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Marc G. Weisskopf, PhD, Henry A. Anderson, MD, Seth Foldy, MD, Lawrence P. Hanrahan, PhD, Kathleen Blair, MS, RN, Thomas J. Török, MD and Peter D. Rumm, MD

At the time of this study, Marc G. Weisskopf was with the Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Ga, assigned to the Wisconsin Department of Health and Family Services, Madison. Henry A. Anderson, Lawrence P. Hanrahan, and Peter D. Rumm are with the Wisconsin Department of Health and Family Services, Madison. Seth Foldy and Kathleen Blair are with the City of Milwaukee Health Department, Milwaukee, Wis. Seth Foldy is also with the Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee. Thomas J. Török is with the Epidemiology Program Office, Division of Applied Public Health Training, Centers for Disease Control and Prevention, Atlanta, Ga.

Correspondence: Requests for reprints should be sent to Marc G. Weisskopf, PhD, Harvard School of Public Health, Department of Nutrition, 665 Huntington Ave, Boston, MA 02115 (e-mail: mweissko{at}hsph.harvard.edu).

Objectives. This study examined whether differences in heat alone, as opposed to public health interventions or other factors, accounted for the reduction in heat-related deaths and paramedic emergency medical service (EMS) runs between 1995 and 1999 during 2 heat waves occurring in Milwaukee, Wis.

Methods. Two previously described prediction models were adapted to compare expected and observed heat-related morbidity and mortality in 1999 based on the city's 1995 experience.

Results. Both models showed that heat-related deaths and EMS runs in 1999 were at least 49% lower than levels predicted by the 1995 relation between heat and heat-related deaths or EMS runs.

Conclusions. Reductions in heat-related morbidity and mortality in 1999 were not attributable to differences in heat levels alone. Changes in public health preparedness and response may also have contributed to these reductions.

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