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Cold-Related Illness In An Era Of Extreme Climate Events: US Trends, 1998-2022.

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Hospitalizations for cold-related illnesses (CRIs) tripled from 1998-2022. Patients with CRIs faced higher mortality, poverty, and housing instability, underscoring the need for social support and climate resilience measures.

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Area of Science:

  • Public Health
  • Environmental Health
  • Epidemiology

Background:

  • Cold-related illnesses (CRIs) represent a significant, yet preventable, cause of mortality.
  • Social determinants of health, including housing insecurity and behavioral health conditions, are increasingly recognized as critical factors in health outcomes.
  • Climate change is linked to more extreme weather events, potentially exacerbating health risks associated with cold exposure.

Purpose of the Study:

  • To analyze nationwide trends in hospitalizations for CRIs between 1998 and 2022.
  • To investigate the prevalence of alcohol use, substance use, mental health disorders, and housing insecurity among hospitalized CRI patients.
  • To identify disparities in CRI hospitalization rates and outcomes based on socioeconomic factors.

Main Methods:

  • Utilized twenty-five years of data (1998-2022) from the National Inpatient Sample.
  • Conducted a weighted analysis of 345,314 identified CRI hospitalizations.
  • Assessed age- and sex-adjusted trends and compared characteristics of CRI inpatients with the general hospitalized population.

Main Results:

  • Age- and sex-adjusted CRI hospitalization rates nearly tripled, increasing from 42.0 to 122.5 per 100,000 hospitalizations.
  • CRI inpatients were disproportionately more likely to experience mortality during hospitalization.
  • Patients hospitalized for CRIs frequently resided in high-poverty areas, had public or no insurance, and presented with behavioral health conditions and housing instability.

Conclusions:

  • The findings reveal a rising and inequitable burden of CRIs, exacerbated by social instability and climate change-driven extreme cold.
  • Interventions addressing behavioral health, home heating affordability, housing security, and extreme weather preparedness are crucial for reducing CRI morbidity and mortality.
  • Public health strategies must integrate social support systems to mitigate the impact of CRIs.