There is a significant increase in cardiovascular and respiratory mortality during periods of high temperature and heat waves and a lack of research on the impact of heat on morbidity, especially for Germany. Against the backdrop of climate change and an increasing frequency of extreme temperatures, the effects of weather on the health of people with common chronic diseases are being investigated. The objective of this study is to provide a foundation for the development of health policy measures designed to address the therapeutic deficits that may arise in association with climate change.

This project consist of two subprojects:

1. A secondary data analysis using anonymised AOK health insurance claims
2. The panel study “Augsburger Klimastudie”

1. Identify disease-promoting environmental factors in Germany that are so far beyond the control of the individual and beyond the personalised advice and therapy of the general practitioner.
2. Provide scientific evidence for targeted health policy measures to reduce the prognostically relevant treatment deficits associated with climate change in Germany.
3. Contribute to the core elements of the health-related heat protection plans: targeted protection of susceptible and vulnerable groups and input to social services, nursing homes, GPs, and hospitals

Subproject 1: Retrospective cohort study

In anonymised health insurance claims from the AOK (provider of statutory medical insurance in Germany) the association between outdoor air temperature and the use of medical services in patients with hypertension, myocardial infarction, heart failure, stroke, type 2 diabetes or COPD across Germany will be examined.

Primary endpoints:

• Inpatient hospital admission/-stay
• Outpatient hospital admission/-stay

Secondary endpoints:

• Contracted medical care („Vertragsärztliche Versorgung“)
• Notifications of incapacity for work by employed insured persons
• Changes/adjustments to medication prescriptions

Environmental exposures will be allocated by the zip code of the insured person.

Environmental data, which are available on a 1kmx1km grid,  comprise e.g. data on air temperature (minimum, maximum and average air temperature, temperature range, hot / cold days), relative humidity, and air pollution data (PM2.5, NO2, O3).

Subproject 2: Panel study “Augsburger Klimastudie"

The study is part of the population-based cohort study KORA (Cooperative Health Research in the Augsburg Region) and will be conducted in the city of Augsburg and its surrounding counties. 

The focus is on patients aged 50 to 80 years with the following specific cardiometabolic and respiratory diseases:

• Hypertension
• Diabetes
• Chronic obstructive pulmonary disease (COPD)

Participants will be invited to 12 study-center visits per person (approximately once per month) for one year and an additional intensification phase per season.

Monthly examinations comprise:

• Blood sample collection
• Self-completion questionnaire (SAF)
• Blood pressure measurement
• Lung function measurement
• Medication update

Additional measurements during the intensification phase:

• Sleep quality and long-term ECG using a Somnowatch
• Questionnaire on sleep quality and well-being
• Activity and symptom diary

Study Funding:

Innovationsausschuss beim Gemeinsamen Bundesausschuss

Funding of the KORA study Center:

Helmholtz Munich

Duration:

01/2024 – 06/2027