Geographical variations in seasonal mortality across the United States: A bioclimatological approach

Human mortality exhibits a strong seasonal pattern with deaths in winter far exceeding those in the summer. Surprisingly, this seasonal trend is evident in all major cities across the United States, seemingly independent of climate. While the pattern itself is clear, its magnitude varies considerably across space, and it is not known if there is regional homogeneity among cities. Additionally, the causal mechanisms relating to pattern variability are not clearly understood.;The findings here indicate that the seasonality of mortality exhibits strong spatial variation with the largest seasonal mortality amplitudes found in the southwestern United States and the smallest in the North, along with South Florida. In addition, there have been changes in the timing of seasonal mortality; the date of maximum mortality is occurring increasingly early in the year. Demographics also play an important role with women, Whites, and the elderly exhibiting the strongest seasonality in mortality. There is a strong connection between respiratory disease and other causes of death, implying a cause-effect relationship. Meteorology also plays an important role in seasonal mortality; variations in the frequency of certain air masses were associated with changes in the timing and amplitude of seasonal mortality. Finally, there were strong intra-regional similarities that exist among the examined cities, implying that environmental factors are more important than social factors in determining seasonal mortality response.;This work begins to fill a large gap within the scientific literature concerning the causes, geographic variation, and meteorological influences on seasonal mortality. Additionally, these results will increase the forecasting capabilities of determining when and where winter mortality will reach unusually high levels.;The goal of this study is to conduct a comprehensive geographic analysis of seasonal mortality across the United States, to uncover systematic regional differences in such mortality, and to determine what role weather plays in impacting seasonal mortality rates. Unique seasonal mortality curves were created for 28 Metropolitan Statistical Areas across the United States, and the amplitude and timing of mortality peaks were determined. In addition, seasonality was calculated for different demographic groups and causes of death. Meteorological factors were also evaluated as possible causal mechanisms.