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Abstract
The relationship between temperature and mortality has been found to be U-, V-, or J-shaped in developed temperate countries; however, in developing tropical/subtropical cities, it remains unclear. Our goal was to investigate the relationship between temperature and mortality in Hue, a subtropical city in Viet Nam. We collected daily mortality data from the Vietnamese A6 mortality reporting system for 6,214 deceased persons between 2009 and 2013. A distributed lag non-linear model was used to examine the temperature effects on all-cause and cause-specific mortality by assuming negative binomial distribution for count data. We developed an objective-oriented model selection with four steps following the Akaike information criterion (AIC) rule (i.e. a smaller AIC value indicates a better model). High temperature-related mortality was more strongly associated with short lags, whereas low temperature-related mortality was more strongly associated with long lags. The low temperatures increased risk in all-category mortality compared to high temperatures. We observed elevated temperature-mortality risk in vulnerable groups: elderly people (high temperature effect, relative risk [RR]=1.42, 95% confidence interval [CI]=1.11–1.83; low temperature effect, RR=2.0, 95% CI=1.13–3.52), females (low temperature effect, RR=2.19, 95% CI=1.14–4.21), people with respiratory disease (high temperature effect, RR=2.45, 95% CI=0.91–6.63), and those with cardiovascular disease (high temperature effect, RR=1.6, 95% CI=1.15–2.22; low temperature effect, RR=1.99, 95% CI=0.92–4.28). In Hue, the temperature significantly increased the risk of mortality, especially in vulnerable groups (i.e. elderly, female, people with respiratory and cardiovascular diseases). These findings may provide a foundation for developing adequate policies to address the effects of temperature on health in Hue City.
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Details
1 Department of Health Care Policy and Management Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; Department of Environmental Health Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
2 Department of Health Care Policy and Management Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
3 Department of Global Health Promotion Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Department of Pediatrics Hue University of Medicine and Pharmacy, Hue City, Viet Nam
4 Institute for Community Heath Research Hue University of Medicine and Pharmacy, Hue City, Viet Nam
5 Department of International Cooperation Ministry of Health, Hanoi, Viet Nam
6 Department of Epidemiology and Preventive Medicine Graduate School of Medical and Dental Sciences, University of Kagoshima, Kagoshima, Japan
7 Department of Global Public Health Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
8 Faculty of Health and Sport Sciences University of Tsukuba, Tsukuba, Japan