Background: Although adverse effects of high temperature on mortality have been studied extensively in urban areas, little is known of the heat–mortality associations outside of cities.
Objective: We investigated whether heat–mortality associations differed between urban and nonurban areas and how urbanicity affected the vulnerability to heat-related mortality.
Methods: We first analyzed heat-related mortality risk in each of 102 counties in Jiangsu Province, China, during 2009–2013 using a distributed-lag nonlinear model. The county-specific estimates were then pooled for more urban (percentage of urban population ≥ 57.11%) and less urban (percentage of urban population < 57.11%) counties using a Bayesian hierarchical model. To explain the spatial variation in associations by county, county-level characteristics affecting heat vulnerability were also examined.
Results: We found that the overall mortality risk comparing the 99th vs. 75th percentiles of temperature was 1.43 [95% posterior intervals (PI): 1.36, 1.50] in less urban counties and 1.26 (95% PI: 1.23, 1.30) in more urban counties. The heat effects on cardiorespiratory mortality followed a similar pattern. Higher education level and prevalence of air conditioning were significantly associated with counties having lower risks, whereas percentage of elderly people was significantly associated with increased risks.
Conclusion: Our findings reveal that nonurban areas have significant heat-related mortality risks in Jiangsu, China. These results suggest the need for enhanced adaptation planning in Chinese nonurban areas under a changing climate.
1State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China; 2Program in Climate and Health, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA; 3Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China; 4Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
Recommended Citation:
Kai Chen,1,2 Lian Zhou,et al. Urbanization Level and Vulnerability to Heat-Related Mortality in Jiangsu Province, China[J]. Environmental Health Perspectives,2016-01-01,Volume 124(Issue 12):1863