Building Resilience to Climate Change: Pilot Evaluation of the Impact of India's First Heat Action Plan on All-Cause Mortality.

• Type of Material: Article
• Authors: Jeremy Hess, Emory University; Sathish Lm, Indian Institute of Public Health; Kim Knowlton, Natural Resources Defense Council; Shubhayu Saha, Emory University; Priya Dutta, Indian Institute of Public Health; Parthasarathi Ganguly, Indian Institute of Public Health; Abhiyant Tiwari, Indian Institute of Public Health; Anjali Jaiswal, Natural Resources Defense Council; Perry Sheffield, Icahn School of Medicine at Mount Sinai; Jayanta Sarkar, Indian Meteorological Department; S.C. Bhan, Indian Meteorological Department; Amit Begda, Ahmedabad Municipal Corporation; Tejas Shah, Ahmedabad Municipal Corporation; Bhavin Solanki, Ahmedabad Municipal Corporation; Dileep Mavalankar, Indian Institute of Public Health
• Language: English
• Date: 2018
• Publisher: Hindawi Publishing Corporation
• Publication Version: Final Published Version
• Copyright Statement: © 2018 Jeremy J. Hess et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1155/2018/7973519
• Title of Journal or Parent Work: Journal of Environmental and Public Health
• ISSN: 1687-9805
• Volume: 2018
• Start Page: 7973519
• End Page: 7973519
• Grant/Funding Information: This work was funded by the National Institutes of Health (Grant numbers 5R21TW009535-02 and K23ES024127) and the Climate Development and Knowledge Network.
• Keywords: Heat Action Plan; Climate change; Impact; mortality; India
• Research Categories: Health Sciences, Public Health

Abstract

Background: Ahmedabad implemented South Asia's first heat action plan (HAP) after a 2010 heatwave. This study evaluates the HAP's impact on all-cause mortality in 2014-2015 relative to a 2007-2010 baseline. Methods: We analyzed daily maximum temperature (Tmax)-mortality relationships before and after HAP. We estimated rate ratios (RRs) for daily mortality using distributed lag nonlinear models and mortality incidence rates (IRs) for HAP warning days, comparing pre- and post-HAP periods, and calculated incidence rate ratios (IRRs). We estimated the number of deaths avoided after HAP implementation using pre- and post-HAP IRs. Results: The maximum pre-HAP RR was 2.34 (95%CI 1.98-2.76) at 47°C (lag 0), and the maximum post-HAP RR was 1.25 (1.02-1.53) estimated at 47°C (lag 0). Post-to-pre-HAP nonlagged mortality IRR for Tmax over 40°C was 0.95 (0.73-1.22) and 0.73 (0.29-1.81) for Tmax over 45°C. An estimated 1,190 (95%CI 162-2,218) average annualized deaths were avoided in the post-HAP period. Conclusion: Extreme heat and HAP warnings after implementation were associated with decreased summertime all-cause mortality rates, with largest declines at highest temperatures. Ahmedabad's plan can serve as a guide for other cities attempting to increase resilience to extreme heat.