The Toronto–Windsor corridor of Southern Ontario, Canada, experiences hot and humid weather conditions in summer, thus exposing
the population to heat stress and a greater risk of mortality. In the event of a climate change, heat-stress conditions may
become more frequent and severe in Southern Ontario. To assess the impact of summer weather on health, we analyzed heat-related
mortality in the elderly (older than 64 years) in the metropolitan areas of Windsor, London, Kitchener-Waterloo-Cambridge,
Hamilton, and Toronto for a 17-year period. Demographic, socioeconomic, and housing factors were also evaluated to assess
their effect on the potential of the population to adapt and their vulnerability to heat stress. Heat-stress days were defined
as those with an apparent temperature (heat index) above 32°C. Mortality among the elderly was significantly higher on heat-stress
days than on non-heat-stress days in all cities except Windsor. The strongest relationships occurred in Toronto and London,
followed by Hamilton. Cities with the greatest heat-related mortality have relatively high levels of urbanization and high
costs of living. Even without the warming induced by a climate change, (1) vulnerability is likely to increase as the population
ages, and (2) ongoing urban development and sprawl are expected to intensify heat-stress conditions in Southern Ontario. Actions
should be taken to reduce vulnerability to heat stress conditions, and to develop a comprehensive hot weather watch/warning
system for the region.
Keywords Heat-related mortality - Apparent temperature - Heat stress - Southern Ontario - Canada
Received: 9 August 1999 / Revised: 9 March 2000 / Accepted: 1 May 2000