Research on Heat Deaths, a Culminating Experience that Won’t Stop

Preparing for Extreme Heat Events: Practices in Identifying Mortality,”  a paper co-authored by  Associate Professor Sabrina McCormick and Environmental Health Science and Policy MPH Alumna Emma Zinsmeister is the first quantitative study to reflect why heat deaths (HDs), and therefore the implications of climate change, are vastly mis-estimated. McCormick is at the forefront of efforts to improve our ability to identify cases of heat-related mortality, which are expected to rise due to climate change.  

Ms. Zinsmeister’s active role in the peer-reviewed research, published in the March-April edition of Health Security, served as the basis of her culminating experience (CE) project. In this instance, the culminating experience was the start of acquiring more skills for Zinsmeister, inspiring more research for other students, and recognizing the need for refined collection and interpretation of evidence to improve preparedness for heat events.

Zinsmeister and McCormick started formulating the idea for the CE based on a research proposal McCormick had in the works for an ethnographic investigation of the social constructs influencing the diagnosis of HDs. (The goal of which was to contribute to the standardization of criteria for classifying mortalities as heat-related.) Zinsmeister took charge of the original data collection to build the database for the project and contribute a regression analysis of the socioeconomic and demographic characteristics of the study subjects.

The study took place in New York City because its health department is very active on heat-health issues and interested in this type research. The project involved analyzing over 1000 NYC death records issued from 2010 to 2012 to identify characteristics that vary between deaths officially categorized as caused by heat wave exposure (oHDs) and those possibly caused by heat (pHDs).

To carry out the research, Zinmeister competed for and received a Capital Connection Fieldwork Award, which covered her transportation, lodging and per diem for the field research. Zinsmeister made several trips to NYC’s Office of the Chief Medical Examiner to access its database of medical examiner records. All data extraction had to be done onsite.

With the guidance of McCormick and RAND Corporation Researcher Jaime Madrigano, ScD, MPH, and the support of GW undergraduate students, Zinsmeister found that the victims of oHDs were more often black and of a younger age than would typically be expected. The team also found that a dearth of evidence to substantiate that an oHD had occurred, using the NYC official criteria. They concluded that deaths from heat waves are not being accurately recorded, leading to a mis-estimation. The team asserts that training regarding the collection and interpretation of evidence may improve preparedness for heat events.

The repercussions of the research are profound; McCormick explains. “There is a gross mis-estimation of who is affected by heat and therefore climate change. There is a need to change regulatory policy of greenhouse gases and improve measurement of their impact on human health. Policymakers rely on this kind of research to protect human health,” she says.

Zinsmeister echoes McCormick’s emphasis on the importance of research and its distribution. Upon completing her CE, Zinsmeister began to look into publishing the research. “It was eye opening how much effort it takes to publish. Progress in the scientific body of evidence is made in small increments,” she observed. The peer-reviewed publishing experience increased her appreciation of the process behind all the peer-reviewed studies that students read in the MPH program. It also exemplified the value of vetting process and the gaining skills to evaluate research.

Zinsmeister came to the project with a strong background.  She completed her MPH studies at GW while working full time at the U.S. Environmental Protection Agency, where she continues to work on climate and energy resources for state, local, and tribal governments. At the EPA, Zinsmeister’s work focuses on creating and delivering peer-exchange opportunities and technical policy and program guidance to help local governments address climate change (i.e., reduce their greenhouse gas emissions, increase their resilience to extreme weather events, and advance their clean energy goals). Zinsmeister’s CE research was done in her private capacity as a student and was not connected to her position at the EPA.

When planning her CE, Zinsmeister recognized the value of the research she often distilled and decided to focus on quantitative research. Her concern about extreme heat as important public health and humanitarian issues, her professional work, combined with the personal experience of dealing with summer weather in Washington, DC, created an interest that dovetailed well with the research on heat deaths that Dr. McCormick was planning.

For students about to embark on their CE, Zinsmeister advises them to be strategic and thoughtful about the skills and experience they want to develop.  She believes that many students create personal pressure to find their own, original idea and they don’t have to. “Look at the experiences of the faculty and the skills that you want to develop. The more you discuss what you want to do, the more opportunities you will learn of,” she recommends. In the end, Zinsmeister came out of her CE with impressive skills and a project that the department and many environmental health professionals finds valuable. Although she had no expectation that the research would lead to a peer-reviewed publishing experience, she is glad that it did.

Zinsmeister’s research with McCormick has resonated and inspired others. After the conclusion of Zinsmeister’s work, Mamta Chaudhari, MPH, went back to New York City and expanded the data set. With the expanded data, Chaudhari completed her CE, “The role of social isolation upon heat deaths: New York City, 2008-2013," last December and hopes to publish a paper on the risk of social isolation.  McCormick reports that interesting findings have emerged.