How urban characteristics affect vulnerability to heat and cold: a multi-country analysis
Por:
Sera F, Armstrong B, Tobias A, Vicedo-Cabrera, A, Åström C, Bell ML, Chen BY, de Sousa Zanotti Stagliorio Coelho M, Matus Correa P, Cruz JC, Dang TN, Hurtado-Diaz M, Do Van D, Forsberg B, Guo YL, Guo Y, Hashizume M, Honda Y, Iñiguez C, Jaakkola JJK, Kan H, Kim H, Lavigne E, Michelozzi P, Ortega NV, Osorio S, Pascal M, Ragettli MS, Ryti NRI, Saldiva PHN, Schwartz J, Scortichini M, Seposo X, Tong S, Zanobetti A and Gasparrini A
Publicada:
1 ago 2019
Ahead of Print:
27 feb 2019
Resumen:
Background The health burden associated with temperature is expected to increase due to a warming climate. Populations living in cities are likely to be particularly at risk, but the role of urban characteristics in modifying the direct effects of temperature on health is still unclear. In this contribution, we used a multi-country dataset to study effect modification of temperature-mortality relationships by a range of city-specific indicators.
Methods We collected ambient temperature and mortality daily time-series data for 340 cities in 22 countries, in periods between 1985 and 2014. Standardized measures of demographic, socio-economic, infrastructural and environmental indicators were derived from the Organisation for Economic Co-operation and Development (OECD) Regional and Metropolitan Database. We used distributed lag non-linear and multivariate meta-regression models to estimate fractions of mortality attributable to heat and cold (AF%) in each city, and to evaluate the effect modification of each indicator across cities.
Results Heat- and cold-related deaths amounted to 0.54% (95% confidence interval: 0.49 to 0.58%) and 6.05% (5.59 to 6.36%) of total deaths, respectively. Several city indicators modify the effect of heat, with a higher mortality impact associated with increases in population density, fine particles (PM2.5), gross domestic product (GDP) and Gini index (a measure of income inequality), whereas higher levels of green spaces were linked with a decreased effect of heat.
Conclusions This represents the largest study to date assessing the effect modification of temperature-mortality relationships. Evidence from this study can inform public-health interventions and urban planning under various climate-change and urban-development scenarios.
Filiaciones:
Sera F:
Department of Public Health, Environments and Society, London School of Hygiene Tropical Medicine, London, UK
Armstrong B:
Department of Public Health, Environments and Society, London School of Hygiene Tropical Medicine, London, UK
Tobias A:
Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
:
Department of Public Health, Environments and Society, London School of Hygiene Tropical Medicine, London, UK
Åström C:
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
Bell ML:
School of Forestry and Environmental Studies, Yale University, New Haven, CT, USA
Chen BY:
National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
de Sousa Zanotti Stagliorio Coelho M:
Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
Matus Correa P:
Department of Public Health, Universidad de los Andes, Santiago, Chile
Cruz JC:
Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
Dang TN:
Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy of Ho Chi Minh City, Ho Chi Minh City, Vietnam
Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
Hurtado-Diaz M:
Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
Do Van D:
Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy of Ho Chi Minh City, Ho Chi Minh City, Vietnam
Forsberg B:
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
Guo YL:
National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
Environmental and Occupational Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
Guo Y:
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Hashizume M:
Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
Honda Y:
Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
:
Department of Statistics and Computational Research, Environmental Health Research Joint Reseaech Unit FISABIO-UV-UJI CIBERESP, University of València, València, Spain
Jaakkola JJK:
Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
Kan H:
Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
Kim H:
Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
Lavigne E:
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
Air Health Science Division, Health Canada, Ottawa, Canada
Michelozzi P:
Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
Ortega NV:
Department of Public Health, Universidad de los Andes, Santiago, Chile
Osorio S:
Department of Environmental Health, University of São Paulo, São Paulo, Brazil
Pascal M:
Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
Ragettli MS:
Swiss Tropical and Public Health Institute, Basel, Switzerland
University of Basel, Basel, Switzerland
Ryti NRI:
Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
Saldiva PHN:
Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
Schwartz J:
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Scortichini M:
Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
Seposo X:
Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
Tong S:
Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, Shanghai, China
School of Public Health and Institute of Environment and Human Health, Anhui Medical University, Hefei, China
School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
Zanobetti A:
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Gasparrini A:
Department of Public Health, Environments and Society, London School of Hygiene Tropical Medicine, London, UK
Bronze, Green Accepted, Green Submitted
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