Spatial Variability in the Effect of High Ambient Temperature on Mortality: An Analysis at Municipality Level within the Greater Athens Area

Sofia Zafeiratou, Antonis Analitis, Dimitra Founda, Christos Giannakopoulos, Konstantinos V. Varotsos, Panagiotis Sismanidis, Iphigenia Keramitsoglou and Klea Katsouyanni
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Sofia Zafeiratou: Department of Hygiene and Epidemiology, University of Athens Medical School, GR11527 Athens, Greece
Antonis Analitis: Department of Hygiene and Epidemiology, University of Athens Medical School, GR11527 Athens, Greece
Dimitra Founda: Institute for Environmental Research and Sustainable Development, National Observatory of Athens, GR15236 Athens, Greece
Christos Giannakopoulos: Institute for Environmental Research and Sustainable Development, National Observatory of Athens, GR15236 Athens, Greece
Konstantinos V. Varotsos: Institute for Environmental Research and Sustainable Development, National Observatory of Athens, GR15236 Athens, Greece
Panagiotis Sismanidis: Institute for Astronomy, Astrophysics, Space Applications and Remote Sensing, National Observatory of Athens, GR15236 Athens, Greece
Iphigenia Keramitsoglou: Institute for Astronomy, Astrophysics, Space Applications and Remote Sensing, National Observatory of Athens, GR15236 Athens, Greece
Klea Katsouyanni: Department of Hygiene and Epidemiology, University of Athens Medical School, GR11527 Athens, Greece

IJERPH, 2019, vol. 16, issue 19, 1-20

Abstract: Spatial variability in temperature exists within metropolitan areas but very few studies have investigated intra-urban differentiation in the temperature-mortality effects. We investigated whether local characteristics of 42 Municipalities within the Greater Athens Area lead to modified temperature effects on mortality and if effect modifiers can be identified. Generalized Estimating Equations models were used to assess the effect of high ambient temperature on the total and cause-specific daily number of deaths and meta-regression to investigate effect modification. We found significant effects of daily temperature increases on all-cause, cardiovascular, and respiratory mortality (e.g., for all ages 4.16% (95% CI: 3.73,4.60%) per 1 °C increase in daily temperature (lags 0–3). Heterogeneity in the effect estimates between Municipalities was observed in several outcomes and environmental and socio-economic effect modifying variables were identified, such as % area coverage of buildings, length of roads/km 2 , population density, % unemployed, % born outside the EU countries and mean daily temperature. To further examine the role of temperature, we alternatively used modelled temperature per Municipality and calculated the effects. We found that heterogeneity was reduced but not eliminated. It appears that there are socioeconomic status and environmental determinants of the magnitude of heat-related effects on mortality, which are detected with some consistency and should be further investigated.

Keywords: heat-mortality association; intra-city variability; effect modifiers; socioeconomic modifiers; environmental modifiers (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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