Department of Urban Planning and Design, The University of Hong Kong, Pok Fu Lam, Hong Kong.
Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
Environ Sci Pollut Res Int. 2019 Aug;26(23):24272-24285. doi: 10.1007/s11356-019-05594-0. Epub 2019 Jun 22.
Temperature is associated with mortality risk across cities. However, there is lack of study investigating the summer effect on mortality associated with mental/behavioral disorders, especially in cities with subtropical climate. In addition, summer mortality in subtropical cities is different from tropical cities, and previous studies have not investigated the urban environmental inequality on heat mortality associated with mental/behavioral disorders. A register-based study was developed to estimate the temperature effects on decedents on days with 50 percentile of average daily temperature between 2007 and 2014 in Hong Kong (n = 133,359). Poisson regression was firstly applied to estimate the incidence rate ratio (IRR) from the summer temperature effects on all-cause mortality, cardiovascular mortality, respiratory mortality, and mortality associated with mental/behavioral disorders. For a 1 °C increase in average temperature on days with temperature ≥ 24.51 °C, IRRs of mortality associated with mental and behavioral disorders on lag 0 and lag 1 days were 1.033 [1.004, 1.062] and 1.030 [1.002, 1.060], while temperature effects on cardiovascular mortality and respiratory mortality during normal summer days (not extreme heat events) were not significant. A further investigation with linear regression has shown that decedents with mental/behavioral disorders on higher temperature days resided in areas with lower percentage of sky view, lower percentage of vegetation cover, higher level of neighborhood-level PM, higher level of neighborhood-level NO, and higher level of neighborhood-level black carbon (BC). In order to develop protocols for community healthcare based on the "Leaving no one behind" scheme documented in the 2016 Sustainable Development Goals report of the United Nations, it is necessary to include heat effects on mental/behavioral disorders, especially people with dementia, for community planning and healthcare development.
温度与城市死亡率风险相关。然而，缺乏研究调查与精神/行为障碍相关的夏季对死亡率的影响，特别是在亚热带气候的城市。此外，亚热带城市的夏季死亡率与热带城市不同，之前的研究也没有调查与精神/行为障碍相关的热死亡率的城市环境不平等。本研究开展了一项基于登记的研究，以估计 2007 年至 2014 年期间香港平均日温度中位数 50%日温度下死亡人数的温度效应（n=133359）。首先应用泊松回归来估计夏季温度对全因死亡率、心血管死亡率、呼吸死亡率和与精神/行为障碍相关的死亡率的影响的发生率比（IRR）。对于温度≥24.51°C 日平均温度每升高 1°C，滞后 0 天和滞后 1 天与精神和行为障碍相关的死亡率的 IRR 分别为 1.033 [1.004, 1.062]和 1.030 [1.002, 1.060]，而正常夏季（非极端高温事件）期间温度对心血管死亡率和呼吸死亡率的影响不显著。进一步的线性回归调查表明，在高温日患有精神/行为障碍的死者居住在天空视野百分比较低、植被覆盖百分比较低、邻里水平 PM 水平较高、邻里水平 NO 水平较高和邻里水平较高的地区黑碳（BC）。为了根据联合国 2016 年可持续发展目标报告中记录的“不让任何人掉队”计划制定社区医疗保健方案，有必要将热对精神/行为障碍的影响，特别是痴呆症患者，纳入社区规划和医疗保健发展。
