@prefix dcterms: <http://purl.org/dc/terms/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
@prefix gcis: <http://data.globalchange.gov/gcis.owl#> .
@prefix cito: <http://purl.org/spar/cito/> .
@prefix biro: <http://purl.org/spar/biro/> .

<http://52.38.26.42:8080/report/usgcrp-climate-human-health-assessment-2016/chapter/temperature-related-death-and-illness/finding/even-small-differences-seasonal-average-temperatures-result-illness-death>
   dcterms:identifier "even-small-differences-seasonal-average-temperatures-result-illness-death";
   gcis:findingNumber "2.2"^^xsd:string;
   gcis:findingStatement "Days that are hotter than usual in the summer or colder than usual in the winter are both associated with increased illness and death [Very High Confidence]. Mortality effects are observed even for small differences from seasonal average temperatures [High Confidence]. Because small temperature differences occur much more frequently than large temperature differences, not accounting for the effect of these small differences would lead to underestimating the future impact of climate change [Likely, High Confidence]."^^xsd:string;
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   gcis:isFindingOf <http://52.38.26.42:8080/report/usgcrp-climate-human-health-assessment-2016>;

## Properties of the finding:
   gcis:findingProcess "The chapter was developed through technical discussions of relevant evidence and expert deliberation by the report authors at several workshops, teleconferences, and email exchanges. The authors considered inputs and comments submitted by the public, the National Academies of Sciences, and Federal agencies. For additional information on the overall report process, see <a href=\"https://health2016.globalchange.gov/node/103\">Appendices 2</a>&ndash;<a href=\"https://health2016.globalchange.gov/node/104\">3</a>.<br/><br/>The content of this chapter was determined after reviewing the collected literature. The authors determined that there was substantial literature available to characterize both observed and projected mortality from elevated temperatures, with sufficient literature available to also characterize mortality from cold as well as cold-related hospitalizations and illness. Populations of concern were also considered to be a high priority for this chapter. As discussed in the chapter, there were limitations in terms of the state of the literature on understanding how future adaptation will influence climate-related changes in temperature-related mortality, addressing the impact of temperature on rural populations, and examining health-related endpoints other than mortality and morbidity."^^xsd:string;
   
   gcis:descriptionOfEvidenceBase "Two well-recognized conclusions from the literature are that extreme temperatures lead to illness and premature death and that these extreme temperatures are best described in relation to local average seasonal temperatures rather than absolute temperature values. Epidemiological studies find an increase in mortality at temperatures that are high related to the local average. Based on absolute temperatures, Anderson and Bell 2011 found that cities in the South and Southeast were the least sensitive to heat, demonstrating acclimatization. <br/><br/> Illness has been linked with hot daily average temperature and apparent temperature, among other metrics. Across studies, adverse health episodes were most strongly associated with exposures to high temperatures that occurred on the same day or the previous day. However, a cumulative effect of heat was also observed at periods of up to one week after exposure, tapering off beyond seven days. Cardiovascular and respiratory illness has been most commonly examined in relation to extreme heat, but the association is more varied for illness than for mortality due to effects across age groupsand differences in morbidity risk associated with emergency room records versus hospital admissions. <br/><br/> The evidence for mortality is clearest for extreme temperatures, as addressed in threshold-based studies, but studies that account for smaller changes in temperature found mortality changes even for small deviations of temperature. This is consistent with studies showing a U-shaped relationship of temperature and mortality&mdash;while there may be some plateau near the optimal temperature, the plateau is often small, and not always coincident with the seasonal average temperature. However, some of the individuals who die in response to elevated temperatures were already near death, and so the temperature event is sometimes considered to have &ldquo;displaced&rdquo; the death by a matter of days rather than created an additional death. Studies have found that this effect is generally below 50% of the total deaths, and is much smaller than that (10% or less) for the most extreme events, such as the 2003 European heat wave. In contrast, one recent study found that in seven U.S. cities mortality displacement was greater than 80% for small temperature deviations and around 50% even for the 3% of warmest events in the study sample."^^xsd:string;
   
   gcis:assessmentOfConfidenceBasedOnEvidence "There is <b>very high confidence</b> in the relationship between extreme temperatures and premature deaths due to the consistency and strength of the literature, particularly given the different study designs that produce this result. There is <b>high confidence</b> that small temperature deviations from normal temperatures contribute to premature mortality due to high agreement among those studies that have examined the issue. Though some studies indicate that for these small temperature differences, mortality displacement may play a larger role than for more extreme temperatures. Fewer studies have examined the role of these smaller temperature differences in projections, but the directionality of the effect is clear, so the determination of the authors was that not including this effect would likely lead to an underestimate of future mortality, with <b>high confidence</b>."^^xsd:string;
   
   gcis:newInformationAndRemainingUncertainties "This finding reflects consideration of a number of recent studies not referenced in the recent 2014 NCA. There is a consensus of studies linking extreme temperatures and mortality, and a growing body of literature demonstrating that smaller differences in temperature are also linked with mortality. However, the mortality displacement effect, and the fact that deaths that do not occur during an identified heat wave are less likely to be directly attributed to extreme heat, contribute to continuing uncertainty about the magnitude of the effect of temperature on mortality."^^xsd:string;

   a gcis:Finding .

## This finding cites the following entities:


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