Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Aug 16, 2023
Open Peer Review Period: Aug 15, 2023 - Aug 29, 2023
Date Accepted: May 28, 2024
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Mortality burden and its spatial heterogeneity due to ambient temperature in a low latitude plateau area: a time-series study in all 129 counties of Yunnan province
ABSTRACT
Background:
The relationship between climate change and human health has become one of the major worldwide public health issues.
Objective:
This study evaluated the effect of ambient temperature on the mortality burden of non-accidental deaths in Yunnan Province and further explored its spatial heterogeneity among different regions.
Methods:
We collected mortality and meteorological data from all 129 counties in Yunnan Province from 2014 to 2020, and 16 prefecture-level cities were analyzed as units. A distributed lagged nonlinear model was utilized to estimate the effect of temperature exposure on years of life lost (YLL) for non-accidental deaths in each prefecture-level city. The effect of ambient temperature on the total attributable fraction (AF) for death was calculated. A multivariate meta-analysis was applied to obtain an overall aggregated estimate of effects and spatial heterogeneity among 16 prefecture-level cities was evaluated by adjusting the city-specific geographical characteristics, demographic characteristics, economic factors, and health resources factors.
Results:
The temperature-YLL association was nonlinear and followed slide-shaped curves in all regions. The cumulative extreme cold and mild cold effects along lag 0–21 days on YLL due to non-accidental deaths were 166.96 (95% empirical confidence interval [eCI] 45.76–288.17) and 47.57 (95% eCI 3.58–91.55), respectively. The AF for non-accidental deaths due to daily mean temperature was 5.99% (95% eCI 3.15–8.37). Cold temperature was responsible for most of the mortality burden (4.29% [95% eCI 2.78–5.67]), while the burden due to heat was low and non-significant. The vulnerable subpopulations include males, age <75, farmers, ethnic minorities, and patients with cardiovascular or respiratory diseases. Moreover, 48.2% heterogeneity in the effect of mean temperature on YLL was found after considering the inherent characteristics of the 16 prefecture-level cities.
Conclusions:
This study suggests that the cold effect dominated the total effect of temperature on mortality burden, and its effect was heterogeneous among different regions, which provides a basis for spatial planning and health policy formulation for disease prevention.
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