National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain.
National School of Public Health, Carlos III Institute of Health (ISCIII), Madrid, Spain.
Environ Res. 2021 Apr;195:110892. doi: 10.1016/j.envres.2021.110892. Epub 2021 Feb 17.
The objective of this study was to analyze and compare the effect of high temperatures on daily mortality in the urban and rural populations in Madrid. Data were analyzed from municipalities in Madrid with a population of over 10,000 inhabitants during the period from January 1, 2000 to December 31, 2020. Four groups were generated: Urban Metropolitan Center, Rural Northern Mountains, Rural Center, and Southern Rural. The dependent variable used was the rate of daily mortality due to natural causes per million inhabitants (CIE-X: A00-R99) between the months of June and September for the period. The primary independent variable was maximum daily temperature. Social and demographic "context variables" were included: population >64 years of age (%), deprivation index and housing indicators. The analysis was carried out in three phases: 1) determination of the threshold definition temperature of a heat wave (Tumbral) for each study group; 2) determination of relative risks (RR) attributable to heat for each group using Poisson linear regression (GLM), and 3) calculation of odds ratios (OR) using binomial family GLM for the frequency of the appearance of heat waves associated with context variables. The resulting percentiles (for the series of maximum daily temperatures for the summer months) corresponding to Tthreshold were: 74th percentile for Urban Metropolitan Center, 76th percentile for Southern Rural, 83rd for Rural Northern Mountains and 98th percentile for Center Rural (98). Greater vulnerability was found for the first two. In terms of context variables that explained the appearance of heat waves, deprivation index level, population >64 years of age and living in the metropolitan area were found to be risk factors. Rural and urban areas behaved differently, and socioeconomic inequality and the composition of the population over age 64 were found to best explain the vulnerability of the Rural Center and Southern Rural zones.
本研究旨在分析和比较高温对马德里城乡人口日死亡率的影响。本研究分析了 2000 年 1 月 1 日至 2020 年 12 月 31 日期间马德里人口超过 10000 人的市镇的数据。共生成了四个组：城市都市区、农村北部山区、农村中心区和南部农村区。使用的因变量是 6 月至 9 月期间每月每百万居民的自然原因导致的日死亡率（CIE-X：A00-R99）。主要的独立变量是最高日温度。纳入了社会和人口统计学“背景变量”：>64 岁人口比例（%）、贫困指数和住房指标。分析分为三个阶段：1）确定每个研究组热浪（Tumbral）的定义温度阈值；2）使用泊松线性回归（GLM）确定每个组归因于热的相对风险（RR）；3）使用二项式 GLM 计算与背景变量相关的热浪出现频率的比值比（OR）。相应的百分位数（夏季日最高温度系列）为：城市都市区为第 74 百分位数，南部农村区为第 76 百分位数，农村北部山区为第 83 百分位数，农村中心区为第 98 百分位数（第 98 百分位数）。前两组的脆弱性更高。就解释热浪出现的背景变量而言，发现贫困指数水平、>64 岁人口以及居住在大都市区是风险因素。农村和城市地区的表现不同，发现社会经济不平等和 64 岁以上人口构成是最好地解释农村中心区和南部农村区脆弱性的因素。
