7116933598 · doi:10.1016/j.envint.2025.110022

Characterizing adaptive capacity for the future heat-related cardiovascular morbidity burden in U.S. Metropolitan areas

2025· article· en· W7116933598 on OpenAlexaff
Wei-Lun Tsai, E. Melissa Mcinroe, Anna M. Jalowska, Corinna Y. Keeler, Stephanie E. Cleland, Cassandra R. O’Lenick, Tanya L. Spero, Alexandra Schneider, Ana G. Rappold

Bibliographic record

VenueEnvironment International · 2025
Typearticle
Languageen
FieldEnvironmental Science
TopicClimate Change and Health Impacts
Canadian institutionsSimon Fraser University
FundersCenter for Public Health and Environmental AssessmentU.S. Environmental Protection Agency
KeywordsMetropolitan areaPercentileBaseline (sea)Burden of diseaseDisease burdenConfidence intervalAdaptive capacityEstimationExtreme heat

Abstract

fetched live from OpenAlex

• By 2099, additional 36 days are projected above the min hospitalization temperature. • By 2099, excess heat-CVD burden is expected to increase at least 20-fold. • Risk scores are built for health, environment, economic/demographic, infrastructure. • Health risk scores explain the most model variance for current burden. • Environment risk scores predict the largest portion of change in burden over time. Exposure to excess heat is linked to increased risks of cardiovascular diseases (CVD). As temperatures increase globally, it is crucial to examine the potential increase in excess heat-related CVD (xHEAT-CVD) burden to inform strategies for adaptation. This study aimed to identify the contextual factors associated with future xHEAT-CVD burden among older adults across eighty U.S. metropolitan statistical areas (MSAs). The MSA-specific xHEAT-CVD risk for adults ≥ 65 years was estimated using hospitalization and temperature data from 2000 to 2017, with excess heat defined as temperatures above the minimum hospitalization percentile (T MHP ). Future xHEAT-CVD hospitalizations were estimated using temperature projections for 2025–2054, 2045–2074, and 2070–2099 under three climate scenarios. Area-level variables were used to identify demographic and economic status, health, environment, and infrastructure contexts and derive Urban Heat Health Risk (UHHR) scores using confirmatory factor analysis. The associations between adaptive capacity (the UHHR scores) and future xHEAT-CVD burden were examined. In 2070–2099 under the mildest scenario, 36 more days annually were projected to be ≥ T MHP , and xHEAT-CVD burden was projected to increase by at least 20.4-fold. Lower adaptive capacity was associated with greater increases in future xHEAT-CVD burden, over 9-fold increase per 1-unit increase in UHHR score (9.1, 95 % Confidence Intervals: 2.8–15.4). The historical xHEAT-CVD burden (2000–2017) was largely driven by the health context, whereas environment played a more important role in the future. Our findings suggest that drivers of the xHEAT-CVD burden may vary across time. Targeting the areas with the highest xHEAT-CVD burden at varying timeframes can help mitigate xHEAT-CVD burden more effectively.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.374
Threshold uncertainty score0.999

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.036
GPT teacher head0.272
Teacher spread0.236 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2025
Admission routes1
Has abstractyes

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