Daily Temperatures and Child Hospital Admissions in Aotearoa New Zealand: Case Time Series Analysis

Hakkan Lai (), Jeong Eun Lee, Luke J. Harrington, Annabel Ahuriri-Driscoll, Christina Newport, Annette Bolton, Claire Salter, Susan Morton, Alistair Woodward and Simon Hales
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Hakkan Lai: Section of Epidemiology and Biostatistics, University of Auckland, Auckland 1023, New Zealand
Jeong Eun Lee: Department of Statistics, University of Auckland, Auckland 1010, New Zealand
Luke J. Harrington: Te Aka Mātuatua School of Science, University of Waikato, Hamilton 3216, New Zealand
Annabel Ahuriri-Driscoll: Te Kura Mātai Hauora School of Health Sciences, University of Canterbury, Christchurch 8041, New Zealand
Christina Newport: School of Population Health, University of Auckland, Auckland 1023, New Zealand
Annette Bolton: Institute of Environmental Science and Research, Christchurch 8041, New Zealand
Claire Salter: Institute of Environmental Science and Research, Christchurch 8041, New Zealand
Susan Morton: Research Institute for Innovative Solutions for Well-being and Health (INSIGHT), Faculty of Health, University of Technology Sydney, Sydney, NSW 2007, Australia
Alistair Woodward: Section of Epidemiology and Biostatistics, University of Auckland, Auckland 1023, New Zealand
Simon Hales: Department of Public Health, University of Otago, Wellington 6011, New Zealand

IJERPH, 2024, vol. 21, issue 9, 1-18

Abstract: The influence of global climate change on temperature-related health outcomes among vulnerable populations, particularly young children, is underexplored. Using a case time series design, we analysed 647,000 hospital admissions of children aged under five years old in New Zealand, born between 2000 and 2019. We explored the relationship between daily maximum temperatures and hospital admissions across 2139 statistical areas. We used quasi-Poisson distributed lag non-linear models to account for the delayed effects of temperature over a 0–21-day window. We identified broad ICD code categories associated with heat before combining these for the main analyses. We conducted stratified analyses by ethnicity, sex, and residency, and tested for interactions with long-term temperature, socioeconomic position, and housing tenure. We found J-shaped temperature–response curves with increased risks of hospital admission above 24.1 °C, with greater sensitivity among Māori, Pacific, and Asian compared to European children. Spatial–temporal analysis from 2013–2019 showed rising attributable fractions (AFs) of admissions associated with increasing temperatures, especially in eastern coastal and densely populated areas. Interactive maps were created to allow policymakers to prioritise interventions. Findings emphasize the need for child-specific and location-specific climate change adaptation policies, particularly for socioeconomically disadvantaged groups.

Keywords: climate change; heat stress; child morbidity; hospitalisation; deprivation; ethnicity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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