BACKGROUND: Non-optimal ambient temperatures have been demonstrated to negatively affect a variety of health outcomes, particularly population mortality. However, the mortality risk of older adults between rural and urban areas exposure to temperature variations remain unclear.
METHODS: Here, leveraging the panel data for 27,193 older adults from the largest and most complete Chinese Longitudinal Healthy Longevity Survey during 2005-2018, we explored the impacts of temperature variations like low/high and extreme temperatures on mortality risk of older adults in China. Subgroup analyses were performed by place (urban and rural), sex, disease, education, income and health-risk behaviors (e.g., chronic drinking).
RESULTS: The relative mortality risk of older adults in rural areas increased by 3.57% (95% CI: 0.56-6.79%) for each 1 °C ascent of high temperature above 25 °C, which was much higher than that in urban areas 2.15% (95% CI: 0.27-4.06%), whereas increased by 8.94% (95% CI: 1.03-15.21%) for each 1 °C descent of low temperature below - 15 °C, much higher than that in urban areas 6.37% (95% CI: 1.83-12.92%). The expected future additional cumulative deaths of older adults in mainland China without effective interventions could approach to 473,351 (95% CI: 282,989 - 878,693) attributable to future high temperature rise with the most extreme climate scenario of SSP5-8.5 under the International Coupled Model Comparison Program Phase 6 (CMIP6) from 2020 to 2050.
CONCLUSION: The effects of high and low temperatures on the mortality risk of older adults in rural areas is much greater than that in urban areas, and future expected temperature increases would lead to a significant increase in excess deaths among older adults in China. These comparable findings provide key scientific evidence for policymakers in the planning of public-tailored interventions to mitigate the risks of abnormal climate, especially in rural areas.
