Cardiovascular Mortality Associated with Low and High Temperatures: Determinants of Inter-Region Vulnerability in China

作者：Xunfeng Yang, Lianfa Li, Jinfeng Wang, Jixia Huang, Shijun Lu · 发表于：International Journal of Environmental Research and Public Health · 年份：2015 · DOI：10.3390/ijerph120605918 · 被引用次数：26 · 研究领域：Climate Change and Health Impacts、Air Quality and Health Impacts、Global Health Care Issues

The objectives of this study were to estimate the effects of temperature on cardiovascular mortality in 26 regions in the south and west of China from 2008 to 2011, and to identify socioeconomic and demographic factors contributing to such inter-region variation in the temperature effect. A separate Poisson generalized additive model (GAM) was fitted to estimate percent changes in cardiovascular mortality at low and high temperatures on a daily basis for each region. The model used the smooth functions to model the nonlinear effects of temperature and humidity and to control for the seasonal factor using the calendar time variable. Given variation in the magnitude of the temperature effect on cardiovascular mortality, we employed a Bayesian network (BN) to identify potential region-specific socioeconomic and demographic factors that may explain the variation. In most regions, an increasing trend in high or low temperature was associated with an increase in cardiovascular mortality, with variation in the magnitude of the temperature effects across regions. Three factors, including per capita years of education (as an indicator of economic status), percentage of the population over 65 years of age and percentage of women had direct impact on cold-related cardiovascular mortality. Number of hospital beds (as an indicator of the availability of medical resources), percentage of population engaged in industrial occupations, and percentage of women showed direct impact on heat-rela...