Comparison of life loss per death attributable to ambient temperature among various development regions: a nationwide study in 364 locations in China

Abstract

Background Several studies have investigated the associations between ambient temperature and years of life lost (YLLs), but few focused on the difference of life loss attributable to temperature among different socioeconomic development levels. Objectives We investigated the disparity in temperature-YLL rate relationships and life loss per death attributable to nonoptimal temperature in regions with various development levels. Methods Three hundred sixty-four Chinese counties or districts were classified into 92 high-development regions (HDRs) and 272 low-development regions (LDRs) according to socioeconomic factors of each location using K-means clustering approach. We used distributed lag non-linear models (DLNM) and multivariate meta-analysis to estimate the temperature-YLL rate relationships. We calculated attributable fraction (AF) of YLL and temperature-related average life loss per death to compare mortality burden of temperature between HDRs and LDRs. Stratified analyses were conducted by region, age, sex and cause of death. Results We found that non-optimal temperatures increased YLL rates in both HDRs and LDRs, but all subgroups in LDRs were more vulnerable. The disparity of cold effects between HDRs and LDRs was significant, while the difference in heat effect was insignificant. The overall AF of non-optimal temperature in LDRs [AF = 12.2, 95% empirical confidence interval (eCI):11.0–13.5%] was higher than that in HDRs (AF = 8.9, 95% eCI: 8.3–9.5%). Subgroups analyses found that most groups in LDRs had greater AFs than that in HDRs. The average life loss per death due to non-optimal temperature in LDRs (1.91 years, 95% eCI: 1.72–2.10) was also higher than that in HDRs (1.32 years, 95% eCI: 1.23–1.41). Most of AFs and life loss per death were caused by moderate cold in both HDRs and LDRs. Conclusions Mortality burden caused by temperature was more significant in LDRs than that in HDRs, which means that more attention should be paid to vulnerable populations in LDRs in planning adaptive strategies.

Time trends in cardiovascular disease mortality attributable to non-optimal temperatures in China: An age-period-cohort analysis using the Global Burden of Disease Study 2019

“…Previous studies had generally found that the death burden caused by low temperatures was higher than that of high temperatures ( 12 – 14 , 16 , 27 ). A study in China showed that 8.86% of CVD deaths were caused by low temperatures, and 0.17% were caused by high temperatures ( 16 ).…”

Mortality burden attributable to high and low ambient temperatures in China and its provinces: Results from the Global Burden of Disease Study 2019

“…Our study found that most of mortality burden attributable to non-optimal temperatures was driven by low temperatures, which is consistent with previous studies. 2 , 5 , 6 , 8 , 18 , 19 Chen et al. reported in a study including 272 main Chinese cities that the PAFs attributable to low and high temperatures were 11·62% and 2·71%, respectively.…”

The association of ambient temperature variability with blood pressure in southern China

“…Daily mass concentrations of air pollutants were collected from the China National Environmental Monitoring Centre, and a land-use-regression model was used to obtain more accurate daily PM 2.5 , SO 2 , and O 3 at each location of Guangdong Province, which was similar to Liu's study [25]. Based on the residential districts/counties of each participant, the daily mass concentrations of air pollutants were extracted.…”