title: Economic status and temperature-related mortality in Asia.
abstract: In developed countries, low latitude and high temperature are positively associated with the population's ability to adapt to heat. However, few studies have examined the effect of economic status on the relationship between long-term exposure to high temperature and health. We compared heterogeneous temperature-related mortality effects relative to the average summer temperature in high-socioeconomic-status (SES) cities to temperature-related effects in low-SES cities. In the first stage of the research, we conducted a linear regression analysis to quantify the mortality effects of high temperature (at or above the 95th percentile) in 32 cities in Taiwan, China, Japan, and Korea. In the second stage, we used a meta-regression to examine the association between mortality risk with average summer temperature and gross domestic product (GDP) per capita. In cities with a low GDP per capita (less than 20,000 USD), the effects of temperature were detrimental to the population if the long-term average summer temperature was high. In contrast, in cities with a high GDP per capita, temperature-related mortality risk was not significantly related to average summer temperature. The relationship between long-term average summer temperature and the short-term effects of high temperatures differed based on the city-level economic status.
authors.affiliation: Institute of Environmental Medicine, Seoul National University of Medical Research Center, Seoul, Korea.|Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Youn-Hee
authors.initials: YH
authors.lastname: Lim
authors.affiliation: School of Forestry and Environmental Studies, Yale University, New Haven, CT, USA.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Bell
authors.affiliation: Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China.
authors.forename: Haidong
authors.initials: H
authors.lastname: Kan
authors.affiliation: Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Honda
authors.affiliation: Environmental and Occupational Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Yue-Liang Leon
authors.initials: YL
authors.lastname: Guo
authors.affiliation: Department of Epidemiology and Biostatistics, Graduate School of Public Health, Seoul National University, Seoul, Korea. hokim@snu.ac.kr.|Institute of Health and Environment, Seoul National University, Seoul, Korea. hokim@snu.ac.kr.
authors.forename: Ho
authors.initials: H
authors.lastname: Kim
mesh_terms: D001208:Asia / Q000453:epidemiology; D002947:Cities / Q000453:epidemiology; D059066:Gross Domestic Product; D006801:Humans; D009026:Mortality / Q000639:trends*; D012044:Regression Analysis; D012959:Socioeconomic Factors; D013696:Temperature; D014504:Urban Health
keywords: Asia; Climate; Economic status; Heat waves; Income; Mortality