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Open AccessArticle

The Mortality Risk and Socioeconomic Vulnerability Associated with High and Low Temperature in Hong Kong

1
Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), The Chinese University of Hong Kong, Hong Kong SAR, China
2
JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(19), 7326; https://doi.org/10.3390/ijerph17197326
Received: 31 July 2020 / Revised: 30 September 2020 / Accepted: 30 September 2020 / Published: 7 October 2020
(1) Background: The adverse health effect associated with extreme temperature has been extensively reported in the current literature. Some also found that temperature effect may vary among the population with different socioeconomic status (SES), but found inconsistent results. Previous studies on the socioeconomic vulnerability of temperature effect were mainly achieved by multi-city or country analysis, but the large heterogeneity between cities may introduce additional bias to the estimation. The linkage between death registry and census in Hong Kong allows us to perform a city-wide analysis in which the study population shares virtually the same cultural, lifestyle and policy environment. This study aims to examine and compare the high and low temperature on morality in Hong Kong, a city with a subtropical climate and address a key research question of whether the extreme high and low temperature disproportionally affects population with lower SES. (2) Methods: Poisson-generalized additive models and distributed-lagged nonlinear models were used to examine the association between daily mortality and daily mean temperature between 2007–2015 with other meteorological and confounding factors controlled. Death registry was linked with small area census and area-level median household income was used as the proxy for socioeconomic status. (3) Results: 362,957 deaths during the study period were included in the analysis. The minimum mortality temperature was found to be 28.9 °C (82nd percentile). With a subtropical climate, the low temperature has a stronger effect than the high temperature on non-accidental, cardiovascular, respiratory and cancer deaths in Hong Kong. The hot effect was more pronounced in the first few days, while cold effect tended to last up to three weeks. Significant heat effect was only observed in the lower SES groups, whilst the extreme low temperature was associated with significantly higher mortality risk across all SES groups. The older population were susceptible to extreme temperature, especially for cold. (4) Conclusions: This study raised the concern of cold-related health impact in the subtropical region. Compared with high temperature, low temperature may be considered a universal hazard to the entire population in Hong Kong rather than only disproportionally affecting people with lower SES. Future public health policy should reconsider the strategy at both individual and community levels to reduce temperature-related mortality. View Full-Text
Keywords: H-EDRM; climate change; extreme temperature; climate change; socioeconomic vulnerability; health disparities H-EDRM; climate change; extreme temperature; climate change; socioeconomic vulnerability; health disparities
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Liu, S.; Chan, E.Y.Y.; Goggins, W.B.; Huang, Z. The Mortality Risk and Socioeconomic Vulnerability Associated with High and Low Temperature in Hong Kong. Int. J. Environ. Res. Public Health 2020, 17, 7326.

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