TY - JOUR
T1 - Effect modifications of green space and blue space on heat–mortality association in Hong Kong, 2008–2017
AU - Song, Jinglu
AU - Lu, Yi
AU - Zhao, Qi
AU - Zhang, Yunquan
AU - Yang, Xuchao
AU - Chen, Qian
AU - Guo, Yuming
AU - Hu, Kejia
N1 - Funding Information:
The study was supported by the National Natural Science Foundation of China (grant numbers 42007421 , 42001013 , 41971019 ), General Research Project Fund of Hong Kong Research Grants Council (grant number 11207520 ), the Career Fellowship of the Australian National Health and Medical Research Council (grant number APP1163693 ), Australian Research Council (grant number DP210102076 ), and Australian National Health and Medical Research Council (grant number APP2000581 ), Key Program Special Fund (grant number KSF-E-43 ) and Research Development Fund (grant number RDF-19-02-13 ) of XJTLU, Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province (grant number 2020E10004 ), and Leading Innovative and Entrepreneur Team Introduction Program of Zhejiang (grant number 2019R01007 ).
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/9/10
Y1 - 2022/9/10
N2 - Background: Despite emerging recognition of the benefits of green and blue spaces on human health, evidence for their effect modifications on heat–mortality associations is limited. We aimed to investigate the effect modifications of green and blue spaces on heat–mortality associations among different age and sex groups and at different heat levels. Methods: Daily mortality and meteorological data from 2008 to 2017 in Hong Kong, China were collected. The Normalized Difference Vegetation Index and distance to coast were used as proxies for green and blue space exposure, respectively. Time-series analyses was performed using fitting generalized linear mixed models with an interaction term between heat and levels of exposure to either green or blue space. Age-, sex-, and heat level-stratified analyses were also conducted. Results: With a 1 °C increase in temperature above the 90th percentile (29.61 °C), mortality increased by 5.7% (95% confidence interval [CI]: 1.6, 10.1%), 5.4% (1.4, 9.5%), and 4.6% (0.8, 8.9%) for low, medium and high levels of green space exposure, respectively, and by 7.5% (3.9, 11.2%) and 3.5% (0.3, 6.8%) for low and high levels of blue space exposure, respectively. Significant effect modifications of green and blue spaces were not observed for the whole population or any specific age and sex group, either at a moderate heat level or a heat level (Ps > 0.05). Conclusions: No significant effect modifications of green and blue spaces on heat-related mortality risk were observed in Hong Kong. These findings challenge the existing evidence on the prominent protective role of green and blue spaces in mitigating heat-related mortality risks.
AB - Background: Despite emerging recognition of the benefits of green and blue spaces on human health, evidence for their effect modifications on heat–mortality associations is limited. We aimed to investigate the effect modifications of green and blue spaces on heat–mortality associations among different age and sex groups and at different heat levels. Methods: Daily mortality and meteorological data from 2008 to 2017 in Hong Kong, China were collected. The Normalized Difference Vegetation Index and distance to coast were used as proxies for green and blue space exposure, respectively. Time-series analyses was performed using fitting generalized linear mixed models with an interaction term between heat and levels of exposure to either green or blue space. Age-, sex-, and heat level-stratified analyses were also conducted. Results: With a 1 °C increase in temperature above the 90th percentile (29.61 °C), mortality increased by 5.7% (95% confidence interval [CI]: 1.6, 10.1%), 5.4% (1.4, 9.5%), and 4.6% (0.8, 8.9%) for low, medium and high levels of green space exposure, respectively, and by 7.5% (3.9, 11.2%) and 3.5% (0.3, 6.8%) for low and high levels of blue space exposure, respectively. Significant effect modifications of green and blue spaces were not observed for the whole population or any specific age and sex group, either at a moderate heat level or a heat level (Ps > 0.05). Conclusions: No significant effect modifications of green and blue spaces on heat-related mortality risk were observed in Hong Kong. These findings challenge the existing evidence on the prominent protective role of green and blue spaces in mitigating heat-related mortality risks.
KW - Blue space
KW - DLNM
KW - Extreme heat
KW - Green space
KW - Heat mortality
KW - Hong Kong
UR - http://www.scopus.com/inward/record.url?scp=85131062295&partnerID=8YFLogxK
U2 - 10.1016/j.scitotenv.2022.156127
DO - 10.1016/j.scitotenv.2022.156127
M3 - Article
C2 - 35605868
AN - SCOPUS:85131062295
SN - 0048-9697
VL - 838
JO - Science of the Total Environment
JF - Science of the Total Environment
M1 - 156127
ER -