School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Environ Int. 2023 Aug;178:108034. doi: 10.1016/j.envint.2023.108034. Epub 2023 Jun 11.
Future climate change is likely to alter cold spell-related disease burden. Few projection studies have considered the potential impact of the aging population with changing population size on cold spell-related disease burdens.
We derived the association between cold spells and daily mortality for 272 main cities in mainland China. We combined these associations with modeled daily temperatures from three different climate models under two climate change scenarios and three population scenarios to project excess deaths related to cold spells. Furthermore, we used the factor separation method to calculate the independent contribution of future population size, age structure, and climate change on projected deaths attributable to cold spells.
Compared to the baseline period, future excess deaths related to cold spells are expected to increase over most of the decades under RCP 2.6 (81.5% in 2050 s and 37% in 2090 s) and RCP 4.5 (55.5% in 2050 s and -19% in 2090 s). The factor analysis indicated that the rise of the aged population (≥65) substantially would amplify the excess deaths related to cold spells (increase by 101.1% in the 2050 s and 146.2% in the 2090 s). For the near future (2021-2040), population aging could fully offset the influence of decreased cold-spell days. In the middle of this century (2051-2070), the total excess deaths will exhibit significant variation across three scenarios. By the end of 21 century (2081-2100), the population shrinking would reduce the total excess deaths.
Excess deaths related to cold spells may still increase in a warming climate and future demographic shifts would produce considerable influences in this increase for different periods.
未来的气候变化可能会改变与寒冷天气相关的疾病负担。很少有预测研究考虑到人口老龄化和人口规模变化对与寒冷天气相关的疾病负担的潜在影响。
我们得出了 272 个中国大陆主要城市寒冷天气与每日死亡率之间的关联。我们将这些关联与三种不同气候模型下的模型化每日温度结合起来，在两种气候变化情景和三种人口情景下预测与寒冷天气相关的超额死亡人数。此外，我们使用因子分离法计算未来人口规模、年龄结构和气候变化对归因于寒冷天气的预计死亡人数的独立贡献。
与基线时期相比，未来与寒冷天气相关的超额死亡人数预计在 RCP 2.6 情景下的大多数十年中都会增加（2050 年代增加 81.5%，2090 年代增加 37%）和 RCP 4.5 情景下（2050 年代增加 55.5%，2090 年代减少 19%）。因子分析表明，老年人口（≥65 岁）的增加将大大放大与寒冷天气相关的超额死亡人数（2050 年代增加 101.1%，2090 年代增加 146.2%）。对于近期（2021-2040 年），人口老龄化可以完全抵消寒冷天气天数减少的影响。在本世纪中叶（2051-2070 年），三个情景下的总超额死亡人数将呈现显著变化。到 21 世纪末（2081-2100 年），人口萎缩将减少总超额死亡人数。
在气候变暖的情况下，与寒冷天气相关的超额死亡人数可能仍会增加，而未来人口结构的变化将对不同时期的这一增加产生相当大的影响。
