Impacts of urbanization on the temperature-cardiovascular mortality relationship in Beijing, China

• Published in: Environmental research 2020-12, Vol.191, p.110234, Article 110234
• Main Authors: Xing, Qian, Sun, ZhaoBin, Tao, Yan, Zhang, Xiaoling, Miao, Shiguang, Zheng, Canjun, Tong, Shilu
• Format: Article
• Language: English
• Subjects: Aged; Beijing - epidemiology; Cardiovascular Diseases; Cardiovascular mortality; China - epidemiology; Cities; Hot Temperature; Humans; Mortality; Temperature; Urbanization; Vulnerability
• ISSN: 0013-9351; 1096-0953
• DOI: 10.1016/j.envres.2020.110234

The effect of temperature on cardiovascular disease (CVD) mortality has been extensively studied. However, it remains largely unknown over whether there is any difference between urban and suburban areas within the same city and how urbanization modifies the relationship between temperature and CVD mortality. In order to examine whether the association between temperature and CVD mortality existed difference in urban and suburban areas, and how urbanization modified this association, we used a distributed lag nonlinear model and a generalized additive model to investigate temperature-related CVD mortality in urban and suburban areas in Beijing, China, from 2006 to 2011. The age, gender, and educational attainment of the population were stratified to explore the modifying effect. We observed that the impacts of heat and cold temperature on CVD mortality were higher in suburban areas than in urban areas. In addition, the elderly and illiterate subjects in suburban areas were more vulnerable to both heat and cold than their counterparts in urban areas. Moreover, higher urbanization levels were significantly associated with districts having lower the excess risks for temperature- CVD mortality. Our findings provide evidence that populations in suburban Beijing have higher risk of temperature-related CVD mortality than those in urban areas. Therefore, greater attention should be paid to vulnerable groups in suburban areas to reduce temperature-related health burden. •Urban/suburban temperature-effect differences on mortality were compared.•Urbanization modifies the relationship between temperature and CVD mortality.•People living in suburban areas were more vulnerable to both hot and cold temperatures.•CVD mortality varied with age, gender, and educational attainment in both urban and suburban areas.•Implies different patterns of temperature impact between developed and developing countries.