Socioeconomic level and associations between heat exposure and all-cause and cause-specific hospitalization in 1,814 Brazilian cities: A nationwide case-crossover study

Rongbin Xu, Qi Zhao, Micheline S Z S Coelho, Paulo H N Saldiva, Michael J Abramson, Shanshan Li and Yuming Guo

PLOS Medicine, 2020, vol. 17, issue 10, 1-18

Abstract: Background: Heat exposure, which will increase with global warming, has been linked to increased risk of a range of types of cause-specific hospitalizations. However, little is known about socioeconomic disparities in vulnerability to heat. We aimed to evaluate whether there were socioeconomic disparities in vulnerability to heat-related all-cause and cause-specific hospitalization among Brazilian cities. Methods and findings: We collected daily hospitalization and weather data in the hot season (city-specific 4 adjacent hottest months each year) during 2000–2015 from 1,814 Brazilian cities covering 78.4% of the Brazilian population. A time-stratified case-crossover design modeled by quasi-Poisson regression and a distributed lag model was used to estimate city-specific heat–hospitalization association. Then meta-analysis was used to synthesize city-specific estimates according to different socioeconomic quartiles or levels. We included 49 million hospitalizations (58.5% female; median [interquartile range] age: 33.3 [19.8–55.7] years). For cities of lower middle income (LMI), upper middle income (UMI), and high income (HI) according to the World Bank’s classification, every 5°C increase in daily mean temperature during the hot season was associated with a 5.1% (95% CI 4.4%–5.7%, P

Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pmed00:1003369

DOI: 10.1371/journal.pmed.1003369

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