Urbanization Level and Vulnerability to Heat-Related Mortality in Jiangsu Province, China

Chen, Kai; Zhou, Lian; Chen, Xiaodong; Ma, Zongwei; Liu, Yang; Huang, Lei; Bi, Jun; Kinney, Patrick L.

doi:10.1289/ehp204

Cited by 92 publications

(70 citation statements)

References 38 publications

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“…Our study showed stronger heat effects in rural counties than in urban counties, which was in line with a previous study39. Moreover, a recent provincial investigation conducted in Jiangsu, China found that, less urban counties showed a higher pooled heat-related mortality risk with 1.43 (95% Posterior Intervals: 1.36–1.50) compared with 1.26 (1.23–1.30) in more urban counties33. These inconsistent results highlight a need to comprehensively understand the contributing proportion attributable to those independent factors influencing heat-related mortality, in order to design county-targeted preventive and control strategies.…”

Section: Discussionsupporting

confidence: 92%

Impact of temperature on mortality in Hubei, China: a multi-county time series analysis

Zhang

Bao

et al. 2017

Sci Rep

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We examined the impact of extreme temperatures on mortality in 12 counties across Hubei Province, central China, during 2009–2012. Quasi-Poisson generalized linear regression combined with distributed lag non-linear model was first applied to estimate county-specific relationship between temperature and mortality. A multivariable meta-analysis was then used to pool the estimates of county-specific mortality effects of extreme cold temperature (1st percentile) and hot temperature (99th percentile). An inverse J-shaped relationship was observed between temperature and mortality at the provincial level. Heat effect occurred immediately and persisted for 2–3 days, whereas cold effect was 1–2 days delayed and much longer lasting. Higher mortality risks were observed among females, the elderly aged over 75 years, persons dying outside the hospital and those with high education attainment, especially for cold effects. Our data revealed some slight differences in heat- and cold- related mortality effects on urban and rural residents. These findings may have important implications for developing locally-based preventive and intervention strategies to reduce temperature-related mortality, especially for those susceptible subpopulations. Also, urbanization should be considered as a potential influence factor when evaluating temperature-mortality association in future researches.

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Section: Discussionsupporting

confidence: 92%

Impact of temperature on mortality in Hubei, China: a multi-county time series analysis

Zhang

Bao

et al. 2017

Sci Rep

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“…Moreover, it is less prone to measurement error [37]. Interestingly, other studies [20,47] reported similar results regardless of the temperature metric used.…”

Section: Discussionmentioning

confidence: 90%

Assessing Heat-Related Mortality Risks among Rural Populations: A Systematic Review and Meta-Analysis of Epidemiological Evidence

Odame

Liu

Zheng

et al. 2018

IJERPH

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Most epidemiological studies of high temperature effects on mortality have focused on urban settings, while heat-related health risks in rural areas remain underexplored. To date there has been no meta-analysis of epidemiologic literature concerning heat-related mortality in rural settings. This study aims to systematically review the current literature for assessing heat-related mortality risk among rural populations. We conducted a comprehensive literature search using PubMed, Web of Science, and Google Scholar to identify articles published up to April 2018. Key selection criteria included study location, health endpoints, and study design. Fourteen studies conducted in rural areas in seven countries on four continents met the selection criteria, and eleven were included in the meta-analysis. Using the random effects model, the pooled estimates of relative risks (RRs) for all-cause and cardiovascular mortality were 1.030 (95% CI: 1.013, 1.048) and 1.111 (95% CI: 1.045, 1.181) per 1 °C increase in daily mean temperature, respectively. We found excess risks in rural settings not to be smaller than risks in urban settings. Our results suggest that rural populations, like urban populations, are also vulnerable to heat-related mortality. Further evaluation of heat-related mortality among rural populations is warranted to develop public health interventions in rural communities.

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“…In addition, many of these studies have focused on urban areas due to the urban heat island effect and high density of susceptible population (Huang et al, 2011; Li et al, 2013). However, there is emerging evidence supporting high risk of heat-related health impacts in nonurban areas (Bennett et al, 2014; Chen et al, 2016; Madrigano et al, 2015; Sarofim et al, 2016; Sheridan and Dolney, 2003). Less is known about how total and cause-specific mortality will change in response to changes in projected heat exposure in nonurban areas.…”

Section: Introductionmentioning

confidence: 99%

“…We applied urban-specific and nonurban-specific ERFs for heat-related total, cardiovascular (including more specific causes of stroke and ischemic heart disease (IHD)), and respiratory (including chronic obstructive pulmonary disease (COPD)) mortality from our previous analysis (Chen et al, 2016) to multiple climate and population projections to estimate the climate change-induced heat-related health burdens in 104 counties of Jiangsu Province, China.…”

Section: Introductionmentioning

confidence: 99%

Impact of climate change on heat-related mortality in Jiangsu Province, China

Chen

Horton

Bader

et al. 2017

Environmental Pollution

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A warming climate is anticipated to increase the future heat-related total mortality in urban areas. However, little evidence has been reported for cause-specific mortality or nonurban areas. Here we assessed the impact of climate change on heat-related total and cause-specific mortality in both urban and rural counties of Jiangsu Province, China in the next five decades. To address the potential uncertainty in projecting future heat-related mortality, we applied localized urban- and nonurban-specific exposure response functions, six population projections including a no population change scenario and five Shared Socioeconomic Pathways (SSPs), and 42 temperature projections from 21 global climate models and two Representative Concentration Pathways (RCPs). Results showed that projected warmer temperatures in 2016–2040 and 2041–2065 will lead to higher heat-related mortality for total non-accidental, cardiovascular, respiratory, stroke, ischemic heart disease (IHD), and chronic obstructive pulmonary disease (COPD) causes occurring annually during May to September in Jiangsu Province, China. Nonurban residents in Jiangsu will suffer from more excess heat-related cause-specific mortality in 2016–2065 than urban residents. Variations across climate models and RCPs dominated the uncertainty of heat-related mortality estimation whereas population size change only had limited influence. Our findings suggest that targeted climate change mitigation and adaptation measures should be taken in both urban and nonurban areas of Jiangsu Province. Specific public health interventions should be focused on the leading causes of death (stroke, IHD, and COPD), whose health burden will be amplified by a warming climate.

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Urbanization Level and Vulnerability to Heat-Related Mortality in Jiangsu Province, China

Cited by 92 publications

References 38 publications

Impact of temperature on mortality in Hubei, China: a multi-county time series analysis

Impact of temperature on mortality in Hubei, China: a multi-county time series analysis

Assessing Heat-Related Mortality Risks among Rural Populations: A Systematic Review and Meta-Analysis of Epidemiological Evidence

Impact of climate change on heat-related mortality in Jiangsu Province, China

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