title: The spatial distribution of health vulnerability to heat waves in Guangdong Province, China.
abstract: BACKGROUND
  International literature has illustrated that the health impacts of heat waves vary according to differences in the spatial variability of high temperatures and the social and economic characteristics of populations and communities. However, to date there have been few studies that quantitatively assess the health vulnerability to heat waves in China.
  
  
  OBJECTIVE
  To assess the spatial distribution of health vulnerability to heat waves in Guangdong Province, China.
  
  
  METHODS
  A vulnerability framework including dimensions of exposure, sensitivity, and adaptive capacity was employed. The last two dimensions were called social vulnerability. An indicator pool was proposed with reference to relevant literatures, local context provided by relevant local stakeholder experts, and data availability. An analytic hierarchy process (AHP) and a principal component analysis were used to determine the weight of indicators. A multiplicative vulnerability index (VI) was constructed for each district/county of Guangdong province, China.
  
  
  RESULTS
  A total of 13 items (two for exposure, six for sensitivity, and five for adaptive capacity) were proposed to assess vulnerability. The results of an AHP revealed that the average VI in Guangdong Province was 0.26 with the highest in the Lianzhou and Liannan counties of Qingyuan (VI=0.50) and the lowest in the Yantian district of Shenzhen (VI=0.08). Vulnerability was gradiently distributed with higher levels in northern inland regions and lower levels in southern coastal regions. In the principal component analysis, three components were isolated from the 11 social vulnerability indicators. The estimated vulnerability had a similar distribution pattern with that estimated by AHP (Intraclass correlation coefficient (ICC)=0.98, p<0.01).
  
  
  CONCLUSIONS
  Health vulnerability to heat waves in Guangdong Province had a distinct spatial distribution, with higher levels in northern inland regions than that in the southern coastal regions.
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhu
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; Environment and Health, Guangdong Provincial Key Medical Discipline of Twelfth Five-Year Plan, Guangzhou, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Liu
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; Environment and Health, Guangdong Provincial Key Medical Discipline of Twelfth Five-Year Plan, Guangzhou, China.
authors.forename: Hualiang
authors.initials: H
authors.lastname: Lin
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; Environment and Health, Guangdong Provincial Key Medical Discipline of Twelfth Five-Year Plan, Guangzhou, China.
authors.forename: Jianpeng
authors.initials: J
authors.lastname: Xiao
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; Environment and Health, Guangdong Provincial Key Medical Discipline of Twelfth Five-Year Plan, Guangzhou, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; Environment and Health, Guangdong Provincial Key Medical Discipline of Twelfth Five-Year Plan, Guangzhou, China.
authors.forename: Weilin
authors.initials: W
authors.lastname: Zeng
authors.affiliation: Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
authors.forename: Siqing
authors.initials: S
authors.lastname: Zeng
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; Environment and Health, Guangdong Provincial Key Medical Discipline of Twelfth Five-Year Plan, Guangzhou, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Wei
authors.affiliation: Griffith School of Environment, Griffith University, Brisbane, Australia.
authors.forename: Cordia
authors.initials: C
authors.lastname: Chu
authors.affiliation: Griffith School of Environment, Griffith University, Brisbane, Australia.
authors.forename: Scott
authors.initials: S
authors.lastname: Baum
authors.affiliation: Guangdong Provincial Climate Center, Guangzhou, China.
authors.forename: Yaodong
authors.initials: Y
authors.lastname: Du
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; Environment and Health, Guangdong Provincial Key Medical Discipline of Twelfth Five-Year Plan, Guangzhou, China; mwj68@vip.tom.com.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Ma
mesh_terms: D002681:China; D002980:Climate; D003710:Demography; D005843:Geography; D006358:Hot Temperature; D006801:Humans; D025341:Principal Component Analysis; D018570:Risk Assessment; D035862:Vulnerable Populations
keywords: analytic hierarchy process; climate change; heat waves; principal component analysis; vulnerability assessment