Aug. 7, 2006
 
HEALTH: Mean Streets Indeed for Elderly During a Heat Wave
 
By Lee Bowman
Scripps Howard News Service
 
The elderly are at greater risk of death from heat waves in big-city neighborhoods having few businesses where seniors feel safe fleeing high temperatures, a new study suggests.
 
Other research has shown that the elderly in low-income neighborhoods are most at risk of dying in a heat wave. But the new study, based on an analysis of deaths during the 1995 Chicago heat wave, shows that there are specific aspects of disadvantaged areas that leave residents more vulnerable.
 
"The neighborhoods with the highest mortality rates were less likely to have stores or other businesses where older people felt comfortable going to, even in the worst heat," said Christopher Browning, an associate professor of sociology at Ohio State University and lead author of the study.
 
"They stayed bunkered in their apartments where they were most at risk for heat-related illnesses that led to death."
 
The report is being published in the August issue of the American Sociological Review.
 
In an average year, some 200 older Americans die of heat-related health problems, according to the American Geriatrics Society.
 
Seniors are at particular risk for developing heat-related illnesses because the body's natural ability to cool itself declines with age, including poor blood circulation and less efficient sweat glands. Seniors are less likely to feel thirsty or hot, even when they're dangerously overheated or dehydrated.
 
A variety of medical conditions affecting the heart, lungs and kidneys increase vulnerability to heat, particularly in the elderly. Being on a restricted diet and taking medications, including diuretics, sedatives, tranquilizers and some heart and blood-pressure drugs that may limit the ability to perspire, also may boost one's vulnerability.
 
Nearly 800 people in Chicago -- mostly elderly people living alone -- died in a week in the midst of the July 1995 heat wave. During several days of that week, the temperature was over 100, with a heat index of 126 reported for July 13.
 
Browning and colleagues at the University of Chicago and Western Washington University in Bellingham, Wash., reviewed data to examine how neighborhood conditions in Chicago were linked to mortality during the heat wave.
 
Most heat-related deaths occurred in lower-income neighborhoods. But factors often associated with such areas -- minority racial makeup, higher rates of murder and other crime, even the extent of graffiti -- didn't show as strong a link to heat-related mortality as did the condition and type of businesses in the area.
 
"Those neighborhoods were in commercial decline," Browning explained. "A lot of the businesses were boarded up or in poor condition. Those that were left were bars and liquor stores, or youth-oriented places that would not attract elderly customers.
 
"They didn't promote an environment where people felt comfortable walking around, and older people were probably fearful to walk into some of these places."
 
Most of the time the strategy of staying at home was probably safer for the elderly, even during July in other years. "But during an extreme heat wave, this left them vulnerable," Browning said.
 
The researchers also noted that even in low-income neighborhoods, seniors are generally better off if the community has higher levels of what is termed "collective efficacy" -- the extent to which people trust each other, help each other and feel responsible for one another.
 
However, during that week in 1995, even living in a neighborhood where people normally watched out for one another was no protection. "We think that neighbors just didn't realize how vulnerable the elderly were while this heat wave was going on," Browning said.
 
"More people probably would have helped, but they just didn't know. The impact didn't become clear until it was too late."
 
Browning said that after the disaster, people in Chicago may be more prepared to look after elderly neighbors during extreme heat, but other areas may not be so aware.
 
Experts on aging note that temperatures don't have to break 100 to put seniors at risk -- hyperthermia deaths can occur when the mercury's in the 90s or even lower, depending on one's physical condition and surroundings.
 
On the Net: http://www.niapublications.org/agepages/hyperther.asp
 
www.asanet.org
 
Contact Lee Bowman at BowmanL@SHNS.com. Distributed by Scripps Howard News Service, http://www.shns.com