A study of intracity variation of temperature-related mortality and socioeconomic status among the Chinese population in Hong Kong.
BACKGROUND
Hong Kong, a major city in China, has one of the world's highest income inequalities and one of the world's highest average increases in urban ambient temperatures. Heat-related mortality in urban areas may vary with acclimatisation and population characteristics. This study examines how the effect of temperature on mortality is associated with sociodemographic characteristics at an intracity level in Hong Kong, China, during the warm season.


METHODS
Data from the Hong Kong Observatory, Census and Statistics Department, Environmental Protection Department and government general outpatient clinics during 1998-2006 were used to construct generalised additive (Poisson) models to examine the temperature mortality relationship in Hong Kong. Adjusted for seasonality, long-term trends, pollutants and other potential confounders, effect modification of the warm season temperature-mortality association by demographic, socioeconomic factors and urban design were examined.


RESULTS
An average 1°C increase in daily mean temperature above 28.2°C was associated with an estimated 1.8% increase in mortality. Heat-related mortality varied with sociodemographic characteristics: women, men less than 75 years old, people living in low socioeconomic districts, those with unknown residence and married people were more vulnerable. Non-cancer-related causes such as cardiovascular and respiratory infection-related deaths were more sensitive to high temperature effects.


CONCLUSIONS
Public health protection strategies that target vulnerable population subgroups during periods of elevated temperature should be considered.
Chan
Emily Ying Yang
EY
School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong. emily.chan@cuhk.edu.hk
Goggins
William B
WB
Kim
Jacqueline Jakyoung
JJ
Griffiths
Sian M
SM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000397:Air Pollution / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000208:ethnology*; D016012:Poisson Distribution; D012111:Residence Characteristics; D012621:Seasons; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*