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Luque-García L, Bataineh S, Al-Bakri J, Abdulla FA, Al-Delaimy WK. The heat-mortality association in Jordan: Effect modification by greenness, population density and urbanization level. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 952:176010. [PMID: 39233083 DOI: 10.1016/j.scitotenv.2024.176010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 08/10/2024] [Accepted: 09/01/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND The Middle East is one of the most vulnerable regions to the impacts of climate change, yet evidence of the heat-related mortality remains limited in this area. Our present study investigated the heat-mortality association in Jordan and the potential modifying effect of greenness, population density and urbanization level on the association. METHODS For each of the 42 included districts, daily meteorological and mortality data from 2000 to 2020 were obtained for the warmest months (May to September). First, a distributed lag non-linear model was applied to estimate the district level heat-mortality association, then the district specific estimates were pooled using multivariate meta-regression models to obtain an overall estimate. Last, the modifying effect of district level greenness, population density and urbanization level was examined through subgroup analysis. RESULTS When compared to the minimum mortality temperature (MMT, percentile 0th, 22.20 °C), the 99th temperature percentile exhibited a relative risk (RR) of 1.34 (95 % CI 1.23, 1.45). Districts with low greenness had a higher heat-mortality risk (RR 1.39, 95 % CI 1.22, 1.58) when compared to the high greenness (RR 1.28, 95 % CI 1.13, 1.45). While heat-mortality risk did not significantly differ between population density subgroups, highly urbanized districts had a greater heat-mortality risk (RR 1.41, 95 % CI 1.23, 1.62) as compared to ones with low levels of urbanization (RR 1.32, 95 % CI 1.13, 1.55). Districts with high urbanization level had the highest heat-mortality risk if they were further categorized as having low greenness (RR 1.63, 95 % CI 1.30, 2.04). CONCLUSION Exposure to heat was associated with increased mortality risk in Jordan. This risk was higher in districts with low greenness and high urbanization level. As climate change-related heat mortality will be on the rise, early warning systems in highly vulnerable communities in Jordan are required and greening initiatives should be pursued.
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Affiliation(s)
- L Luque-García
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa 48940, Spain; Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain s/n, 20014 Donostia-San Sebastián, Spain; Osakidetza Basque Health Service, Goierri Alto-Urola Integrated Health Organisation, Zumarraga Hospital, Zumarraga 20700, Spain
| | - S Bataineh
- Civil Engineering Department, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - J Al-Bakri
- Department of Land, Water and Environment, School of Agriculture, The University of Jordan, Amman 11942, Jordan
| | - F A Abdulla
- Civil Engineering Department, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - W K Al-Delaimy
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States.
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Hreha H, Spencer-Hwang R, Knutsen S, Shavlik D. The impact of green space on nonaccidental and cause-specific mortality in the Adventist Health Study-2 population. Environ Epidemiol 2024; 8:e332. [PMID: 39157693 PMCID: PMC11326467 DOI: 10.1097/ee9.0000000000000332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 08/01/2024] [Indexed: 08/20/2024] Open
Abstract
Background There is growing interest in evaluating the long-term health effects of neighborhood environments, particularly green space. However, only a limited body of research further incorporates multiple ambient air pollutants. Methods This study looked at the relationship between green space, as measured by the Normalized Difference Vegetation Index, and mortality adjusted by key confounders in the Adventist Health Study-2, a longitudinal cohort study from 2002 to 2015, across the contiguous United States (N = 67,400). We used Cox proportional hazard regression models to assess the risk of nonaccidental, cardiovascular disease (CVD), ischemic heart disease (IHD), and respiratory disease mortality from green space around subjects' home address under multiple covariate and pollutant adjustments. Results We found a 0.1 unit increase in the Normalized Difference Vegetation Index was associated with nonaccidental (hazard ratio [HR]: 0.96 [95% confidence interval (CI): 0.93, 0.99]), CVD (HR: 0.94 [95% CI: 0.90, 0.98]), and IHD (HR: 0.87 [95% CI: 0.81, 0.94]) mortality, with the greatest precision in fully adjusted three-pollutant models using the 1000-m buffer. Effect estimates were strengthened in urban areas, when incorporating seasons, and for females. However, all associations between green space and respiratory mortality were null. Conclusion This study supports evidence that increased neighborhood green space is inversely associated with nonaccidental, CVD, and IHD mortality, where the inclusion of multiple environmental covariates had a greater impact on effect estimate magnitude and precision than adjustment by individual lifestyle and health factors.
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Affiliation(s)
- Holly Hreha
- School of Public Health, Loma Linda University, Loma Linda, California
| | | | - Synnove Knutsen
- School of Public Health, Loma Linda University, Loma Linda, California
| | - David Shavlik
- School of Public Health, Loma Linda University, Loma Linda, California
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Chen J, Li H, Luo S, Su D, Xie J, Zang T, Kinoshita T. Estimating changes in inequality of ecosystem services provided by green exposure: From a human health perspective. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 908:168265. [PMID: 37949139 DOI: 10.1016/j.scitotenv.2023.168265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/20/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
Ecosystem services provided by green spaces are closely related to human health, strongly supporting sustainable urban and territorial development. Urbanization has not only resulted in the reduction of green spaces but has also created inequalities in exposure. Inequitable green exposure creates disparities in residents' access to the ecosystem services provided by green spaces and can lead to significant health inequities. In this context, we first categorized green exposures into active and passive types based on their characteristics. Second, utilizing the benefit transfer method and Gini coefficient, we estimated the value and equity of ecosystem services offered by these green exposures around residences at the municipality level in Japan from 2000 to 2020, with a focus on human health implications. Finally, we explored the potential relationship between socioeconomics and ecosystem service inequity. Our findings reveal that: 1) ecosystem service value per capita and equity provided by green exposure are significantly different across municipalities; 2) although most municipalities show an upward trend in per capita ecosystem service value around residences, ecosystem service inequity increases significantly; and 3) ecosystem service inequity is related to the socioeconomic factors of municipalities and could be non-linear. The results of this study suggest that the government should adopt indicators related to the ecosystem services provided by green exposure during urban planning. While focusing on per-capita ecosystem services, they should also consider the equitable distribution of ecosystem services to promote sustainable urban health development.
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Affiliation(s)
- Jie Chen
- Graduate School of Horticulture, Chiba University, 648, Matsudo, Matsudo-city, Chiba 271-8510, Japan.
| | - Hongyu Li
- Graduate School of Horticulture, Chiba University, 648, Matsudo, Matsudo-city, Chiba 271-8510, Japan.
| | - Shixian Luo
- Graduate School of Horticulture, Chiba University, 648, Matsudo, Matsudo-city, Chiba 271-8510, Japan; School of Architecture, Southwest Jiaotong University, Chengdu 611756, China
| | - Daer Su
- Graduate School of Horticulture, Chiba University, 648, Matsudo, Matsudo-city, Chiba 271-8510, Japan
| | - Jing Xie
- Graduate School of Horticulture, Chiba University, 648, Matsudo, Matsudo-city, Chiba 271-8510, Japan.
| | - Tongguang Zang
- Graduate School of Horticulture, Chiba University, 648, Matsudo, Matsudo-city, Chiba 271-8510, Japan
| | - Takeshi Kinoshita
- Graduate School of Horticulture, Chiba University, 648, Matsudo, Matsudo-city, Chiba 271-8510, Japan.
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Linh Tran NQ, Cam Hong Le HT, Pham CT, Nguyen XH, Tran ND, Thi Tran TH, Nghiem S, Ly Luong TM, Bui V, Nguyen-Huy T, Doan VQ, Dang KA, Thuong Do TH, Thi Ngo HK, Nguyen TV, Nguyen NH, Do MC, Ton TN, Thu Dang TA, Nguyen K, Tran XB, Thai P, Phung D. Climate change and human health in Vietnam: a systematic review and additional analyses on current impacts, future risk, and adaptation. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 40:100943. [PMID: 38116497 PMCID: PMC10730327 DOI: 10.1016/j.lanwpc.2023.100943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/29/2023] [Accepted: 10/09/2023] [Indexed: 12/21/2023]
Abstract
This study aims to investigate climate change's impact on health and adaptation in Vietnam through a systematic review and additional analyses of heat exposure, heat vulnerability, awareness and engagement, and projected health costs. Out of 127 reviewed studies, findings indicated the wider spread of infectious diseases, and increased mortality and hospitalisation risks associated with extreme heat, droughts, and floods. However, there are few studies addressing health cost, awareness, engagement, adaptation, and policy. Additional analyses showed rising heatwave exposure across Vietnam and global above-average vulnerability to heat. By 2050, climate change is projected to cost up to USD1-3B in healthcare costs, USD3-20B in premature deaths, and USD6-23B in work loss. Despite increased media focus on climate and health, a gap between public and government publications highlighted the need for more governmental engagement. Vietnam's climate policies have faced implementation challenges, including top-down approaches, lack of cooperation, low adaptive capacity, and limited resources.
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Affiliation(s)
- Nu Quy Linh Tran
- Centre for Environment and Population Health, School of Medicine and Dentistry, Griffith University, Australia
| | - Huynh Thi Cam Hong Le
- Child Health Research Centre, Faculty of Medicine, University of Queensland, Australia
| | | | - Xuan Huong Nguyen
- Centre for Scientific Research and International Collaboration, Phan Chau Trinh University, Quang Nam, Vietnam
| | - Ngoc Dang Tran
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | - Son Nghiem
- Department of Health Economics, Wellbeing and Society, Australian National University, Australia
| | - Thi Mai Ly Luong
- Faculty of Environmental Sciences, Vietnam University of Science, Hanoi, Vietnam
| | - Vinh Bui
- Faculty of Science and Engineering, Southern Cross University, Australia
| | - Thong Nguyen-Huy
- Centre for Applied Climate Sciences, University of Southern Queensland, Australia
| | - Van Quang Doan
- Centre for Computational Sciences, University of Tsukuba, Japan
| | - Kim Anh Dang
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Australia
| | - Thi Hoai Thuong Do
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hieu Kim Thi Ngo
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | - Ngoc Huy Nguyen
- Vietnam National University - Vietnam Japan University, Hanoi, Vietnam
| | - Manh Cuong Do
- Health Environment Management Agency, Ministry of Health, Vietnam
| | | | - Thi Anh Thu Dang
- Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Kien Nguyen
- Hue University of Economics, Hue University, Hue City, Vietnam
| | | | - Phong Thai
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Australia
| | - Dung Phung
- School of Public Health, The University of Queensland, Australia
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Choi EY, Lee H, Chang VW. Cumulative exposure to extreme heat and trajectories of cognitive decline among older adults in the USA. J Epidemiol Community Health 2023; 77:728-735. [PMID: 37541774 DOI: 10.1136/jech-2023-220675] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/24/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND The projected increase in extreme heat days is a growing public health concern. While exposure to extreme heat has been shown to negatively affect mortality and physical health, very little is known about its long-term consequences for late-life cognitive function. We examined whether extreme heat exposure is associated with cognitive decline among older adults and whether this association differs by race/ethnicity and neighbourhood socioeconomic status. METHODS Data were drawn from seven waves of the Health and Retirement Study (2006-2018) merged with historical temperature data. We used growth curve models to assess the role of extreme heat exposure on trajectories of cognitive function among US adults aged 52 years and older. RESULTS We found that high exposure to extreme heat was associated with faster cognitive decline for blacks and residents of poor neighbourhoods, but not for whites, Hispanics or residents of wealthier neighbourhoods. CONCLUSION Extreme heat exposure can disproportionately undermine cognitive health in later life for socially vulnerable populations. Our findings underscore the need for policy actions to identify and support high-risk communities for increasingly warming temperatures.
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Affiliation(s)
- Eun Young Choi
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
| | - Haena Lee
- Department of Sociology, Sungkyunkwan University, Seoul, Korea (the Republic of)
| | - Virginia W Chang
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
- Department of Population Health, Grossman School of Medicine, New York University, New York, New York, USA
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Kapadia F. Climate Justice and Health Equity: A Public Health of Consequence, October 2023. Am J Public Health 2023; 113:1053-1054. [PMID: 37672744 PMCID: PMC10484140 DOI: 10.2105/ajph.2023.307404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/08/2023]
Affiliation(s)
- Farzana Kapadia
- Farzana Kapadia is deputy editor of AJPH and professor of epidemiology at the School of Global Public Health, New York University, New York, NY
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Cleland SE, Steinhardt W, Neas LM, Jason West J, Rappold AG. Urban heat island impacts on heat-related cardiovascular morbidity: A time series analysis of older adults in US metropolitan areas. ENVIRONMENT INTERNATIONAL 2023; 178:108005. [PMID: 37437316 PMCID: PMC10599453 DOI: 10.1016/j.envint.2023.108005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 07/14/2023]
Abstract
Many United States (US) cities are experiencing urban heat islands (UHIs) and climate change-driven temperature increases. Extreme heat increases cardiovascular disease (CVD) risk, yet little is known about how this association varies with UHI intensity (UHII) within and between cities. We aimed to identify the urban populations most at-risk of and burdened by heat-related CVD morbidity in UHI-affected areas compared to unaffected areas. ZIP code-level daily counts of CVD hospitalizations among Medicare enrollees, aged 65-114, were obtained for 120 US metropolitan statistical areas (MSAs) between 2000 and 2017. Mean ambient temperature exposure was estimated by interpolating daily weather station observations. ZIP codes were classified as low and high UHII using the first and fourth quartiles of an existing surface UHII metric, weighted to each have 25% of all CVD hospitalizations. MSA-specific associations between ambient temperature and CVD hospitalization were estimated using quasi-Poisson regression with distributed lag non-linear models and pooled via multivariate meta-analyses. Across the US, extreme heat (MSA-specific 99th percentile, on average 28.6 °C) increased the risk of CVD hospitalization by 1.5% (95% CI: 0.4%, 2.6%), with considerable variation among MSAs. Extreme heat-related CVD hospitalization risk in high UHII areas (2.4% [95% CI: 0.4%, 4.3%]) exceeded that in low UHII areas (1.0% [95% CI: -0.8%, 2.8%]), with upwards of a 10% difference in some MSAs. During the 18-year study period, there were an estimated 37,028 (95% CI: 35,741, 37,988) heat-attributable CVD admissions. High UHII areas accounted for 35% of the total heat-related CVD burden, while low UHII areas accounted for 4%. High UHII disproportionately impacted already heat-vulnerable populations; females, individuals aged 75-114, and those with chronic conditions living in high UHII areas experienced the largest heat-related CVD impacts. Overall, extreme heat increased cardiovascular morbidity risk and burden in older urban populations, with UHIs exacerbating these impacts among those with existing vulnerabilities.
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Affiliation(s)
- Stephanie E Cleland
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Oak Ridge Institute for Science and Education at the Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, NC, USA
| | - William Steinhardt
- Oak Ridge Institute for Science and Education at the Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Lucas M Neas
- Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, NC, USA
| | - J Jason West
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Ana G Rappold
- Center for Public Health and Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Research Triangle Park, NC, USA.
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Yu W, Li Y, Zhang K, Wang X, Wang J, Cheng X, Li Z, Mao Y, Zhao J, Li T, Chen M, Gao G, Di K, Hu C, Zhang X. The association between early pregnancy exposure to green space and maternal glucolipid metabolism disorders: evaluation of the mediating role of serum 25-hydroxyvitamin D. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:40978-40986. [PMID: 36624358 DOI: 10.1007/s11356-022-25073-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Green space and 25-hydroxyvitamin D (25(OH)D) can affect maternal and infant health, but limited studies have examined their effects on disorders of maternal glucolipid metabolism. We aimed to explore the interaction between green space, maternal serum 25(OH)D, and disorders of glucolipid metabolism in early pregnancy. A total of 2551 pregnant women were recruited from the Maanshan Maternal and Child Health Hospital birth cohort in China between 2020 and 2022. We calculated average residential greenness during early pregnancy using 250 m normalized difference vegetation index (NDVI) from satellites. Serum biomarkers (25(OH)D, total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol(HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1(ApoA1), and apolipoprotein B(ApoB)) were measured. Associations between the factors were analyzed using multiple linear regression, mediation analysis, and stratified analysis. After adjusting for potential confounders, green space exposure associated with decreased TG (- 7.8%; 95% confidence interval (CI): - 12.8, - 2.9), TC (- 7.0%; 95% CI: - 11.4, - 2.7), and LDL-C (- 8.4%; 95% CI: - 12.9, - 3.9), ApoB (- 2.0%; 95% CI: - 3.0, - 1.0) and increased HDL-C (2.7%; 95% CI: 1.5, 3.8) and ApoA1 (5.1%; 95% CI: 3.9, 6.3) for each IQR increase in NDVI. A comparable link was found between maternal serum 25(OH)D and indicators of glucolipid metabolism (P < 0.05). In addition, mediation analysis showed that the association between green space exposure and maternal glucolipid metabolic index was mediated by serum 25(OH)D at 6.37%. In stratified analyses, a considerable association between 25(OH)D and glucolipid metabolic index (except TG) was observed only at higher green space exposures. This study confirms that high levels of green space exposure in early pregnancy and vitamin D are associated with a reduced risk of glucolipid metabolism disorders and suggests that green space may favor glucolipid metabolism by increasing vitamin D levels, particularly at high NDVI values.
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Affiliation(s)
- Wenjie Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yingqing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Kangdi Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xinqiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Jie Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xin Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Zhenhua Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yicheng Mao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Jiawen Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Tao Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China
| | - Maolin Chen
- Department of Gynecology and Obstetrics, Ma'anshan Maternal and Child Health Hospital, Maanshan, 243000, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui, People's Republic of China
| | - Guopeng Gao
- Department of Child Health Care, Maanshan Maternal and Child Health Hospital, Maanshan, 243000, China
| | - Kun Di
- Lishui Traditional Chinese Medicine Hospital, Lishui, 323000, China
| | - Chengyang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xiujun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei, 230032, China.
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Iungman T, Cirach M, Marando F, Pereira Barboza E, Khomenko S, Masselot P, Quijal-Zamorano M, Mueller N, Gasparrini A, Urquiza J, Heris M, Thondoo M, Nieuwenhuijsen M. Cooling cities through urban green infrastructure: a health impact assessment of European cities. Lancet 2023; 401:577-589. [PMID: 36736334 DOI: 10.1016/s0140-6736(22)02585-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/14/2022] [Accepted: 12/07/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND High ambient temperatures are associated with many health effects, including premature mortality. The combination of global warming due to climate change and the expansion of the global built environment mean that the intensification of urban heat islands (UHIs) is expected, accompanied by adverse effects on population health. Urban green infrastructure can reduce local temperatures. We aimed to estimate the mortality burden that could be attributed to UHIs and the mortality burden that would be prevented by increasing urban tree coverage in 93 European cities. METHODS We did a quantitative health impact assessment for summer (June 1-Aug 31), 2015, of the effect of UHIs on all-cause mortality for adults aged 20 years or older in 93 European cities. We also estimated the temperature reductions that would result from increasing tree coverage to 30% for each city and estimated the number of deaths that could be potentially prevented as a result. We did all analyses at a high-resolution grid-cell level (250 × 250 m). We propagated uncertainties in input analyses by using Monte Carlo simulations to obtain point estimates and 95% CIs. We also did sensitivity analyses to test the robustness of our estimates. FINDINGS The population-weighted mean city temperature increase due to UHI effects was 1·5°C (SD 0·5; range 0·5-3·0). Overall, 6700 (95% CI 5254-8162) premature deaths could be attributable to the effects of UHIs (corresponding to around 4·33% [95% CI 3·37-5·28] of all summer deaths). We estimated that increasing tree coverage to 30% would cool cities by a mean of 0·4°C (SD 0·2; range 0·0-1·3). We also estimated that 2644 (95% CI 2444-2824) premature deaths could be prevented by increasing city tree coverage to 30%, corresponding to 1·84% (1·69-1·97) of all summer deaths. INTERPRETATION Our results showed the deleterious effects of UHIs on mortality and highlighted the health benefits of increasing tree coverage to cool urban environments, which would also result in more sustainable and climate-resilient cities. FUNDING GoGreenRoutes, Spanish Ministry of Science and Innovation, Institute for Global Health, UK Medical Research Council, European Union's Horizon 2020 Project Exhaustion.
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Affiliation(s)
- Tamara Iungman
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marta Cirach
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Evelise Pereira Barboza
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sasha Khomenko
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pierre Masselot
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Marcos Quijal-Zamorano
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Natalie Mueller
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK
| | - José Urquiza
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mehdi Heris
- Hunter College, City University of New York, New York, NY, USA
| | - Meelan Thondoo
- Institute for Global Health, Barcelona, Spain; MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Mark Nieuwenhuijsen
- Institute for Global Health, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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He F, Wei J, Dong Y, Liu C, Zhao K, Peng W, Lu Z, Zhang B, Xue F, Guo X, Jia X. Associations of ambient temperature with mortality for ischemic and hemorrhagic stroke and the modification effects of greenness in Shandong Province, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 851:158046. [PMID: 35987239 DOI: 10.1016/j.scitotenv.2022.158046] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/28/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence is scant on the relative and attributable contributions of ambient temperature on stroke subtypes mortality. Few studies have examined modification effects of multiple greenness indicators on such contributions, especially in China. We quantified the associations between ambient temperature and overall, ischemic, and hemorrhagic stroke mortality; further examined whether the associations were modified by greenness. METHODS We conducted a multicenter time-series analysis from January 1, 2013 to December 31, 2019. we adopted a distributed lag non-linear model to evaluate county-specific temperature-stroke mortality associations. We then applied a random-effects meta-analysis to pool county-specific effects. Attributable mortality was calculated for cold and heat, defined as temperatures below and above the minimum mortality temperature (MMT). Finally, We conducted a multivariate meta-regression to determine associations between greenness and stroke mortality risks for cold and heat, using normalized difference vegetation index (NDVI), soil adjusted vegetation index (SAVI), and enhanced vegetation index (EVI) as quantitative indicators of greenness exposure. RESULTS In the study period, 138,749 deaths from total stroke were reported: 86,873 ischemic and 51,876 hemorrhagic stroke. We observed significant W-shaped relationships between temperature and stroke mortality, with substantial differences among counties and regions. With MMT as the temperature threshold, 17.16 % (95 % empirical CI, 13.38 %-19.75 %) of overall, 20.05 % (95 % eCI, 16.46 %-22.70 %) of ischemic, and 12.55 % (95 % eCI, 5.59 %-16.24 %) of hemorrhagic stroke mortality were attributable to non-optimum temperature (combining cold and heat), more mortality was caused by cold (14.94 %; 95 % eCI, 11.57 %-17.34 %) than by heat (2.22 %; 95 % eCI, 1.54 %-2.72 %). Higher levels of NDVI, SAVI and EVI were related to mitigated effects of non-optimum temperatures-especially heat. CONCLUSIONS Exposure to non-optimum temperatures aggravated stroke mortality risks; increasing greenness could alleviate that risks. This evidence has important implications for local communities in developing adaptive strategies to minimize the health consequences of adverse temperatures.
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Affiliation(s)
- Fenfen He
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Yilin Dong
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Chao Liu
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Ke Zhao
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Wenjia Peng
- School of Public Health, Fudan University, Shanghai, China
| | - Zilong Lu
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Bingyin Zhang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China.
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, Jinan, China.
| | - Xianjie Jia
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China.
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Nguyen VT, Doan QV, Tran NN, Luong LTM, Chinh PM, Thai PK, Phung D, Le HHTC, Dang TN. The protective effect of green space on heat-related respiratory hospitalization among children under 5 years of age in Hanoi, Vietnam. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:74197-74207. [PMID: 35635669 DOI: 10.1007/s11356-022-21064-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/20/2022] [Indexed: 06/15/2023]
Abstract
Combined effects of global warming and rapid urbanization replace green spaces with urban facilities. Children in urban areas are at a higher risk of heat-related adverse health effects. Our study aimed to examine the protective effect of urban green space on heat-related respiratory hospitalization among children under 5 years of age in Hanoi, the capital city of Vietnam. We estimated district-specific meteorological conditions from 2010 to 2014 by using a dynamic downscaling approach with a fine-resolution numerical climate model. The green space in each district was calculated using satellite data. The attributable fraction of heat-related respiratory hospitalization was estimated using a two-stage model, including a distributed lag non-linear model (DLNM) coupled with multivariate meta-analysis. The association between heat-related respiratory hospitalization and green spaces at the district level was explored using a linear regression model. The central districts were more crowded and hotter, with less green spaces than the outer districts. At temperatures > 34 °C (extreme heat threshold), the hospitalizations in the central districts increased significantly; however, in the outer districts, the hospitalization rate was insignificant. On average, extreme heat attributed 0.33% to citywide hospitalization, 0.35% in the center, and 0.32% in the outer region. Every 1% increase in the green space fraction will reduce heat-related respiratory hospitalization risk by 3.8%. Heat significantly increased the risk of respiratory hospitalization among children under 5 years in Hanoi, Vietnam. These findings are valuable for authorities to consider strategies to protect children's health against the effects of heat, including increasing green space.
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Affiliation(s)
- Vien Truong Nguyen
- Department of Environmental and Occupational Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam
| | - Quang-Van Doan
- Center for Computational Sciences, the University of Tsukuba, Tsukuba, Japan
| | - Ngoc Nguyen Tran
- School of Information and Communication Technology, Hanoi University of Science and Technology, Hanoi, Vietnam
| | - Ly Thi Mai Luong
- Faculty of Environmental Sciences, VNU University of Science, Vietnam National University, Hanoi, Vietnam
| | - Pham Minh Chinh
- Faculty of Environmental Engineering, National University of Civil Engineering, Hanoi, Vietnam
| | - Phong K Thai
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Brisbane, QLD, 4102, Australia
| | - Dung Phung
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Hong H T C Le
- Department of Environmental Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Tran Ngoc Dang
- Department of Environmental Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam.
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12
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Choi HM, Lee W, Roye D, Heo S, Urban A, Entezari A, Vicedo-Cabrera AM, Zanobetti A, Gasparrini A, Analitis A, Tobias A, Armstrong B, Forsberg B, Íñiguez C, Åström C, Indermitte E, Lavigne E, Mayvaneh F, Acquaotta F, Sera F, Orru H, Kim H, Kyselý J, Madueira J, Schwartz J, Jaakkola JJK, Katsouyanni K, Diaz MH, Ragettli MS, Pascal M, Ryti N, Scovronick N, Osorio S, Tong S, Seposo X, Guo YL, Guo Y, Bell ML. Effect modification of greenness on the association between heat and mortality: A multi-city multi-country study. EBioMedicine 2022; 84:104251. [PMID: 36088684 PMCID: PMC9471476 DOI: 10.1016/j.ebiom.2022.104251] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/29/2022] [Accepted: 08/17/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Identifying how greenspace impacts the temperature-mortality relationship in urban environments is crucial, especially given climate change and rapid urbanization. However, the effect modification of greenspace on heat-related mortality has been typically focused on a localized area or single country. This study examined the heat-mortality relationship among different greenspace levels in a global setting. METHODS We collected daily ambient temperature and mortality data for 452 locations in 24 countries and used Enhanced Vegetation Index (EVI) as the greenspace measurement. We used distributed lag non-linear model to estimate the heat-mortality relationship in each city and the estimates were pooled adjusting for city-specific average temperature, city-specific temperature range, city-specific population density, and gross domestic product (GDP). The effect modification of greenspace was evaluated by comparing the heat-related mortality risk for different greenspace groups (low, medium, and high), which were divided into terciles among 452 locations. FINDINGS Cities with high greenspace value had the lowest heat-mortality relative risk of 1·19 (95% CI: 1·13, 1·25), while the heat-related relative risk was 1·46 (95% CI: 1·31, 1·62) for cities with low greenspace when comparing the 99th temperature and the minimum mortality temperature. A 20% increase of greenspace is associated with a 9·02% (95% CI: 8·88, 9·16) decrease in the heat-related attributable fraction, and if this association is causal (which is not within the scope of this study to assess), such a reduction could save approximately 933 excess deaths per year in 24 countries. INTERPRETATION Our findings can inform communities on the potential health benefits of greenspaces in the urban environment and mitigation measures regarding the impacts of climate change. FUNDING This publication was developed under Assistance Agreement No. RD83587101 awarded by the U.S. Environmental Protection Agency to Yale University. It has not been formally reviewed by EPA. The views expressed in this document are solely those of the authors and do not necessarily reflect those of the Agency. EPA does not endorse any products or commercial services mentioned in this publication. Research reported in this publication was also supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number R01MD012769. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Also, this work has been supported by the National Research Foundation of Korea (2021R1A6A3A03038675), Medical Research Council-UK (MR/V034162/1 and MR/R013349/1), Natural Environment Research Council UK (Grant ID: NE/R009384/1), Academy of Finland (Grant ID: 310372), European Union's Horizon 2020 Project Exhaustion (Grant ID: 820655 and 874990), Czech Science Foundation (22-24920S), Emory University's NIEHS-funded HERCULES Center (Grant ID: P30ES019776), and Grant CEX2018-000794-S funded by MCIN/AEI/ 10.13039/501100011033 The funders had no role in the design, data collection, analysis, interpretation of results, manuscript writing, or decision to publication.
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Affiliation(s)
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven, CT, USA
| | - Dominic Roye
- Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Seulkee Heo
- School of the Environment, Yale University, New Haven, CT, USA
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar Khorasan Razavi, Iran
| | | | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, València, Spain
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Ene Indermitte
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Eric Lavigne
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Air Health Science Division, Health Canada, Ottawa, ON, Canada
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar Khorasan Razavi, Iran
| | | | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic; Global Change Research Institute, Czech Academy of Sciences, Brno, Czech Republic
| | - Joana Madueira
- Department of Environmental Health, National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal; EPI Unit, Institute of Public Health, University of Porto, Lisbon, Portugal
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Magali Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Martina S Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Mathilde Pascal
- Department of Environmental Health, French National Public Health Agency, Public Health France, Saint Maurice, France
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Samuel Osorio
- Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
| | - Shilu Tong
- Shanghai Children's Medical Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Yue Leon Guo
- National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan; National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
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Dang TN, Vy NTT, Thuong DTH, Phung D, Van Dung D, Le An P. Main and added effects of heatwaves on hospitalizations for mental and behavioral disorders in a tropical megacity of Vietnam. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:59094-59103. [PMID: 35378653 DOI: 10.1007/s11356-022-19898-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 03/21/2022] [Indexed: 06/14/2023]
Abstract
Vietnam is highly vulnerable to climate change-related extreme weather events such as heatwaves. This study assesses the association between heatwaves and hospitalizations due to mental and behavioral disorders (MBDs) in Ho Chi Minh City (HCMC). We collected daily MBD hospital admissions data at the HCMC Mental Health Hospital from 2017 to 2019. Heatwaves effects were characterized into the main effect (i.e., the intensity of temperature during heatwaves) and the added effect (i.e., the duration of heatwaves). Time series Poisson regression coupled with a distributed lag linear model (DLM) was used to quantify the 14-day lags effect of heatwaves. Confounders including long-term trend, seasonality, days of the week, holidays, and relative humidity were included in the model. Heatwaves increased all-cause MBD hospitalization by 62% (95%Cl, 36-93%) for the main effect and by 8% (95% Cl, - 3% to 19%) for the added effect. Noticeably, the group aged 18-60 years old was affected by the main effect of the heatwave, while the group aged 61 years and older was affected by the added effect of the heatwave. The effects of heatwaves differed among groups of MBD hospitalizations. The mental and behavioral disorder group due to psychoactive substance use was significantly affected by the main effect of heatwaves (RR:2.21; 95%Cl:1.55-3.15). The group of schizophrenia, schizotypal and delusional disorders were highly vulnerable towards both the main and the added effect of heatwaves with RR = 1.50 (95%CI, 1.20-1.86) and RR = 1.14 (95%CI, 1.01-1.30), respectively.
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Affiliation(s)
- Tran Ngoc Dang
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam.
| | - Nguyen Thi Tuong Vy
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Do Thi Hoai Thuong
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Dung Phung
- Centre for Environment and Population Health, School of Medicine, Griffith University, Brisbane, Australia
| | - Do Van Dung
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Pham Le An
- Family Medicine Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam.
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Effects of Urban Landscape and Sociodemographic Characteristics on Heat-Related Health Using Emergency Medical Service Incidents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031287. [PMID: 35162309 PMCID: PMC8835151 DOI: 10.3390/ijerph19031287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/11/2022] [Accepted: 01/21/2022] [Indexed: 11/16/2022]
Abstract
It is well known that extremely hot weather causes heat-related health issues. Health problems, especially in urban areas, are becoming increasingly important due to urban heat island effect. Understanding the impact of neighborhood characteristics is important for research into the relationship between thermal environment and human health. The objectives of this study were to explore the urban landscape and sociodemographic characteristics affecting heat-related health and identify spatial inequalities for vulnerable groups. A total of 27,807 heat-related EMS incidents were used at the census block group level (N = 285). We used land cover database and Landsat satellite images for urban landscape variables and used 2019 U.S. Census data for sociodemographic variables. Negative binomial regression was used to identify the neighborhood variables associated with the heat-related EMS incidents in each block group. Heat-related health has been alleviated in block groups with high green areas. However, the negative effects of thermal environments on human health were higher in areas with a high percentage of impervious surface, over 65 years, non-white people, no high school diploma, or unemployment. The results indicate that heat-related health problems can be addressed through prevention strategies for block group variables. Local intervention efforts to solve health issues should be targeted at more vulnerable areas and groups.
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Fixed and Mobile Low-Cost Sensing Approaches for Microclimate Monitoring in Urban Areas: A Preliminary Study in the City of Bolzano (Italy). SMART CITIES 2022. [DOI: 10.3390/smartcities5010004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In the current scenario of massive urbanization and global climate change, an intelligent monitoring of the environmental variables is becoming fundamental to ensure good living conditions in cities. Indeed, the acquisition of data with high spatiotemporal resolution can enable the assessment of environmental vulnerabilities in urban areas towards the definition of responsive adaptation and mitigation strategies. In this context, the current work presents a two-fold approach based on low-cost cloud-connected sensors for (i) fixed and (ii) mobile monitoring of several environmental parameters. This paper, which focuses on the measurement aspects of the urban micro-climate, describes in detail the hardware and software components of both approaches, and how to exploit them for setting up a field campaign. The methods were tested in the city of Bolzano (Italy), demonstrating their suitability for identifying the spatial variability of the microclimate in relation to the urban morphology, and for highlighting the presence of the urban heat island and estimating its intensity.
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Giacinto JJ, Fricker GA, Ritter M, Yost J, Doremus J. Urban forest biodiversity and cardiovascular disease: Potential health benefits from California's street trees. PLoS One 2021; 16:e0254973. [PMID: 34731162 PMCID: PMC8565780 DOI: 10.1371/journal.pone.0254973] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 07/08/2021] [Indexed: 01/14/2023] Open
Abstract
Enhanced immune functioning in response to biodiversity may explain potential health benefits from exposure to green space. Using unique data on urban forest biodiversity at the zip code level for California measured from 2014 to 2019 we test whether greater diversity of street trees is associated with reduced death from cardiovascular disease. We find that urban forests with greater biodiversity measured via the Shannon Index at the genus level are associated with a lower mortality rate for heart disease and stroke. Our estimates imply that increasing the Shannon Index by one standard deviation (0.64) is associated with a decrease in the mortality rate of 21.4 per 100,000 individuals for heart disease or 13% and 7.7 per 100,000 individuals for stroke or 16%. Our estimates remain robust across several sensitivity checks. A policy simulation for tree planting in Los Angeles based on our estimates suggests that if these relationships were causal, investment in planting for a more biodiverse set of street trees would be a cost-effective way to reduce mortality related to cardiovascular disease in urban areas.
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Affiliation(s)
- John J. Giacinto
- Economics, California Polytechnic State University, San Luis Obispo, CA, United States of America
| | - G. Andrew Fricker
- Social Sciences, California Polytechnic State University, San Luis Obispo, CA, United States of America
| | - Matthew Ritter
- Biological Sciences, California Polytechnic State University, San Luis Obispo, CA, United States of America
| | - Jenn Yost
- Biological Sciences, California Polytechnic State University, San Luis Obispo, CA, United States of America
| | - Jacqueline Doremus
- Economics, California Polytechnic State University, San Luis Obispo, CA, United States of America
- * E-mail:
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17
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Denpetkul T, Phosri A. Daily ambient temperature and mortality in Thailand: Estimated effects, attributable risks, and effect modifications by greenness. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 791:148373. [PMID: 34126499 DOI: 10.1016/j.scitotenv.2021.148373] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/07/2021] [Accepted: 06/07/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In recent years, many previous studies have examined the association between ambient temperature and mortality in different parts of the world. However, very few studies have explored the mortality burden attributable to temperature, especially those in developing countries. This study aimed to quantify the burden of mortality attributable to non-optimum temperature in Thailand and explore whether greenness, using normalized difference vegetation index (NDVI) as indicator, alleviates the mortality contributed by non-optimum ambient temperature. METHODS Daily number of mortality (i.e., all-cause, cardiovascular and respiratory diseases) and daily meteorological data were obtained over 65 provinces in Thailand during 2010 to 2017. The two-stage statistical approach was applied to estimate the association between temperature and mortality. First, the time-stratified case-crossover analysis was performed to examine province-specific temperature-mortality association. Second, province-specific association was pooled to derive national estimates using multivariate meta-regression. Mortality burden attributable to temperature was then estimated, and the association between attributed mortality and NDVI was explored using multivariate meta-regression models. RESULTS A total of 2,891,407 all-cause of death was included over the study period, in which 403,450 and 264,672 deaths were accounted for cardiovascular and respiratory diseases, respectively. The temperature-mortality association at cumulative lag 0-7 days was non-linear with J-shaped curve for all-cause and respiratory mortality, whereas V-shaped curve was observed for cardiovascular mortality. Using minimum mortality temperature (MMT) as optimum temperature, 3.72% (95% empirical CI: 2.18, 5.21) of all-cause, 2.92% (0.55, 5.10) of cardiovascular and 3.00% (0.27, 5.49) of respiratory mortality were attributable to non-optimum temperature (both hot and cold effects). Higher level of NDVI was associated with alleviated impacts of non-optimum temperature, especially hot temperature. CONCLUSION Exposure to non-optimum temperature was associated with increased risks of mortality in Thailand. This finding is useful for planning the public health interventions to reduce health effects of non-optimum ambient temperature.
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Affiliation(s)
- Thammanitchpol Denpetkul
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Arthit Phosri
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand; Center of Excellence on Environmental Health and Toxicology (EHT), Bangkok, Thailand.
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18
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Choi HM, Chen C, Son JY, Bell ML. Temperature-mortality relationship in North Carolina, USA: Regional and urban-rural differences. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 787:147672. [PMID: 34000533 PMCID: PMC8214419 DOI: 10.1016/j.scitotenv.2021.147672] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 05/06/2021] [Accepted: 05/06/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND Health disparities exist between urban and rural populations, yet research on rural-urban disparities in temperature-mortality relationships is limited. As inequality in the United States increases, understanding urban-rural and regional differences in the temperature-mortality association is crucial. OBJECTIVE We examined regional and urban-rural differences of the temperature-mortality association in North Carolina (NC), USA, and investigated potential effect modifiers. METHODS We applied time-series models allowing nonlinear temperature-mortality associations for 17 years (2000-2016) to generate heat and cold county-specific estimates. We used second-stage analysis to quantify the overall effects. We also explored potential effect modifiers (e.g. social associations, greenness) using stratified analysis. The analysis considered relative effects (comparing risks at 99th to 90th temperature percentiles based on county-specific temperature distributions for heat, and 1st to 10th percentiles for cold) and absolute effects (comparing risks at specific temperatures). RESULTS We found null effects for heat-related mortality (relative effect: 1.001 (95% CI: 0.995-1.007)). Overall cold-mortality risk for relative effects was 1.019 (1.015-1.023). All three regions had statistically significant cold-related mortality risks for relative and absolute effects (relative effect: 1.019 (1.010-1.027) for Coastal Plains, 1.021 (1.015-1.027) for Piedmont, 1.014 (1.006-1.023) for Mountains). The heat mortality risk was not statistically significant, whereas the cold mortality risk was statistically significant, showing higher cold-mortality risks in urban areas than rural areas (relative effect for heat: 1.006 (0.997-1.016) for urban, 1.002 (0.988-1.017) for rural areas; relative effect for cold: 1.023 (1.017-1.030) for urban, 1.012 (1.001-1.023) for rural areas). Findings are suggestive of higher relative cold risks in counties with the less social association, higher population density, less green-space, higher PM2.5, lower education level, higher residential segregation, higher income inequality, and higher income (e.g., Ratio of Relative Risks 1.72 (0.68, 4.35) comparing low to high education). CONCLUSION Results indicate cold-mortality risks in NC, with potential differences by regional, urban-rural areas, and community characteristics.
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Affiliation(s)
| | - Chen Chen
- School of the Environment, Yale University, New Haven, CT, USA
| | - Ji-Young Son
- School of the Environment, Yale University, New Haven, CT, USA
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA.
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Human population induced urban developments and their effects on temperature rise: a nonlinear mathematical model. ECOLOGICAL COMPLEXITY 2021. [DOI: 10.1016/j.ecocom.2021.100947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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20
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The Potential of Stormwater Management in Addressing the Urban Heat Island Effect: An Economic Valuation. SUSTAINABILITY 2021. [DOI: 10.3390/su13168685] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Urban green infrastructure (UGI) within sustainable stormwater management provides numerous benefits to urban residents, including urban heat island (UHI) mitigation. Cost–benefit analyses (CBA) for UGI have been conducted at neighborhood level with a focus on stormwater management, but valuations of reductions in heat-related hospitalizations and mortality are lacking. These benefits create significant social value; the quantification thereof is essential for urban planning in providing a scientific foundation for the inclusion of UGI in UHI mitigation strategies. This study assesses the potential of three UGI scenarios developed for an urban neighborhood in Berlin, Germany. First, climate data analyses were conducted to determine the cooling effects of tree drains, facade greening, and green roofs. Second, a CBA was performed for each scenario to value UHI mitigation by estimating the damage costs avoided in reduced heat-related hospitalizations and fatalities, using the net present value (NPV) and benefit–cost ratio (BCR) as indicators of economic feasibility. The results indicate heat mitigation capabilities of all three UGI types, with tree drains achieving the strongest cooling effects. Regarding economic feasibility, all scenarios achieve positive NPVs and BCRs above one. The findings confirm the potential of stormwater management in mitigating UHI and generating substantial social value.
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21
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Lee W, Ebi KL, Kim Y, Hashizume M, Honda Y, Hideki H, Choi HM, Choi M, Kim H. Heat-mortality risk and the population concentration of metropolitan areas in Japan: a nationwide time-series study. Int J Epidemiol 2021; 50:602-612. [PMID: 33346831 DOI: 10.1093/ije/dyaa245] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 11/12/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The complex role of urbanisation in heat-mortality risk has not been fully studied. Japan has experienced a rapid population increase and densification in metropolitan areas since the 2000s; we investigated the effects of population concentration in metropolitan areas on heat-mortality risk using nationwide data. METHODS We collected time-series data for mortality and weather variables for all 47 prefectures in Japan (1980-2015). The prefectures were classified into three sub-areas based on population size: lowest (<1 500 000), intermediate (1 500 000 to 3 000 000), and highest (>3 000 000; i.e. metropolitan areas). Regional indicators associated with the population concentration of metropolitan areas were obtained. RESULTS Since the 2000s, the population concentration intensified in the metropolitan areas, with the highest heat-mortality risk in prefectures with the highest population. Higher population density and apartment % as well as lower forest area and medical services were associated with higher heat-mortality risk; these associations have generally become stronger since the 2000s. CONCLUSIONS Population concentration in metropolitan areas intensified interregional disparities in demography, living environments, and medical services in Japan; these disparities were associated with higher heat-mortality risk. Our results can contribute to policies to reduce vulnerability to high temperatures.
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Affiliation(s)
- Whanhee Lee
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Hashimoto Hideki
- Department of Health Economics and Epidemiology Research, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hayon Michelle Choi
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, USA
| | - Moonjung Choi
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
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22
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Kua KP, Lee S. The influence of residential greenness on mortality in the Asia-Pacific region: a systematic review and meta-analysis. Perspect Public Health 2021; 141:342-353. [PMID: 34120524 DOI: 10.1177/17579139211011496] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS To critically appraise the evidence of the impact of exposure to salutogenic green environment on mortality, which is an important endpoint in epidemiological and clinical studies. METHODS We searched for studies published and indexed in three databases (PubMed, AMED, and CINAHL Plus) from inception until 31 March 2020, complemented with a search of cited literature for articles describing the effects of greenness on mortality in Asia-Pacific region. Eligible articles were screened and data were extracted independently by two reviewers. A random-effects model was utilised to obtain pool hazard ratio (HR) and risk ratio of all-cause mortality outcome. RESULTS The search identified 3239 studies, of which 20 studies reporting 133,363 participants from longitudinal cohort studies and 202 million people from population-based prevalence studies were included in the review. The majority of the studies (60%) were conducted in high-income countries in Asia-Pacific. All participants of the longitudinal cohort studies were aged 60 years or older, whereas the prevalence studies involved people of all age groups. A significant protective association of green environment exposure with all-cause mortality was reported in 18 studies. Pooled results from five studies showed increased level of greenness exposure was associated with a significant decrease in all-cause mortality (pooled HR = 0.97; 95% confidence interval (CI) = 0.93 to 1.02; p < 0.01; I²= 87.8%). Meta-analysis of total number of deaths in different quartiles of green spaces noted decreased risks of mortality with all causes of death with increased surrounding greenness. CONCLUSIONS Some limited evidence suggests that populations exposed to the greener environment have a lower risk of mortality, implying the potential role of greenness in increasing longevity. Further studies with standardised design and outcome reporting should be conducted in low- and middle-income countries and in populations of low socioeconomic status to glean more generalisable and complete evidence for public health policy implications.
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Affiliation(s)
- K P Kua
- Puchong Health Clinic, Petaling District Health Office, Ministry of Health Malaysia, Petaling, Selangor, Malaysia
| | - Swh Lee
- School of Pharmacy, Monash University, Subang Jaya, Selangor, Malaysia; Asian Centre for Evidence Synthesis in Population, Implementation, and Clinical Outcomes (PICO), Health and Well-Being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University, Subang Jaya, Selangor, Malaysia; Gerontechnology Laboratory, Global Asia in the 21st Century (GA21) Platform, Monash University, Subang Jaya, Selangor, Malaysia; Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
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23
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Yi W, Cheng J, Wei Q, Pan R, Song S, He Y, Tang C, Liu X, Zhou Y, Su H. Disparities of weather type and geographical location in the impacts of temperature variability on cancer mortality: A multicity case-crossover study in Jiangsu Province, China. ENVIRONMENTAL RESEARCH 2021; 197:110985. [PMID: 33744269 DOI: 10.1016/j.envres.2021.110985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Considering the serious health burden caused by adverse weather events, increasing researches focused on the relationship between temperature variability (TV) and cause-specific mortality, but its association with cancer was not well explored. We aimed to investigate the impacts of TV on cancer mortality and examine the modifying effects of weather type and geographical location as well as other characteristics. MATERIALS AND METHODS Daily city-specific data of cancer deaths, mean temperature (Tmean), maximum and minimum temperatures (Tmax and Tmin), relative humidity (RH), rainfall, and air pollutants were collected during 2016-2017 in 13 cities in Jiangsu Province, China. TV0-t was defined as the standard deviation of the daily Tmax and Tmin on the exposure 0-t days. A two-stage analysis was applied. First, a time-stratified case-crossover design was used to examine the odds ratio (OR) and attributable fraction of cancer mortality per 1 °C increase in TV by adjusting for potential confounders. Random effect meta-analysis was used to summarize the pooled ORs. Second, stratified analysis was performed for weather type, geographical location, demographics, and other city-level characteristics. The weather was defined as four types according to days during warm or cold season combined with high or low RH. RESULTS A total of 303670 cases were included in our study. Meta-analysis showed that the ORs of cancer mortality per 1 °C increase in TV0-t significantly increased and peaked in TV0-2 (OR=1.0098, 95% CI: 1.0039-1.0157). The attributable fraction of TV0-2 on cancer mortality was 4.74%, accounting for 14395 deaths in the study period. Significant ORs of TV-related cancer mortality were found during the warm season combined with high RH and in the northern region of Jiangsu. Susceptible groups of TV-related cancer mortality were identified as female patients, patients aged 45-65 years, and those living in cities with lower per capita green area. CONCLUSIONS TV can significantly increase the risk of cancer mortality, especially during warm and humid days and in the northern region of Jiangsu. Findings are of great significance to formulate urban planning, resource allocation, and health intervention to prolong the life of cancer patients.
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Affiliation(s)
- Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Shasha Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Chao Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Xiangguo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yu Zhou
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
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24
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Dimitrova A, Ingole V, Basagaña X, Ranzani O, Milà C, Ballester J, Tonne C. Association between ambient temperature and heat waves with mortality in South Asia: Systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2021; 146:106170. [PMID: 33395923 DOI: 10.1016/j.envint.2020.106170] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/16/2020] [Accepted: 09/26/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND South Asia is highly vulnerable to climate change and is projected to experience some of the highest increases in average annual temperatures throughout the century. Although the adverse impacts of ambient temperature on human health have been extensively documented in the literature, only a limited number of studies have focused on populations in this region. OBJECTIVES Our aim was to systematically review the current state and quality of available evidence on the direct relationship between ambient temperature and heat waves and all-cause mortality in South Asia. METHODS The databases Pubmed, Web of Science, Scopus and Embase were searched from 1990 to 2020 for relevant observational quantitative studies. We applied the Navigation Guide methodology to assess the strength of the evidence and performed a meta-analysis based on a novel approach that allows for combining nonlinear exposure-response associations without access to data from individual studies. RESULTS From the 6,759 screened papers, 27 were included in the qualitative synthesis and five in a meta-analysis. Studies reported an association of all-cause mortality with heat wave episodes and both high and low daily temperatures. The meta-analysis showed a U-shaped pattern, with increasing mortality for both high and low temperatures, but a statistically significant association was found only at higher temperatures - above 31° C for lag 0-1 days and above 34° C for lag 0-13 days. Effects were found to vary with cause of death, age, sex, location (urban vs. rural), level of education and socio-economic status, but the profile of vulnerabilities was somewhat inconsistent and based on a limited number of studies. Overall, the strength of the evidence for ambient temperature as a risk factor for all-cause mortality was judged as limited and for heat wave episodes as inadequate. CONCLUSIONS The evidence base on temperature impacts on mortality in South Asia is limited due to the small number of studies, their skewed geographical distribution and methodological weaknesses. Understanding the main determinants of the temperature-mortality association as well as how these may evolve in the future in a dynamic region such as South Asia will be an important area for future research. Studies on viable adaptation options to high temperatures for a region that is a hotspot for climate vulnerability, urbanisation and population growth are also needed.
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Affiliation(s)
- Asya Dimitrova
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública, Avda. Monforte de Lemos 3-5, Madrid, Spain
| | - Vijendra Ingole
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública, Avda. Monforte de Lemos 3-5, Madrid, Spain
| | - Xavier Basagaña
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública, Avda. Monforte de Lemos 3-5, Madrid, Spain
| | - Otavio Ranzani
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública, Avda. Monforte de Lemos 3-5, Madrid, Spain
| | - Carles Milà
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública, Avda. Monforte de Lemos 3-5, Madrid, Spain
| | - Joan Ballester
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública, Avda. Monforte de Lemos 3-5, Madrid, Spain
| | - Cathryn Tonne
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader, 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública, Avda. Monforte de Lemos 3-5, Madrid, Spain.
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25
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Surface Subsidence in Urbanized Coastal Areas: PSI Methods Based on Sentinel-1 for Ho Chi Minh City. REMOTE SENSING 2020. [DOI: 10.3390/rs12244130] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In Ho Chi Minh City (HCMC), Vietnam, though at present flooding is merely a recurring nuisance, there is increasing concern that a combination of impending climate change and rapid urbanization will significantly exacerbate the situation. Given the significant measures taken in HCMC to reduce groundwater extraction and sea-level rise (SLR) inundation since the most recent subsidence studies, we aim to update and contribute to the subsidence information of HCMC with continuous temporal coverage from 2017 to 2019. In this study, we use Persistent Scatterer Interferometry (PSI) with Copernicus Sentinel-1 data and open source tools to determine current subsidence rates within the urban center of HCMC. Additionally, the scalability of this method and use of freely accessible data allows for continuous updating and monitoring of this high-vulnerability region. The observed average subsidence rates were 3.3 mm per year with a maximum local subsidence of 5.3 cm per year. These results largely align with findings of previous studies and reflect similar spatial distributed subsidence patterns. Inundation risk awareness is enhanced by not only continued improved subsidence analysis, but also incorporating latest advancements in Digital Elevation Model (DEM) accuracy. This study compares local differences between traditionally used AW3D30 DEM with the CoastalDEM. Our findings indicate that although we identify lower than previously accepted elevations in the urban core, that stabilization of subsidence is observed in this same region.
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26
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Jang J, Lee W, Choi M, Kang C, Kim H. Roles of urban heat anomaly and land-use/land-cover on the heat-related mortality in the national capital region of South Korea: A multi-districts time-series study. ENVIRONMENT INTERNATIONAL 2020; 145:106127. [PMID: 32950794 DOI: 10.1016/j.envint.2020.106127] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
The urban heat anomaly has been suggested as a representative risk factor for human health in metropolitan areas, but few studies have measured a quantitative increase in risk due to the urban heat anomaly on heat-related mortality in the summer season or assessed the role of various types of land-use/land-cover (LULC), which may contribute to the urban heat anomaly. In this study, we evaluated the association between the urban heat anomaly and heat-related mortality risk in the summer and the potential roles of multiple types of LULC indicators. We used district-level time-series and cadastral data from 51 urban districts in the national capital region of South Korea. We applied a two-stage analysis. In the first stage, we estimated the district-specific heat-related mortality risk by using a distributed lag non-linear model. In the second stage, we used a meta-analysis to pool the estimates across all districts and calculate the association between the urban heat anomaly/LULC indicators and heat-related mortality risk. We found that the higher urban heat anomaly was related to lower vegetation and higher urban surface indicators, and the urban heat anomaly was positively associated with the heat-related mortality risk. The association between the urban heat anomaly and the heat-related mortality risk was more pronounced in the elderly (age ≥ 65 years) and female population than in the non-elderly and male population. We also found that the LULC indicators affected the heat-related mortality only through the urban heat anomaly. Our findings indicate that urban areas may be more vulnerable to heat-related mortality risk as determined by the urban heat anomaly. These results suggest a need for urban heat mitigation strategies such as increased vegetation or surface albedo to help reduce heat-related mortality risk.
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Affiliation(s)
- Jeongju Jang
- Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Whanhee Lee
- Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Munjeong Choi
- Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Cinoo Kang
- Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea.
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27
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Varquez ACG, Darmanto NS, Honda Y, Ihara T, Kanda M. Future increase in elderly heat-related mortality of a rapidly growing Asian megacity. Sci Rep 2020; 10:9304. [PMID: 32518364 PMCID: PMC7283254 DOI: 10.1038/s41598-020-66288-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 05/15/2020] [Indexed: 11/17/2022] Open
Abstract
Urban dwellers are at risk of heat-related mortality in the onset of climate change. In this study, future changes in heat-related mortality of elderly citizens were estimated while considering the combined effects of spatially-varying megacity’s population growth, urbanization, and climate change. The target area is the Jakarta metropolitan area of Indonesia, a rapidly developing tropical country. 1.2 × 1.2 km2 daily maximum temperatures were acquired from weather model outputs for the August months from 2006 to 2015 (present 2010s) and 2046 to 2055 (future 2050s considering pseudo-global warming of RCP2.6 and RCP8.5). The weather model considers population-induced spatial changes in urban morphology and anthropogenic heating distribution. Present and future heat-related mortality was mapped out based on the simulated daily maximum temperatures. The August total number of heat-related elderly deaths in Jakarta will drastically increase by 12~15 times in the 2050s compared to 2010s because of population aging and rising daytime temperatures under “compact city” and “business-as-usual” scenarios. Meanwhile, mitigating climate change (RCP 2.6) could reduce the August elderly mortality count by up to 17.34%. The downwind areas of the densest city core and the coastal areas of Jakarta should be avoided by elderly citizens during the daytime.
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Affiliation(s)
| | - Nisrina S Darmanto
- Department of Transdisciplinary Science and Engineering, Tokyo Institute of Technology, Tokyo, Japan
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tomohiko Ihara
- Department of Environment Systems, University of Tokyo, Tokyo, Japan
| | - Manabu Kanda
- Department of Transdisciplinary Science and Engineering, Tokyo Institute of Technology, Tokyo, Japan
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28
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O'Brien DT, Gridley Msui B, Trlica A, Wang JA, Shrivastava A. Urban Heat Islets: Street Segments, Land Surface Temperatures, and Medical Emergencies During Heat Advisories. Am J Public Health 2020; 110:e1-e8. [PMID: 32437273 PMCID: PMC7287541 DOI: 10.2105/ajph.2020.305636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2020] [Indexed: 11/04/2022]
Abstract
Objectives. To examine the relationships among environmental characteristics, temperature, and health outcomes during heat advisories at the geographic scale of street segments.Methods. We combined multiple data sets from Boston, Massachusetts, including remotely sensed measures of temperature and associated environmental characteristics (e.g., canopy cover), 911 dispatches for medical emergencies, daily weather conditions, and demographic and physical context from the American Community Survey and City of Boston Property Assessments. We used multilevel models to analyze the distribution of land surface temperature and elevated vulnerability during heat advisories across streets and neighborhoods.Results. A substantial proportion of variation in land surface temperature existed between streets within census tracts (38%), explained by canopy, impervious surface, and albedo. Streets with higher land surface temperature had a greater likelihood of medical emergencies during heat advisories relative to the frequency of medical emergencies during non-heat advisory periods. There was no independent effect of the average land surface temperature of the census tract.Conclusions. The relationships among environmental characteristics, temperature, and health outcomes operate at the spatial scale of the street segment, calling for more geographically precise analysis and intervention. (Am J Public Health. Published online ahead of print May 21, 2020: e1-e8. doi:10.2105/AJPH.2020.305636).
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Affiliation(s)
- Daniel T O'Brien
- Daniel T. O'Brien and Brian Gridley are with the School of Public Policy and Urban Affairs and the Boston Area Research Initiative, Northeastern University, Boston, MA. Andrew Trlica and Jonathan A. Wang are with the Department of Earth and Environment, Boston University, Boston. Aatmesh Shrivastava is with the Department of Electrical and Computer Engineering, Northeastern University
| | - Brian Gridley Msui
- Daniel T. O'Brien and Brian Gridley are with the School of Public Policy and Urban Affairs and the Boston Area Research Initiative, Northeastern University, Boston, MA. Andrew Trlica and Jonathan A. Wang are with the Department of Earth and Environment, Boston University, Boston. Aatmesh Shrivastava is with the Department of Electrical and Computer Engineering, Northeastern University
| | - Andrew Trlica
- Daniel T. O'Brien and Brian Gridley are with the School of Public Policy and Urban Affairs and the Boston Area Research Initiative, Northeastern University, Boston, MA. Andrew Trlica and Jonathan A. Wang are with the Department of Earth and Environment, Boston University, Boston. Aatmesh Shrivastava is with the Department of Electrical and Computer Engineering, Northeastern University
| | - Jonathan A Wang
- Daniel T. O'Brien and Brian Gridley are with the School of Public Policy and Urban Affairs and the Boston Area Research Initiative, Northeastern University, Boston, MA. Andrew Trlica and Jonathan A. Wang are with the Department of Earth and Environment, Boston University, Boston. Aatmesh Shrivastava is with the Department of Electrical and Computer Engineering, Northeastern University
| | - Aatmesh Shrivastava
- Daniel T. O'Brien and Brian Gridley are with the School of Public Policy and Urban Affairs and the Boston Area Research Initiative, Northeastern University, Boston, MA. Andrew Trlica and Jonathan A. Wang are with the Department of Earth and Environment, Boston University, Boston. Aatmesh Shrivastava is with the Department of Electrical and Computer Engineering, Northeastern University
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Abstract
The importance of the global climate crisis requires linking physical activity promotion and climate action. This article provides a first overview of interconnections between physical activity promotion and climate action, potential synergies and discrepancies, aiming to stimulate further discussion about this topic. The analysis is based on the World Health Organization’s Global Action Plan on Physical Activity 2018-2030 (GAPPA). The GAPPA covers five perspectives that are of particular relevance with respect to potential links with climate policy: (1) Infrastructures supporting active transport, (2) green spaces and recreational/exercise facilities, (3) exercise programs, (4) mass communication campaigns and mass participation events and (5) training of professionals. Our analysis demonstrates a considerable alignment between strategies for physical activity promotion and efforts for the reduction of greenhouse gas emissions. However, in some of the areas, this alignment could still be improved. Additionally, more climate-conscious policies, research and surveillance need to be developed in the field of physical activity promotion.
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Affiliation(s)
- Karim Abu-Omar
- Department for Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91054, Germany
| | - Peter Gelius
- Department for Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91054, Germany
| | - Sven Messing
- Department for Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91054, Germany
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30
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Ingole V, Marí-Dell’Olmo M, Deluca A, Quijal M, Borrell C, Rodríguez-Sanz M, Achebak H, Lauwaet D, Gilabert J, Murage P, Hajat S, Basagaña X, Ballester J. Spatial Variability of Heat-Related Mortality in Barcelona from 1992-2015: A Case Crossover Study Design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072553. [PMID: 32276439 PMCID: PMC7177772 DOI: 10.3390/ijerph17072553] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/01/2020] [Accepted: 04/04/2020] [Indexed: 11/23/2022]
Abstract
Numerous studies have demonstrated the relationship between summer temperatures and increased heat-related deaths. Epidemiological analyses of the health effects of climate exposures usually rely on observations from the nearest weather station to assess exposure-response associations for geographically diverse populations. Urban climate models provide high-resolution spatial data that may potentially improve exposure estimates, but to date, they have not been extensively applied in epidemiological research. We investigated temperature-mortality relationships in the city of Barcelona, and whether estimates vary among districts. We considered georeferenced individual (natural) mortality data during the summer months (June–September) for the period 1992–2015. We extracted daily summer mean temperatures from a 100-m resolution simulation of the urban climate model (UrbClim). Summer hot days (above percentile 70) and reference (below percentile 30) temperatures were compared by using a conditional logistic regression model in a case crossover study design applied to all districts of Barcelona. Relative Risks (RR), and 95% Confidence Intervals (CI), of all-cause (natural) mortality and summer temperature were calculated for several population subgroups (age, sex and education level by districts). Hot days were associated with an increased risk of death (RR = 1.13; 95% CI = 1.10–1.16) and were significant in all population subgroups compared to the non-hot days. The risk ratio was higher among women (RR = 1.16; 95% CI= 1.12–1.21) and the elderly (RR = 1.18; 95% CI = 1.13–1.22). Individuals with primary education had similar risk (RR = 1.13; 95% CI = 1.08–1.18) than those without education (RR = 1.10; 95% CI= 1.05–1.15). Moreover, 6 out of 10 districts showed statistically significant associations, varying the risk ratio between 1.12 (95% CI = 1.03–1.21) in Sants-Montjuïc and 1.25 (95% CI = 1.14–1.38) in Sant Andreu. Findings identified vulnerable districts and suggested new insights to public health policy makers on how to develop district-specific strategies to reduce risks.
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Affiliation(s)
- Vijendra Ingole
- Barcelona Institute for Global Health (ISGlobal), Barcelona 08003, Spain; (V.I.)
- Climate and Health Program (CLIMA), Barcelona Institute for Global Health (ISGlobal), Barcelona 08003, Spain
| | - Marc Marí-Dell’Olmo
- Agència de Salut Pública de Barcelona (ASPB), Barcelona 08023, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona 08041, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
- Correspondence: ; Tel.: +34-93-2384545
| | - Anna Deluca
- Barcelona Institute for Global Health (ISGlobal), Barcelona 08003, Spain; (V.I.)
- Climate and Health Program (CLIMA), Barcelona Institute for Global Health (ISGlobal), Barcelona 08003, Spain
| | - Marcos Quijal
- Barcelona Institute for Global Health (ISGlobal), Barcelona 08003, Spain; (V.I.)
- Climate and Health Program (CLIMA), Barcelona Institute for Global Health (ISGlobal), Barcelona 08003, Spain
- Agència de Salut Pública de Barcelona (ASPB), Barcelona 08023, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona 08041, Spain
| | - Carme Borrell
- Agència de Salut Pública de Barcelona (ASPB), Barcelona 08023, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona 08041, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
- Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain
| | - Maica Rodríguez-Sanz
- Agència de Salut Pública de Barcelona (ASPB), Barcelona 08023, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona 08041, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
- Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain
| | - Hicham Achebak
- Climate and Health Program (CLIMA), Barcelona Institute for Global Health (ISGlobal), Barcelona 08003, Spain
- Centre for Demographic Studies (CED), Autonomous University of Barcelona, Barcelona 08193, Spain
| | - Dirk Lauwaet
- Environmental Modelling Department, Flemish Institute for Technological Research (VITO), Mol 2400, Belgium
| | - Joan Gilabert
- PCOT, Cartographic and Geological Institute of Catalonia (ICGC), Barcelona 08038, Spain
| | - Peninah Murage
- Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Shakoor Hajat
- Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Xavier Basagaña
- Barcelona Institute for Global Health (ISGlobal), Barcelona 08003, Spain; (V.I.)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
- Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain
| | - Joan Ballester
- Barcelona Institute for Global Health (ISGlobal), Barcelona 08003, Spain; (V.I.)
- Climate and Health Program (CLIMA), Barcelona Institute for Global Health (ISGlobal), Barcelona 08003, Spain
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He Y, Cheng L, Bao J, Deng S, Liao W, Wang Q, Tawatsupa B, Hajat S, Huang C. Geographical disparities in the impacts of heat on diabetes mortality and the protective role of greenness in Thailand: A nationwide case-crossover analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 711:135098. [PMID: 32000339 DOI: 10.1016/j.scitotenv.2019.135098] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 10/09/2019] [Accepted: 10/19/2019] [Indexed: 05/21/2023]
Abstract
Diabetes is a major public health problem globally, and heat exposure may be a potential risk factor for death among diabetes. This study examines the association between heat and diabetes mortality in different regions of Thailand and investigates whether heat effects are modified by regional greenness. Daily temperature and daily diabetes deaths data were obtained for 60 provinces of Thailand during 2000-2008. A case-crossover analysis was conducted to quantify the odds of heat-related death among diabetes. Meta-regression was then used to examine potential modification effects of regional greenness (as represented by the Normalized Difference Vegetation Index) on heat-related mortality. A strong association between heat and diabetes mortality was found in Thailand, with important regional variations. Nationally, the pooled odds ratio of diabetes mortality was 1.10 (95% confidence interval (CI): 1.06-1.14) for heat (90th percentile of temperature) and 1.20 (95% CI: 1.10-1.30) for extreme heat (99th percentile of temperature) compared with the minimum mortality temperature, across lag 0-1 days. Central and northeast Thailand were the most vulnerable regions. Regional greenness modified the effects of heat, with lower mortality impacts in areas of higher levels of greenness. In conclusion, heat exposure increases mortality risk in diabetes, with large geographical variations in risk suggesting the need for region-specific public health strategies. Increasing greenness levels may help to reduce the burden of heat on diabetes in Thailand against the backdrop of a warming climate.
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Affiliation(s)
- Yiling He
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Shanghai Typhoon Institute, China Meteorological Administration, Shanghai, China
| | - Liangliang Cheng
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Junzhe Bao
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shizhou Deng
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wenmin Liao
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Benjawan Tawatsupa
- Health Impact Assessment Division, Department of Health, Ministry of Public Health, Bangkok, Thailand
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China; School of Public Health, Zhengzhou University, Zhengzhou, China.
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Wang H, Tassinary LG. Effects of greenspace morphology on mortality at the neighbourhood level: a cross-sectional ecological study. Lancet Planet Health 2019; 3:e460-e468. [PMID: 31777337 DOI: 10.1016/s2542-5196(19)30217-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The association between urban greenspace and mortality risk is well known, but less is known about how the spatial arrangement of greenspace affects population health. We aimed to investigate the relation between urban greenspace distribution and mortality risk. METHODS We did a cross-sectional study in Philadelphia, PA, USA, using high-resolution landcover data for 2008 from the Pennsylvania Spatial Data Access database. We calculated landscape metrics to measure the greenness, fragmentation, connectedness, aggregation, and shape of greenspace, including and omitting green areas 83·6 m2 or smaller, using Geographical Information System and spatial pattern analysis programs. We analysed all-cause and cause-specific mortality (related to heart disease, chronic lower respiratory diseases, and neoplasms) recorded in 2006 for 369 census tracts (small geographical areas with a population of 2500-8000 people). We did negative binomial regression and principal component analyses to assess associations between landscape spatial metrics and mortality, controlling for geographical, demographic, and socioeconomic factors. FINDINGS A 1% increase in the percentage of greenspace was predicted to reduce all-cause mortality by 0·419% (95% CI 0·050-0·777), with no effect on cause-specific mortality. All-cause mortality was negatively associated with the area of greenspace. A 1 m2 increase in the mean area of greenspace led to a 0·011% (95% CI 0·004-0·018) fall in all-cause mortality and a 0·019% (0·007-0·032) decrease in cardiac mortality; considering only green areas larger than 83·6 m2 would contribute to a 0·002% (95% CI 0·001-0·003) decrease in all-cause mortality and a 0·003% (0·001-0·006) reduction in cardiac deaths. Census tracts with more connected, aggregated, coherent, and complex shape greenspaces had a lower risk of all-cause and cause-specific mortality. The negative association between articulated landscape parcels and all-cause mortality varied with age and education, such that the relation was stronger for census tracts with a higher percentage of older and less well-educated adults. INTERPRETATION A significant modest association exists between the spatial distribution of greenspace in cities and mortality risk. The overall amount of greenspace alone is probably failing to capture significant variance in local health outcomes and, thus, environment-based health planning should consider the shape, form, and function of greenspace. FUNDING None.
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Affiliation(s)
- Huaqing Wang
- Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, TX, USA
| | - Louis G Tassinary
- Department of Visualization, College of Architecture, Texas A&M University, College Station, TX, USA.
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Abstract
See Article by Wang et al
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Affiliation(s)
- John R Balmes
- 1 Department of Medicine University of California San Francisco CA.,2 Division of Environmental Health Sciences School of Public Health University of California Berkeley CA
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