Emergency Department Visits and Summer Temperatures in Bologna, Northern Italy, 2010–2019: A Case-Crossover Study and Geographically Weighted Regression Methods

Francesco Guolo, Elisa Stivanello, Lorenzo Pizzi, Teodoro Georgiadis (), Letizia Cremonini, Muriel Assunta Musti, Marianna Nardino, Filippo Ferretti, Paolo Marzaroli, Vincenza Perlangeli, Paolo Pandolfi and Rossella Miglio
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Francesco Guolo: Department of Public Health, Local Health Authority of Bologna, 40121 Bologna, Italy
Elisa Stivanello: Department of Public Health, Local Health Authority of Bologna, 40121 Bologna, Italy
Lorenzo Pizzi: Governance of Screening Programs Unit, Local Health Authority of Bologna, 40121 Bologna, Italy
Teodoro Georgiadis: Institute for the BioEconomy IBE-CNR, 40129 Bologna, Italy
Letizia Cremonini: Institute for the BioEconomy IBE-CNR, 40129 Bologna, Italy
Muriel Assunta Musti: Department of Public Health, Local Health Authority of Bologna, 40121 Bologna, Italy
Marianna Nardino: Institute for the BioEconomy IBE-CNR, 40129 Bologna, Italy
Filippo Ferretti: Department of Public Health, Local Health Authority of Bologna, 40121 Bologna, Italy
Paolo Marzaroli: Department of Public Health, Local Health Authority of Bologna, 40121 Bologna, Italy
Vincenza Perlangeli: Department of Public Health, Local Health Authority of Bologna, 40121 Bologna, Italy
Paolo Pandolfi: Department of Public Health, Local Health Authority of Bologna, 40121 Bologna, Italy
Rossella Miglio: Department of Statistical Sciences, University of Bologna, 40126 Bologna, Italy

IJERPH, 2022, vol. 19, issue 23, 1-15

Abstract: The aim of the study is to evaluate the association between summer temperatures and emergency department visits (EDVs) in Bologna (Italy) and assess whether this association varies across areas with different socioeconomic and microclimatic characteristics. We included all EDVs within Bologna residences during the summers of 2010–2019. Each subject is attributed a deprivation and a microclimatic discomfort index according to the residence. A time-stratified case-crossover design was conducted to estimate the risk of EDV associated with temperature and the effect modification of deprivation and microclimatic characteristics. In addition, a spatial analysis of data aggregated at the census block level was conducted by applying a Poisson and a geographically weighted Poisson regression model. For each unit increase in temperature above 26 °C, the risk of EDV increases by 0.4% (95%CI: 0.05–0.8). The temperature–EDV relationship is not modified by the microclimatic discomfort index but rather by the deprivation index. The spatial analysis shows that the EDV rate increases with deprivation homogeneously, while it diminishes with increases in median income and microclimatic discomfort, with differences across areas. In conclusion, in Bologna, the EDV risk associated with high temperatures is not very relevant overall, but it tends to increase in areas with a low socioeconomic level.

Keywords: microclimate classification; high temperature; case-crossover; geographically weighted regression; emergency department visits (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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