Nonlinear relationship between extreme temperature and mortality in different temperature zones: A systematic study of 122 communities across the mainland of China
Abstract
Background Numerous previous studies have reported that human health risk is extremely sensitive to temperature. Very few studies, however, have characterized the relationship between temperature and mortality in different temperature zones due to the previous conclusions deduced from a regional or administrative division. A research covers different temperature zones was indispensable to have a comprehensive understanding of regional ambient temperature effect on public health. Methods Based on the mortality dataset and meteorological variables of 122 communities in China from 2007 to 2012, a distributed lag nonlinear model (DLNM) was utilized to estimate the temperature effect on non-accidental mortality at the community level. Then, a meta-regression analysis was applied to pool the estimates of community-specific effects in various latitude-effected temperature zones. Results At the community level, the mean value of relative extreme cold risk (1.63) of all 122 communities was higher than that of extreme high temperature (1.15). At regional level, we found temperature-mortality relationship (e.g., U- or J-shaped) varied in different temperature zones. Meanwhile, the minimum-mortality temperature of each zone was near the 75th percentile of local mean temperature except the north subtropics (50th percentiles). Lag effect was also obvious, especially for cold effect. An interesting M-shaped curve for the relationship between cold risk and temperature was detected, while an inverted "U" shaped with a right tail for the heat effect. Such different responses might be attributed to the difference in social-economic status of temperature zones. Conclusion The temperature-mortality relationship showed a distinct spatial heterogeneity along temperature zones across the Chinese mainland. Different characteristics of mortality responding to cold and heat stress highlighted the fact that, apart from the circumstance of temperature, the social-economic condition was also linked with health risk. Our findings suggest decision-makers should take more adaptive and effective measures to reduce health risks in China.
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Health impacts of summer heat exposure are likely nonlinear, i.e., incremental increases in environmental heat load may lead to disproportionately higher risk.
“Recognizing that health impacts of summer heat exposure are likely to be nonlinear48–51, i.e., incremental increases in environmental heat load may lead to disproportionately higher risk47”
From Disproportionate exposure to urban heat island intensity across major US cities (2021) · cites this paper as [51]
Above a moderate threshold, damage is an increasing convex function of temperature.
“Evidence suggests that above a moderate threshold damage is an increasing convex function of temperature, i.e., a 1° temperature increase causes more damage at higher temperatures48–51.”
From Disproportionate exposure to urban heat island intensity across major US cities (2021) · cites this paper as [51]
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- Authors
- Wang, C., Zhang, Z., Zhou, M., Zhang, L., Yin, P., Ye, W., & Chen, Y.
- Affiliations
- Beijing Normal University (CN)
- National Center for Chronic and Noncommunicable Disease Control and Prevention (CN)
- Corresponding author
- Zhang, Zhao
- Zhou, Maigeng
- Venue
- Science of The Total Environment
- Publisher
- Elsevier BV
- Published
- 2017-05
- Volume
- 586
- Pages
- 96-106
- ISSN
- 0048-9697 (ISSN-L)
- OpenAlex
- W2588035346
- Cited by
- 80
- References
- 67
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 4 · 2023: 9 · 2022: 11 · 2021: 8 · 2020: 13 · 2019: 7 · 2018: 8 · 2017: 1
- FWCI
- 4.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Science of The Total Environment (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (41321001, 41571493, 41571088)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Keywords
- temperature extremes, temperature-mortality relationship, cold-related mortality, heat-related mortality, temperature zones, spatial heterogeneity, lagged effects, minimum mortality temperature, socioeconomic status, non-accidental mortality, China
- MeSH terms
- China, Cold Temperature, Hot Temperature, Humans, Mortality, Nonlinear Dynamics
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