The short-term association of temperature and rainfall with mortality in Vadu Health and Demographic Surveillance System: a population level time series analysis

Background: Research in mainly developed countries has shown that some changes in weather are associated with increased mortality. However, due to the lack of accessible data, few studies have examined such effects of weather on mortality, particularly in rural regions in developing countries. Objective: In this study, we aimed to investigate the relationship between temperature and rainfall with daily mortality in rural India. Design: Daily mortality data were obtained from the Health and Demographic Surveillance System (HDSS) in Vadu, India. Daily mean temperature and rainfall data were obtained from a regional meteorological center, India Meteorological Department (IMD), Pune. A Poisson regression model was established over the study period (January 2003-May 2010) to assess the short-term relationship between weather variables and total mortality, adjusting for time trends and stratifying by both age and sex. Result: Mortality was found to be significantly associated with daily ambient temperatures and rainfall, after controlling for seasonality and long-term time trends. Children aged 5 years or below appear particularly susceptible to the effects of warm and cold temperatures and heavy rainfall. The population aged 20-59 years appeared to face increased mortality on hot days. Most age groups were found to have increased mortality rates 7-13 days after rainfall events. This association was particularly evident in women. Conclusion: We found the level of mortality in Vadu HDSS in rural India to be highly affected by both high and low temperatures and rainfall events, with time lags of up to 2 weeks. These results suggest that weatherrelated mortality may be a public health problem in rural India today. Furthermore, as changes in local climate occur, adaptation measures should be considered to mitigate the potentially negative impacts on public health in these rural communities.