Heat-Related Illness Is Associated with Lack of Air Conditioning and Pre-Existing Health Problems in Detroit, Michigan, USA: A Community-Based Participatory Co-Analysis of Survey Data

• Main Authors: Jacqueline E. Cardoza, Carina J. Gronlund, Justin Schott, Todd Ziegler, Brian Stone, Marie S. O’Neill
• Format: Article
• Language: English
• Published: MDPI AG 2020-08-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: climate change; heat wave; heat exhaustion; community-based participatory research
• Online Access: https://www.mdpi.com/1660-4601/17/16/5704

The objective of the study was to investigate, using academic-community epidemiologic co-analysis, the odds of reported heat-related illness for people with (1) central air conditioning (AC) or window unit AC versus no AC, and (2) fair/poor vs. good/excellent reported health. From 2016 to 2017, 101 Detroit residents were surveyed once regarding extreme heat, housing and neighborhood features, and heat-related illness in the prior 5 years. Academic partners selected initial confounders and, after instruction on directed acyclic graphs, community partners proposed alternate directed acyclic graphs with additional confounders. Heat-related illness was regressed on AC type or health and co-selected confounders. The study found that heat-related illness was associated with no-AC (<i>n</i> = 96, odds ratio (OR) = 4.66, 95% confidence interval (CI) = 1.22, 17.72); living ≤5 years in present home (<i>n</i> = 57, OR = 10.39, 95% CI = 1.13, 95.88); and fair/poor vs. good/excellent health (<i>n</i> = 97, OR = 3.15, 95% CI = 1.33, 7.48). Co-analysis suggested multiple built-environment confounders. We conclude that Detroit residents with poorer health and no AC are at greater risk during extreme heat. Academic-community co-analysis using directed acyclic graphs enhances research on community-specific social and health vulnerabilities by identifying key confounders and future research directions for rigorous and impactful research.