4.7 Article

Associations of climate variability driven by El Ni?o-southern oscillation with excess mortality and related medical costs in Chinese elderly

Journal

SCIENCE OF THE TOTAL ENVIRONMENT
Volume 851, Issue -, Pages -

Publisher

ELSEVIER
DOI: 10.1016/j.scitotenv.2022.158196

Keywords

Climate change; ENSO; Healthy aging; All-cause mortality; Medical burden; China

Funding

  1. China Postdoctoral Science Foundation [2021M690249]
  2. Beijing Natural Science Foundation [7222246]
  3. China National Key Research and Development Projects [2017YFC0211701]

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Climate variability driven by ENSO can increase mortality risks and medical burden among older elderly adults, especially among lower-income individuals, drinkers, and those with higher blood pressure and heart rate.
Climate variability driven by El Nino-Southern Oscillation (ENSO) is a significant public health concern in parallel with global population aging; however, its role in healthy aging is less studied. We examined the longitudinal impacts of ENSO exposure on excess mortality and related medical costs in the elderly from 23 provinces of China. A total of 27,533 non-accidental all-cause deaths were recorded in 30,763 participants during 1998-2018. We found that both low and high levels of ENSO metrics over lags of 0-12 months were associated with increased mortality risks. Specifically, comparing the 10th percentile (-1.8) and 90th percentile (2.0) multivariate El Nino index (MEI) levels to the reference level with the minimum effect of MEI exposure, the risk of mortality was 1.87 (95 % confidence inter-val [CI], 1.75, 2.00) and 4.89 (95 % CI, 4.36, 5.49), respectively. ENSO exposure was also positively related to medical costs. Further, the associations were stronger among drinkers, lower-income participants, and those with higher blood pressure and heart rate measured at the most recent follow-ups. Our results suggested that ENSO exposure was capable of heightening mortality risks and medical burden among older elderly adults, highlighting that climate variability driven by ENSO could be a crucial determinant of healthy aging.

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