Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
Environ Res. 2012 Feb;113:46-51. doi: 10.1016/j.envres.2012.01.004. Epub 2012 Jan 26.
This paper explores how housing modifies the temperature-mortality relationship in the Eastern and Western Cape provinces of South Africa. We estimate dose-response relationships for residents living in each of the five common types of South African housing by combining linear-threshold models for Cape Town with concurrent data on the city's housing composition and expert estimates of how well different types of housing protect against heat and cold. We then apply temperature data to determine provincial-level dose-response relationships, relative risks, attributable fractions and mortality burdens for heat and cold under seven housing scenarios--three past, three future and a scenario of maximum protection. We find that future mortality burdens would be lower under a policy scenario that prioritizes the replacement of informal housing compared to one that prioritizes the replacement of traditional dwellings. In a maximum protection scenario, where everyone lived in houses characteristic of the wealthy, temperature-related mortality could be reduced by over 50% (approximately 5000 deaths annually) in the two provinces combined. These results have relevance to current housing policy but also reinforce the importance of the built environment in mitigating adverse effects of future climate change.
本文探讨了住房如何改变南非东开普省和西开普省的温度-死亡率关系。我们通过将开普敦的线性阈值模型与该市住房结构的同期数据以及不同类型住房在防寒保暖方面的保护效果的专家评估相结合，为五种常见南非住房类型的居民估计了剂量反应关系。然后，我们应用温度数据来确定七种住房情景下的省级剂量反应关系、相对风险、归因分数和热冷相关的死亡负担，这七种情景包括三个过去情景、三个未来情景和一个最大保护情景。我们发现，与优先更换传统住宅的政策情景相比，优先更换非正式住房的政策情景下，未来的死亡负担会更低。在最大保护情景下，如果每个人都住在富有阶层的典型住房中，那么两个省份因温度相关而导致的死亡人数可减少 50%以上（每年约 5000 人）。这些结果与当前的住房政策有关，但也强化了建筑环境在减轻未来气候变化不利影响方面的重要性。
