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Individual-level and community-level effect modifiers of the temperature–mortality relationship in 66 Chinese communities

OBJECTIVES: To examine the modification of temperature-mortality association by factors at the individual and community levels. DESIGN AND METHODS: This study investigated this issue using a national database comprising daily data of 66 Chinese communities for 2006–2011. A ‘threshold-natural cubic s...

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Autores principales: Huang, Zhengjing, Lin, Hualiang, Liu, Yunning, Zhou, Maigeng, Liu, Tao, Xiao, Jianpeng, Zeng, Weilin, Li, Xing, Zhang, Yonghui, Ebi, Kristie L, Tong, Shilu, Ma, Wenjun, Wang, Lijun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4577931/
https://www.ncbi.nlm.nih.gov/pubmed/26369803
http://dx.doi.org/10.1136/bmjopen-2015-009172
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author Huang, Zhengjing
Lin, Hualiang
Liu, Yunning
Zhou, Maigeng
Liu, Tao
Xiao, Jianpeng
Zeng, Weilin
Li, Xing
Zhang, Yonghui
Ebi, Kristie L
Tong, Shilu
Ma, Wenjun
Wang, Lijun
author_facet Huang, Zhengjing
Lin, Hualiang
Liu, Yunning
Zhou, Maigeng
Liu, Tao
Xiao, Jianpeng
Zeng, Weilin
Li, Xing
Zhang, Yonghui
Ebi, Kristie L
Tong, Shilu
Ma, Wenjun
Wang, Lijun
author_sort Huang, Zhengjing
collection PubMed
description OBJECTIVES: To examine the modification of temperature-mortality association by factors at the individual and community levels. DESIGN AND METHODS: This study investigated this issue using a national database comprising daily data of 66 Chinese communities for 2006–2011. A ‘threshold-natural cubic spline’ distributed lag non-linear model was utilised to estimate the mortality effects of daily mean temperature, and then examined the modification of the relationship by individual factors (age, sex, education level, place of death and cause of death) using a meta-analysis approach and community-level factors (annual temperature, population density, sex ratio, percentage of older population, health access, household income and latitude) using a meta-regression method. RESULTS: We found significant effects of high and low temperatures on mortality in China. The pooled excess mortality risk was 1.04% (95% CI 0.90% to 1.18%) for a 1°C temperature decrease below the minimum mortality temperature (MMT), and 3.44% (95% CI 3.00% to 3.88%) for a 1°C temperature increase above MMT. At the individual level, age and place of death were found to be significant modifiers of cold effect, while age, sex, place of death, cause of death and education level were effect modifiers of heat effect. At the community level, communities with lower socioeconomic status and higher annual temperature were generally more vulnerable to the mortality effects of high and low temperatures. CONCLUSIONS: This study identifies susceptibility based on both individual-level and community-level effect modifiers; more attention should be given to these vulnerable individuals and communities to reduce adverse health effects of extreme temperatures.
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spelling pubmed-45779312015-10-02 Individual-level and community-level effect modifiers of the temperature–mortality relationship in 66 Chinese communities Huang, Zhengjing Lin, Hualiang Liu, Yunning Zhou, Maigeng Liu, Tao Xiao, Jianpeng Zeng, Weilin Li, Xing Zhang, Yonghui Ebi, Kristie L Tong, Shilu Ma, Wenjun Wang, Lijun BMJ Open Epidemiology OBJECTIVES: To examine the modification of temperature-mortality association by factors at the individual and community levels. DESIGN AND METHODS: This study investigated this issue using a national database comprising daily data of 66 Chinese communities for 2006–2011. A ‘threshold-natural cubic spline’ distributed lag non-linear model was utilised to estimate the mortality effects of daily mean temperature, and then examined the modification of the relationship by individual factors (age, sex, education level, place of death and cause of death) using a meta-analysis approach and community-level factors (annual temperature, population density, sex ratio, percentage of older population, health access, household income and latitude) using a meta-regression method. RESULTS: We found significant effects of high and low temperatures on mortality in China. The pooled excess mortality risk was 1.04% (95% CI 0.90% to 1.18%) for a 1°C temperature decrease below the minimum mortality temperature (MMT), and 3.44% (95% CI 3.00% to 3.88%) for a 1°C temperature increase above MMT. At the individual level, age and place of death were found to be significant modifiers of cold effect, while age, sex, place of death, cause of death and education level were effect modifiers of heat effect. At the community level, communities with lower socioeconomic status and higher annual temperature were generally more vulnerable to the mortality effects of high and low temperatures. CONCLUSIONS: This study identifies susceptibility based on both individual-level and community-level effect modifiers; more attention should be given to these vulnerable individuals and communities to reduce adverse health effects of extreme temperatures. BMJ Publishing Group 2015-09-14 /pmc/articles/PMC4577931/ /pubmed/26369803 http://dx.doi.org/10.1136/bmjopen-2015-009172 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Epidemiology
Huang, Zhengjing
Lin, Hualiang
Liu, Yunning
Zhou, Maigeng
Liu, Tao
Xiao, Jianpeng
Zeng, Weilin
Li, Xing
Zhang, Yonghui
Ebi, Kristie L
Tong, Shilu
Ma, Wenjun
Wang, Lijun
Individual-level and community-level effect modifiers of the temperature–mortality relationship in 66 Chinese communities
title Individual-level and community-level effect modifiers of the temperature–mortality relationship in 66 Chinese communities
title_full Individual-level and community-level effect modifiers of the temperature–mortality relationship in 66 Chinese communities
title_fullStr Individual-level and community-level effect modifiers of the temperature–mortality relationship in 66 Chinese communities
title_full_unstemmed Individual-level and community-level effect modifiers of the temperature–mortality relationship in 66 Chinese communities
title_short Individual-level and community-level effect modifiers of the temperature–mortality relationship in 66 Chinese communities
title_sort individual-level and community-level effect modifiers of the temperature–mortality relationship in 66 chinese communities
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4577931/
https://www.ncbi.nlm.nih.gov/pubmed/26369803
http://dx.doi.org/10.1136/bmjopen-2015-009172
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