TY - JOUR
T1 - Geographic and socioeconomic differences in heat-related mortality among the Dutch population
T2 - a time series analysis
AU - de Visser, Mara
AU - Kunst, Anton E.
AU - Fleischmann, Maria
N1 - Publisher Copyright: ©
PY - 2022/11/16
Y1 - 2022/11/16
N2 - OBJECTIVES: This study was conducted to examine modification in heat-related mortality in the Netherlands by sociodemographic and geographical factors including socioeconomic position and population density (PD). DESIGN: This observational study applied time series analysis on daily mortality counts according to mean daily temperature (°C). SETTING: Statistics Netherlands. PARTICIPANTS: Death registrations in 2006, 2018 and 2019 from residents registered at the Dutch Personal Records Database, restricted to deaths in the period between April and October. MAIN OUTCOME MEASURES: Assuming a V-like relation between temperature and mortality, a segmented linear model was used to estimate the temperature effects on mortality. In order to estimate the effects of severe heat, a second model including a heat threshold of 22°C was included in the model. We stratified by sociodemographic groups, calendar year and the five main causes of death (cardiovascular, respiratory, neoplasm, psychological and nervous system, and other) and controlled for time trend and seasonality. RESULTS: The effect of 1°C increase in temperature whereby the mean daily temperature exceeded 16°C was a 1.57% (95% CI 1.51% to 1.63%) increase in mortality among the total population. In temperature segments whereby the mean daily temperature exceeded 22°C, this effect was 2.84% (95% CI 2.73% to 2.93%). Low-income groups were at higher risk of heat-related mortality, compared with high-income groups. Areas with a high PD show relatively weak effects within both the warm and heat segments. CONCLUSION: Results of this study highlight the variation in terms of heat vulnerability among the Dutch population, whereby poor living conditions specifically may increase the effect on high temperature on mortality.
AB - OBJECTIVES: This study was conducted to examine modification in heat-related mortality in the Netherlands by sociodemographic and geographical factors including socioeconomic position and population density (PD). DESIGN: This observational study applied time series analysis on daily mortality counts according to mean daily temperature (°C). SETTING: Statistics Netherlands. PARTICIPANTS: Death registrations in 2006, 2018 and 2019 from residents registered at the Dutch Personal Records Database, restricted to deaths in the period between April and October. MAIN OUTCOME MEASURES: Assuming a V-like relation between temperature and mortality, a segmented linear model was used to estimate the temperature effects on mortality. In order to estimate the effects of severe heat, a second model including a heat threshold of 22°C was included in the model. We stratified by sociodemographic groups, calendar year and the five main causes of death (cardiovascular, respiratory, neoplasm, psychological and nervous system, and other) and controlled for time trend and seasonality. RESULTS: The effect of 1°C increase in temperature whereby the mean daily temperature exceeded 16°C was a 1.57% (95% CI 1.51% to 1.63%) increase in mortality among the total population. In temperature segments whereby the mean daily temperature exceeded 22°C, this effect was 2.84% (95% CI 2.73% to 2.93%). Low-income groups were at higher risk of heat-related mortality, compared with high-income groups. Areas with a high PD show relatively weak effects within both the warm and heat segments. CONCLUSION: Results of this study highlight the variation in terms of heat vulnerability among the Dutch population, whereby poor living conditions specifically may increase the effect on high temperature on mortality.
KW - EPIDEMIOLOGY
KW - PUBLIC HEALTH
KW - STATISTICS & RESEARCH METHODS
UR - http://www.scopus.com/inward/record.url?scp=85142188569&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/bmjopen-2021-058185
DO - https://doi.org/10.1136/bmjopen-2021-058185
M3 - Article
C2 - 36385032
SN - 2044-6055
VL - 12
SP - e058185
JO - BMJ Open
JF - BMJ Open
IS - 11
M1 - e058185
ER -