Identifying older adults at risk for heat-related illness is crucial for healthcare systems to effectively prepare for and address the increasing incidence of heat-related emergencies. A recent study published in JAMA Network Open highlights the importance of tailoring health interventions based on localized data.

Nationally, heat-related mortality has surged by nearly 17% annually since 2016, prompting cities like New York to implement preventive measures such as heat alerts and cooling centers. Due to physiological changes and medication effects, older adults face heightened risks for conditions like heat stroke and other complications. The study performed at the NYU Grossman School of Medicine utilized electronic health record (EHR) data from two NYC emergency departments (EDs) to analyze heat-associated illnesses in patients aged 65 and older.

Research Findings

This investigation revealed significant insights regarding the temperature thresholds at which older adults exhibit increased risks of heat-associated emergency department utilization. The study focused on patients visiting two EDs that served different demographic populations:

ED Location Population Density Key Findings
ED-1 Socioeconomically vulnerable, predominantly minority Risk began at a daily heat index maximum of 66°F, peaking between 90°F and 101°F.
ED-2 Higher-income, more white patients No significant association between heat and ED visits noted.

The risk profile observed at ED-1 significantly contrasts with that of ED-2, which serves a more affluent population, indicating that social and economic factors substantially modify health outcomes in heat emergencies.

Implications for Health Systems

Dr. Alexander Azan, the study's senior author, emphasized the necessity for healthcare systems to adapt their interventions based on detailed local data instead of employing generalized advisories which may not accurately reflect the risk levels for specific populations:

“Now is the time for health care systems to prepare… our hope is that other health care systems will leverage their own electronic health record data to identify heat thresholds at which their patients are most at risk.”

The findings suggest that if heat advisories were triggered on days exceeding 90°F, approximately 116 ED visits could have been prevented at the vulnerable ED-1 site during the study period. This emphasizes the critical need for evidence-informed decision-making in public health interventions.

Future Directions and Recommendations

To effectively reduce heat-related morbidity and mortality among older adults, the researchers propose several targeted interventions:

  • Localized Heat Advisory Thresholds: Health systems should establish specific heat exposure thresholds for vulnerable populations based on EHR data.
  • Improved Community Outreach: Develop educational programs about heat safety tailored to older adults, particularly in low-income neighborhoods.
  • Enhanced Cooling Infrastructure: Increase accessibility to cooling centers during extreme heat events.

Conclusion

As extreme heat events become more prevalent, understanding the unique vulnerabilities of older adults is essential for preventing heat-related emergencies. This research not only highlights existing gaps in current health warning systems but also serves as a call to action for healthcare systems to employ data-driven strategies to mitigate risks.

Publication Details

Extreme Urban Heat and Emergency Department Visits in Older Adults, JAMA Network Open (2026).

Read the full article here.

Literature Cited

  • Azan, A., et al. (2026). Extreme Urban Heat and Emergency Department Visits in Older Adults. JAMA Network Open.

This document highlights the increasing importance of identifying risk factors among older adults related to environmental changes, and calls for strategic actions in healthcare management to ensure the safety and well-being of this vulnerable population.