Current and future temperature-related mortality and morbidity in the UK: a public health and climate change perspective

几项科学研究表明，暴露在室外极端温度下会增加死亡和发病的风险。近年来，由于越来越多的证据表明，气候变化将增加极端天气事件的频率和强度，从而增加相关的健康影响，人们对这一风险因素的兴趣大大增加。各国政府和国际卫生组织面临着做出回应的压力，主要是通过实施有效的公共卫生和气候政策，这些政策必须以可靠的科学评估为基础。然而，对于非最佳温度如何影响人类健康，以及这些风险在全球变暖中将如何变化，我们的知识仍然有限。该项目将通过全面评估英格兰和威尔士与非最佳室外温度和气候变化相关的当前和未来健康风险来解决这些差距。研究计划是在四个工作包（WPs）的详细计划结构。在第一个工作计划中，研究小组将把全国卫生数据库与高分辨率环境措施联系起来，然后将应用先进的流行病学方法来研究暴露在高温和低温下如何增加死亡和住院的风险。评估将在WP2中扩展，通过元回归和机器学习方法评估小地理区域和时间的风险变化，并根据当地气候、社会经济条件、基础设施和城市环境等背景特征定义人口的不同脆弱性水平。WP3将利用这些信息量化过去35年来小地区的超额死亡率和发病率，然后预测未来情景下的健康影响，这些变化包括全球变暖趋势、社会经济途径和潜在的公共卫生政策。最后一个WP将创建存储库来存储项目的全部结果，并将开发易于使用的web工具来提取、总结、显示和映射风险度量，并执行场景模拟。这些资源将以开放获取的形式免费发布，并将提供给广泛的用户，包括科学家、公共卫生专家、记者和一般公众。该项目将提供与热和冷有关的健康风险的详细情况，并将有助于确定英格兰和威尔士人口中脆弱性和复原力的驱动因素。这些信息对于以证据为基础对气候和公共卫生政策相关的潜在惠益进行量化，以及在国家和国际一级比较减轻全球变暖健康负担的备选缓解和适应战略至关重要。

Several scientific studies have demonstrated that exposure to extreme outdoor temperatures increases the risk of mortality and morbidity. The interest in this risk factor has grown considerably in the last few years, with the mounting evidence that climate change will increase the frequency and intensity of extreme weather episodes, and consequently the associated health impacts. Governments and international health organisations are under pressure to respond, primarily through the implementation of effective public health and climate policies, which must be based on solid scientific assessments. However, our knowledge on how non-optimal temperature affect human health, and how these risks will change in a warming planet, is still limited. This project will address these gaps by offering a comprehensive assessment of current and future health risks associated to non-optimal outdoor temperature and climate change in the England and Wales. The research proposal is structured in a detailed plan of four work packages (WPs). In the first WP, the research team will link country-wide health databases with high-resolution environmental measures, and will then apply advanced epidemiological methods to study how exposure to heat and cold increase the risk of mortality and hospital admissions. The evaluation will be extended in WP2 to assess through meta-regression and machine learning methods how the risk varies across small geographical areas and time, and to define differential vulnerability levels of the population in terms of contextual characteristics, such as local climate, socio-economic conditions, infrastructure, and urban settings. This information will be used in WP3 to quantify excess mortality and morbidity at small-area level in the last 35 years, and then to project health impacts under future scenarios that account for several changes, such as trends in global warming, socio-economic pathways, and potential public health policies. The last WP will create repositories to store the full set of results from the project, and will develop easy-to-use web tools to extract, summarise, display, and map risk measures, and to perform scenario simulations. These resources will be released for free and in open-access form, and will be made available to a broad range of users including scientists, public health experts, journalists, and the general public.The project will provide a detailed picture of health risks associated to heat and cold, and will help identify drivers of vulnerability and resilience within the population of England and Wales. This information is critical to perform an evidence-based quantification of potential benefits related to climate and public health policies, and to compare alternative mitigation and adaptation strategies to reduce the health burden of global warming at national and international level.