title: Spatial Patterns of Heat-Related Cardiovascular Mortality in the Czech Republic.
abstract: The study examines spatial patterns of effects of high temperature extremes on cardiovascular mortality in the Czech Republic at a district level during 1994-2009. Daily baseline mortality for each district was determined using a single location-stratified generalized additive model. Mean relative deviations of mortality from the baseline were calculated on days exceeding the 90th percentile of mean daily temperature in summer, and they were correlated with selected demographic, socioeconomic, and physical-environmental variables for the districts. Groups of districts with similar characteristics were identified according to socioeconomic status and urbanization level in order to provide a more general picture than possible on the district level. We evaluated lagged patterns of excess mortality after hot spell occurrences in: (i) urban areas vs. predominantly rural areas; and (ii) regions with different overall socioeconomic level. Our findings suggest that climatic conditions, altitude, and urbanization generally affect the spatial distribution of districts with the highest excess cardiovascular mortality, while socioeconomic status did not show a significant effect in the analysis across the Czech Republic as a whole. Only within deprived populations, socioeconomic status played a relevant role as well. After taking into account lagged effects of temperature on excess mortality, we found that the effect of hot spells was significant in highly urbanized regions, while most excess deaths in rural districts may be attributed to harvesting effects.
authors.affiliation: Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic. urban@ufa.cas.cz.|Faculty of Science, Charles University, Albertov 6, 12843 Prague 2, Czech Republic. urban@ufa.cas.cz.
authors.forename: Aleš
authors.initials: A
authors.lastname: Urban
authors.affiliation: Department of Environmental Health Science, Mailman School of Public Health, Columbia University, 722 W 168th Street, New York, NY 10032, USA. burkarka@cms.hu-berlin.de.
authors.forename: Katrin
authors.initials: K
authors.lastname: Burkart
authors.affiliation: Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic. kysely@ufa.cas.cz.|Faculty of Environmental Sciences, Czech University of Life Sciences, Kamýcká 129, 16521 Prague 6, Czech Republic. kysely@ufa.cas.cz.|Global Change Research Centre, Czech Academy of Sciences, Bělidla 986, 60300 Brno, Czech Republic. kysely@ufa.cas.cz.
authors.forename: Jan
authors.initials: J
authors.lastname: Kyselý
authors.affiliation: Department of Geography, Geoinformation Science Lab, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany. christian.schuster@hu-berlin.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Schuster
authors.affiliation: Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic. plavcova@ufa.cas.cz.
authors.forename: Eva
authors.initials: E
authors.lastname: Plavcová
authors.affiliation: Institute of Atmospheric Physics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic. hanzlikova@ig.cas.cz.|Institute of Geophysics, Czech Academy of Sciences, Boční II 1401, 14131 Prague 4, Czech Republic. hanzlikova@ig.cas.cz.
authors.forename: Hana
authors.initials: H
authors.lastname: Hanzlíková
authors.affiliation: Global Change Research Centre, Czech Academy of Sciences, Bělidla 986, 60300 Brno, Czech Republic. petrstep2@gmail.com.|Czech Hydrometeorological Institute, Regional Office Brno, Kroftova 2578, 61667 Brno, Czech Republic. petrstep2@gmail.com.
authors.forename: Petr
authors.initials: P
authors.lastname: Štěpánek
authors.affiliation: Department of Geography, Geoinformation Science Lab, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany. tobia.lakes@geo.hu-berlin.de.
authors.forename: Tobia
authors.initials: T
authors.lastname: Lakes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality*; D018153:Czech Republic / Q000453:epidemiology; D003710:Demography; D005260:Female; D005843:Geography; D018882:Heat Stress Disorders / Q000453:epidemiology / Q000401:mortality*; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data*; D012621:Seasons; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: cardiovascular disease; heat stress; mortality; socioeconomic status; spatial differences