Evolution of temperature-attributable mortality trends looking at social inequalities: An observational case study of urban maladaptation to cold and heat

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• dc.contributor.author Ellena, Marta
• dc.contributor.author Ballester, Joan
• dc.contributor.author Costa, Giuseppe
• dc.contributor.author Achebak, Hicham
• dc.date.accessioned 2023-10-18T06:38:15Z
• dc.date.issued 2022
• dc.description.abstract Background: To date, little is known about the temporal variation of the temperature-mortality association among different demographic and socio-economic groups. The aim of this work is to investigate trends in cold- and heat- attributable mortality risk and burden by sex, age, education, marital status, and number of household occupants in the city of Turin, Italy. Methods: We collected daily time-series of temperature and mortality counts by demographic and socio-economic groups for the period 1982-2018 in Turin. We applied standard quasi-Poisson regression models to data subsets of 25-year moving subperiods, and we estimated the temperature-mortality associations with distributed lag non-linear models (DLNM). We provided cross-linkages between the evolution of minimum mortality temperatures, relative risks of mortality and temperature-attributable deaths under cold and hot conditions. Results: Our findings highlighted an overall increase in risk trends under cold and heat conditions. All-cause mortality at the 1st percentile increased from 1.15 (95% CI: 1.04; 1.28) in 1982-2006 to 1.24 (95% CI: 1.11; 1.38) in 1994-2018, while at the 99th percentile the risk shifted from 1.51 (95% CI: 1.41; 1.61) to 1.59 (95% CI: 1.49; 1.71). In relation to social differences, women were characterized by greater values in respect to men, and similar estimates were observed among the elderly in respect to the youngest subgroup. Risk trends by educational subgroups were mixed, according to the reference temperature condition. Finally, individuals living in conditions of isolation were characterized by higher risks, with an increasing vulnerability throughout time. Conclusions: The overall increase in cold- and heat- related mortality risk suggests a maladaptation to ambient temperatures in Turin. Despite alert systems in place increase public awareness and improve the efficiency of existing health services at the local level, they do not necessarily prevent risks in a homogeneous way. Targeted public health responses to cold and heat in Turin are urgently needed to adapt to extreme temperatures due to climate change.
• dc.description.sponsorship JB and HA gratefully acknowledge funding from the EU's Horizon 2020 research and innovation programme under grant agreement n. 865564 (European Research Council Consolidator Grant EARLY-ADAPT). JB gratefully acknowledges funding from the EU's Horizon 2020 research and innovation programme under grant agreements n. 727852 (project Blue-Action) and n. 956396 (project EDIPI), and from the Spanish Ministry of Science and Innovation (MCIU) under grant agreements n. RYC 2018-025446-I (programme Ramón y Cajal) and EUR 2019-103822 (project EURO-ADAPT). JR gratefully acknowledges funding from the EU Community Action Program for Public Health (grant agreement no 2005114). ISGlobal acknowledges support from the Spanish Ministry of Science and Innovation through the Centro de Excelencia Severo Ochoa 2019–2023 Program (CEX 2018-000806-S) and support from the Generalitat de Catalunya through the CERCA programme.
• dc.format.mimetype application/pdf
• dc.identifier.citation Ellena M, Ballester J, Costa G, Achebak H. Evolution of temperature-attributable mortality trends looking at social inequalities: An observational case study of urban maladaptation to cold and heat. Environ Res. 2022 Nov;214(Pt 3):114082. DOI: 10.1016/j.envres.2022.114082
• dc.identifier.doi http://dx.doi.org/10.1016/j.envres.2022.114082
• dc.identifier.issn 0013-9351
• dc.identifier.uri http://hdl.handle.net/10230/58089
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Environ Res. 2022 Nov;214(Pt 3):114082
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/865564
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/727852
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/956396
• dc.rights © Elsevier http://dx.doi.org/10.1016/j.envres.2022.114082
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword Climate change
• dc.subject.keyword Italy
• dc.subject.keyword Maladaptation
• dc.subject.keyword Social inequalities
• dc.subject.keyword Temperature
• dc.subject.keyword Urban
• dc.title Evolution of temperature-attributable mortality trends looking at social inequalities: An observational case study of urban maladaptation to cold and heat
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion