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Abstract Background Published literature detailing the effects of heatwaves on human health is readily available. However literature describing the effects of heat on morbidity is less plentiful, as is research describing events in the southern hemisphere and Australia in particular. To identify susceptible populations and direct public health responses research must move beyond description of the temperature morbidity relationship to include social and spatial risk factors. This paper presents a spatial and socio-demographic picture of the effects of hot weather on persons admitted to hospital with acute myocardial infarction (AMI) in Melbourne. Results In this study, the use of a spatial and socio-economic perspective has identified two groups within the population that have an increased 'risk' of AMI admissions to hospital during hot weather. AMI increases during hot weather were only identified in the most disadvantaged and the least disadvantaged areas. Districts with higher AMI admissions rates during hot weather also had larger proportions of older residents. Age provided some explanation for the spatial distribution of AMI admissions on single hot days whereas socio-economic circumstance did not. During short periods (3-days) of hot weather, age explained the spatial distribution of AMI admissions slightly better than socioeconomic circumstance. Conclusions This study has demonstrated that both age and socioeconomic inequality contribute to AMI admissions to hospital in Melbourne during hot weather. By using socioeconomic circumstance to define quintiles, differences in AMI admissions were quantified and demographic differences in AMI admissions were described. Including disease specificity into climate-health research methods is necessary to identify climate-sensitive diseases and highlight the burden of climate-sensitive disease in the community. Cardiac disease is a major cause of death and disability and identifying cardiac-specific climate thresholds and the spatio-demographic characteristics of vulnerable groups within populations is an important step towards preventative health care by informing public health officials and providing a guide for an early heat-health warning system. This information is especially important under current climatic conditions and for assessing the future impact of climate change.

Abstract Background Seasonal patterns in cardiac disease in the northern hemisphere are well described in the literature. More recently age and gender differences in cardiac mortality and to a lesser extent morbidity have been presented. To date spatial differences between the seasonal patterns of cardiac disease has not been presented. Literature relating to seasonal patterns in cardiac disease in the southern hemisphere and in Australia in particular is scarce. The aim of this paper is to describe the seasonal, age, gender, and spatial patterns of cardiac disease in Melbourne Australia by using acute myocardial infarction admissions to hospital as a marker of cardiac disease. Results There were 33,165 Acute Myocardial Infarction (AMI) admissions over 2186 consecutive days. There is a seasonal pattern in AMI admissions with increased rates during the colder months. The peak month is July. The admissions rate is greater for males than for females, although this difference decreases with advancing age. The maximal AMI season for males extends from April to November. The difference between months of peak and minimum admissions was 33.7%. Increased female AMI admissions occur from May to November, with a variation between peak and minimum of 23.1%. Maps of seasonal AMI admissions demonstrate spatial differences. Analysis using Global and Local Moran's I showed increased spatial clustering during the warmer months. The Bivariate Moran's I statistic indicated a weaker relationship between AMI and age during the warmer months. Conclusion There are two distinct seasons with increased admissions during the colder part of the year. Males present a stronger seasonal pattern than females. There are spatial differences in AMI admissions throughout the year that cannot be explained by the age structure of the population. The seasonal difference in AMI admissions warrants further investigation. This includes detailing the prevalence of cardiac disease in the community and examining issues of social and environmental justice.

Outdoor thermal comfort studies have mainly examined the perception of local residents, and there has been little work on how those conditions are perceived differently by tourists, especially tourists of diverse origins. This issue is important because it will improve the application of thermal indices in predicting the thermal perception of tourists. This study aims to compare the differences in thermal perception and preferences between local and overseas visitors to the Royal Botanic Garden (RBG) in Melbourne during summer. An 8-day survey was conducted in February 2014 at four sites in the garden ( n = 2198), including 2 days with maximum temperature exceeding 40 °C. The survey results were compared with data from four weather stations adjacent to the survey locations. One survey location, 'Fern Gully', has a misting system and visitors perceived the Fern Gully to be cooler than other survey locations. As the apparent temperature exceeded 32.4 °C, visitors perceived the environment as being 'warm' or 'hot'. At 'hot' conditions, 36.8 % of European visitors voted for no change to the thermal conditions, which is considerably higher than the response from Australian visitors (12.2 %) and Chinese visitors (7.5 %). Study results suggest that overseas tourists have different comfort perception and preferences compared to local Australians in hot weather based at least in part on expectations. Understanding the differences in visitors' thermal perception is important to improve the garden design. It can also lead to better tour planning and marketing to potential visitors from different countries. [ABSTRACT FROM AUTHOR]

Background: Several studies have identified the association between ambient temperature and mortality; however, several features of temperature behavior and their impacts on health remain unresolved. We obtain daily counts of nonaccidental all-cause mortality data in the elderly (65 + years) and corresponding meteorological data for Melbourne, Australia during 1999 to 2006. We then characterize the temporal behavior of ambient temperature development by quantifying the rates of temperature change during periods designated by pre-specified windows ranging from 1 to 30 days. Finally, we evaluate if the association between same day temperature and mortality in the framework of a Poisson regression and include our temperature trajectory variables in order to assess if associations were modified by the nature of how the given daily temperature had evolved. Results: We found a positive significant association between short-term mortality risk and daily average temperature as mortality risk increased 6 % on days when temperatures were above the 90th percentile as compared to days in the referent 25-75th. In addition, we found that mortality risk associated with daily temperature varied by the nature of the temperature trajectory over the preceding twelve days and that peaks in mortality occurred during periods of high temperatures and stable trajectories and during periods of increasing higher temperatures and increasing trajectories. Conclusion: Our method presents a promising tool for improving understanding of complex temperature health associations. These findings suggest that the nature of sub-monthly temperature variability plays a role in the acute impacts of temperature on mortality; however, further studies are suggested. [ABSTRACT FROM AUTHOR]

Building healthy societies is a key step towards climate resilient communities. Ill health is related to increased risk during heat events and is disproportionally distributed within and between communities. To understand the differences in the spatial distribution of climate related health risks and how this will change in the future we have undertaken a spatiotemporal analysis of heatwave risks in urban populations in Brisbane, Australia. The aim of this was to advise emergency managers and public health authorities of high- risk areas during extreme heat events (EHEs). The spatial distribution of heat related morbidity identified areas of high healthcare service demand during EHEs. An index of risk was developed based on social and environmental determinants of vulnerability. Regression analysis was used to determine the key drivers of heat related morbidity from the index. A weighted map of population vulnerability was produced which identified the high risk areas and provided key information to target public health interventions and heat stress prevention policy. The predicted changes in high risk populations such as the proportion of elderly people living in urban areas were also mapped to support longer term adaptation and develop health care infrastructure and health promotion strategies. INSET: 2. [ABSTRACT FROM AUTHOR]

Theeffects of extreme temperatures on human health have beenwell described. However, the adverse health effects of warm weather that occurs outside the summer period have had little attention. We used daily anomalous AMI morbidity and daily anomalous temperature to determine the impact of "unseasonable" temperature on human health. The "unseasonably" warm weather was attributed to a slow moving high pressure system to the east of Melbourne. No morbidity displacement was noted during either of these periods suggesting that morbidity due to "unseasonable" temperatures is avoidable. An increase in warmer weather during the cooler months of spring may result in increased morbidity, and an alert system based on summer thresholds may not be appropriate for early season heat health warnings. A straightforward alert system based on calculating anomalous temperature from daily weather forecasts may reduce the public health impact of "unseasonably" warm weather. [ABSTRACT FROM AUTHOR]

Urban drainage infrastructure is generally designed to rapidly export stormwater away from the urban environment to minimize flood risk created by extensive impervious surface cover. This deficit is resolved by importing high-quality potable water for irrigation. However, cities and towns at times face water restrictions in response to drought and water scarcity. This can exacerbate heating and drying, and promote the development of unfavourable urban climates. The combination of excessive heating driven by urban development, low water availability and future climate change impacts could compromise human health and amenity for urban dwellers. This paper draws on existing literature to demonstrate the potential of Water Sensitive Urban Design (WSUD) to help improve outdoor human thermal comfort in urban areas and support Climate Sensitive Urban Design (CSUD) objectives within the Australian context. WSUD provides a mechanism for retaining water in the urban landscape through stormwater harvesting and reuse while also reducing urban temperatures through enhanced evapotranspiration and surface cooling. Research suggests that WSUD features are broadly capable of lowering temperatures and improving human thermal comfort, and when integrated with vegetation (especially trees) have potential to meet CSUD objectives. However, the degree of benefit (the intensity of cooling and improvements to human thermal comfort) depends on a multitude of factors including local environmental conditions, the design and placement of the systems, and the nature of the surrounding urban landscape. We suggest that WSUD can provide a source of water across Australian urban environments for landscape irrigation and soil moisture replenishment to maximize the urban climatic benefits of existing vegetation and green spaces. WSUD should be implemented strategically into the urban landscape, targeting areas of high heat exposure, with many distributed WSUD features at regular intervals to promote infiltration and evapotranspiration, and maintain tree health. [ABSTRACT FROM AUTHOR]

Background: Published literature detailing the effects of heatwaves on human health is readily available. However literature describing the effects of heat on morbidity is less plentiful, as is research describing events in the southern hemisphere and Australia in particular. To identify susceptible populations and direct public health responses research must move beyond description of the temperature morbidity relationship to include social and spatial risk factors. This paper presents a spatial and socio-demographic picture of the effects of hot weather on persons admitted to hospital with acute myocardial infarction (AMI) in Melbourne. Results: In this study, the use of a spatial and socio-economic perspective has identified two groups within the population that have an increased 'risk' of AMI admissions to hospital during hot weather. AMI increases during hot weather were only identified in the most disadvantaged and the least disadvantaged areas. Districts with higher AMI admissions rates during hot weather also had larger proportions of older residents. Age provided some explanation for the spatial distribution of AMI admissions on single hot days whereas socio-economic circumstance did not. During short periods (3-days) of hot weather, age explained the spatial distribution of AMI admissions slightly better than socioeconomic circumstance. Conclusions: This study has demonstrated that both age and socioeconomic inequality contribute to AMI admissions to hospital in Melbourne during hot weather. By using socioeconomic circumstance to define quintiles, differences in AMI admissions were quantified and demographic differences in AMI admissions were described. Including disease specificity into climate-health research methods is necessary to identify climate-sensitive diseases and highlight the burden of climate-sensitive disease in the community. Cardiac disease is a major cause of death and disability and identifying cardiac-specific climate thresholds and the spatio-demographic characteristics of vulnerable groups within populations is an important step towards preventative health care by informing public health officials and providing a guide for an early heat-health warning system. This information is especially important under current climatic conditions and for assessing the future impact of climate change. [ABSTRACT FROM AUTHOR]

Background: Seasonal patterns in cardiac disease in the northern hemisphere are well described in the literature. More recently age and gender differences in cardiac mortality and to a lesser extent morbidity have been presented. To date spatial differences between the seasonal patterns of cardiac disease has not been presented. Literature relating to seasonal patterns in cardiac disease in the southern hemisphere and in Australia in particular is scarce. The aim of this paper is to describe the seasonal, age, gender, and spatial patterns of cardiac disease in Melbourne Australia by using acute myocardial infarction admissions to hospital as a marker of cardiac disease. Results: There were 33,165 Acute Myocardial Infarction (AMI) admissions over 2186 consecutive days. There is a seasonal pattern in AMI admissions with increased rates during the colder months. The peak month is July. The admissions rate is greater for males than for females, although this difference decreases with advancing age. The maximal AMI season for males extends from April to November. The difference between months of peak and minimum admissions was 33.7%. Increased female AMI admissions occur from May to November, with a variation between peak and minimum of 23.1%. Maps of seasonal AMI admissions demonstrate spatial differences. Analysis using Global and Local Moran's I showed increased spatial clustering during the warmer months. The Bivariate Moran's I statistic indicated a weaker relationship between AMI and age during the warmer months. Conclusion: There are two distinct seasons with increased admissions during the colder part of the year. Males present a stronger seasonal pattern than females. There are spatial differences in AMI admissions throughout the year that cannot be explained by the age structure of the population. The seasonal difference in AMI admissions warrants further investigation. This includes detailing the prevalence of cardiac disease in the community and examining issues of social and environmental justice. [ABSTRACT FROM AUTHOR]

Most regions of Australia are exposed to hot summers and regular extreme heat events; and numerous studies have associated high ambient temperatures with adverse health outcomes in Australian cities. Extreme environmental heat can trigger the onset of acute conditions, including heat stroke and dehydration, as well as exacerbate a range of underlying illnesses. Consequently, in the absence of adaptation, the associated mortality and morbidity are expected to increase in a warming climate, particularly within the vulnerable populations of the elderly, children, those with chronic diseases, and people engaged in physical labour in noncooled environments. There is a need for further research to address the evidence needs of public health agencies in Australia. Building resilience to extreme heat events, especially for the most vulnerable groups, is a priority. Public health professionals and executives need to be aware of the very real and urgent need to act now. [ABSTRACT FROM PUBLISHER]

Background: Several studies have identified the association between ambient temperature and mortality; however, several features of temperature behavior and their impacts on health remain unresolved. We obtain daily counts of nonaccidental all-cause mortality data in the elderly (65 + years) and corresponding meteorological data for Melbourne, Australia during 1999 to 2006. We then characterize the temporal behavior of ambient temperature development by quantifying the rates of temperature change during periods designated by pre-specified windows ranging from 1 to 30 days. Finally, we evaluate if the association between same day temperature and mortality in the framework of a Poisson regression and include our temperature trajectory variables in order to assess if associations were modified by the nature of how the given daily temperature had evolved., Results: We found a positive significant association between short-term mortality risk and daily average temperature as mortality risk increased 6 % on days when temperatures were above the 90th percentile as compared to days in the referent 25-75th. In addition, we found that mortality risk associated with daily temperature varied by the nature of the temperature trajectory over the preceding twelve days and that peaks in mortality occurred during periods of high temperatures and stable trajectories and during periods of increasing higher temperatures and increasing trajectories., Conclusion: Our method presents a promising tool for improving understanding of complex temperature health associations. These findings suggest that the nature of sub-monthly temperature variability plays a role in the acute impacts of temperature on mortality; however, further studies are suggested.

Most regions of Australia are exposed to hot summers and regular extreme heat events; and numerous studies have associated high ambient temperatures with adverse health outcomes in Australian cities. Extreme environmental heat can trigger the onset of acute conditions, including heat stroke and dehydration, as well as exacerbate a range of underlying illnesses. Consequently, in the absence of adaptation, the associated mortality and morbidity are expected to increase in a warming climate, particularly within the vulnerable populations of the elderly, children, those with chronic diseases, and people engaged in physical labour in noncooled environments. There is a need for further research to address the evidence needs of public health agencies in Australia. Building resilience to extreme heat events, especially for the most vulnerable groups, is a priority. Public health professionals and executives need to be aware of the very real and urgent need to act now.