Small-area assessment of temperature-related mortality risks in England and Wales: a case time series analysis.

作者：A. Gasparrini, P. Masselot, M. Scortichini, Rochelle Schneider, M. Mistry, F. Sera, H. Macintyre, R. Phalkey, A. Vicedo-Cabrera · 发表于：Lancet Planetary Health · 年份：2022 · DOI：10.1016/s2542-5196(22)00138-3 · 被引用次数：115 · 研究领域：Medicine

BACKGROUND Epidemiological literature on the health risks associated with non-optimal temperature has mostly reported average estimates across large areas or specific population groups. However, the heterogeneous distribution of drivers of vulnerability can result in local differences in health risks associated with heat and cold. We aimed to analyse the association between ambient air temperature and all-cause mortality across England and Wales and characterise small scale patterns in temperature-related mortality risks and impacts. METHODS We performed a country-wide small-area analysis using data on all-cause mortality and air temperature for 34 753 lower super output areas (LSOAs) within 348 local authority districts (LADs) across England and Wales between Jan 1, 2000, and Dec 31, 2019. We first performed a case time series analysis of LSOA-specific and age-specific mortality series matched with 1 × 1 km gridded temperature data using distributed lag non-linear models, and then a repeated-measure multivariate meta-regression to pool LAD-specific estimates using area-level climatological, socioeconomic, and topographical predictors. FINDINGS The final analysis included 10 716 879 deaths from all causes. The small-area assessment estimated that each year in England and Wales, there was on average 791 excess deaths (empirical 95% CI 611-957) attributable to heat and 60 573 (55 796-65 145) attributable to cold, corresponding to standardised excess mortality rates of 1·57 ...