Mortality and the heat waves 2003 and 2006 in Switzerland. A story about vulnerability

Michel Oris, Université de Genève
Mathias Lerch, Université de Genève

The aim of our communication is twofold. First, we seek to identify subpopulations most vulnerable to death during the last two heat-waves in Switzerland. The analysis will focus on individual profiles defined by sex, age, living arrangement and socioeconomic position as well as on dwelling characteristics (i.e. floor within the building). Second, we investigate to what extent the effect of heat-waves on mortality varies according to context, which we characterize at the communal level using indicators of urban status, economic deprivation, social cohesion, built environment (size and population density, green areas) and communal expenses in health care while controlling for the confounding impact of air pollution (particular matters). The Swiss National Cohort database is mobilized for our research: registered deaths for the years 2001-2008 have been linked to individuals enumerated at the 2000 Census. Working on the exhaustive Swiss population aged above 54 who lived in one of the non-mountainous communes equipped with a meteorological station of MeteoSuisse, we specify a three-level-random-intercept logistic regression model with persons-days nested temporally and spatially (3-day intervals as level-2 and communes as level-3). Through the specification of cross-level interaction effects we are able to identify the beneficial impact of environmental amenities and good practices in public health on heat-wave mortality in Switzerland.