Evaluating the potential public health impacts of the Toronto cold weather program

TitleEvaluating the potential public health impacts of the Toronto cold weather program
Publication TypeJournal Article
Year of Publication2019
AuthorsBenmarhnia T., Zhao X., Wang J., Macdonald M, Chen H.
Volume127
Pagination381-386
Date Published2019/06
Type of ArticleArticle
ISBN Number0160-4120
Accession NumberWOS:000467383500037
Keywordsambient-temperature; cities; Environmental Sciences & Ecology; heat; morbidity; mortality; spells
Abstract

Background: Extreme cold weather alert programs have been implemented in some areas to address the significant health impacts of exposure to cold. One such program is the Toronto Cold Weather Program (TCWP) that was implemented in the City of Toronto since 1996 to protect the public from extreme weather conditions. In this paper, we aim to evaluate the effectiveness of the TCWP in reducing mortality and morbidity outcomes related to cold temperatures. Methods: We applied a quasi-experimental study design using the Difference-in-Differences method coupled with propensity-score-matching to determine the effect of the TCMP on daily hospitalizations and deaths due to cardiovascular disease (CVD), coronary heart disease (CHD) or cerebrovascular disease, using two complementary analytical approaches. Results: Overall, the analysis did not detect an impact on reduced mortality/morbidity in the City of Toronto from the TCMP. For example, we obtained a Risk Difference (RD) of -0.88 (per 1,000,000 people) (95% CI: -3.27 to 1.51) and a Risk Ratio (RR) of 0.98 (95% CI: 0.91 to 1.05) people for CVD hospitalizations. Conclusions: The TCWP was not found to be effective in reducing cold related mortality and morbidity which demonstrates the importance of improving existing policies related to cold in Canada and other countries.

DOI10.1016/j.envint.2019.03.042
Student Publication: 
No
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