Spatial Patterns of Heat-Related Cardiovascular Mortality in the Czech Republic.
Spatial Patterns of Heat-Related Cardiovascular Mortality in the Czech Republic.
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DOI：
10.3390/ijerph13030284
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发表时间：
2016-03-04
影响因子：
--
通讯作者：
Lakes T
中科院分区：
文献类型：
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作者：
Urban A;Burkart K;Kyselý J;Schuster C;Plavcová E;Hanzlíková H;Štěpánek P;Lakes T
该研究考察了1994-2009年捷克共和国地区极端高温对心血管死亡率影响的空间格局。使用单一地点分层广义加性模型确定每个地区的每日基线死亡率。死亡率相对于基线的平均相对偏差是在夏季平均日温度超过90个百分位数的天数计算的，它们与选定的人口、社会经济和自然环境变量相关。根据社会经济状况和城市化水平确定具有相似特征的地区组，以便在地区一级尽可能提供更全面的情况。我们评估了热浪发生后死亡率过高的滞后模式：(i)城市地区与以农村为主的地区；②整体社会经济水平不同的地区。我们的研究结果表明，气候条件、海拔高度和城市化通常会影响心血管疾病死亡率最高的地区的空间分布，而社会经济状况在整个捷克共和国的分析中没有显示出显著的影响。只有在贫困人口中，社会经济地位也发挥了相关作用。在考虑了温度对超额死亡率的滞后效应后，我们发现高温期的影响在高度城市化的地区是显著的，而农村地区的大多数超额死亡率可能归因于收获效应。
The study examines spatial patterns of effects of high temperature extremes on cardiovascular mortality in the Czech Republic at a district level during 1994–2009. Daily baseline mortality for each district was determined using a single location-stratified generalized additive model. Mean relative deviations of mortality from the baseline were calculated on days exceeding the 90th percentile of mean daily temperature in summer, and they were correlated with selected demographic, socioeconomic, and physical-environmental variables for the districts. Groups of districts with similar characteristics were identified according to socioeconomic status and urbanization level in order to provide a more general picture than possible on the district level. We evaluated lagged patterns of excess mortality after hot spell occurrences in: (i) urban areas vs. predominantly rural areas; and (ii) regions with different overall socioeconomic level. Our findings suggest that climatic conditions, altitude, and urbanization generally affect the spatial distribution of districts with the highest excess cardiovascular mortality, while socioeconomic status did not show a significant effect in the analysis across the Czech Republic as a whole. Only within deprived populations, socioeconomic status played a relevant role as well. After taking into account lagged effects of temperature on excess mortality, we found that the effect of hot spells was significant in highly urbanized regions, while most excess deaths in rural districts may be attributed to harvesting effects.