International Journal of Epidemiology 2003;32:390-397
© International Epidemiological Association 2003
Special Theme: Socio-economic position |
Socioeconomic differentials in the temperature–mortality relationship in São Paulo, Brazil
1 Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, Brazil.
2 London School of Hygiene and Tropical Medicine, London, UK.
Correspondence:
Dr Nelson Gouveia, Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de São Paulo—FMUSP, Av. Dr Arnaldo 455, São Paulo 01246–903, SP, Brazil. E-mail:
ngouveia{at}usp.br
Background We investigated the impact of environmental temperature on mortality in São Paulo, Brazil, and examined differences in the temperature–mortality relationship with respect to cause, age group, and socioeconomic position (SEP).
Methods Generalized additive Poisson regression models adjusted for non-temperature related seasonal factors (including air pollution) were used to analyse daily mortality counts for selected causes from 1991 to 1994. Individuals were classified by the aggregate SEP of their area of residency. These were analysed as potential modifiers of the temperature–mortality relationship.
Results Among the elderly we observed a 2.6% increase in all-cause mortality per degree increase in temperature above 20°C, and a 5.5% increase per degree drop in temperature below 20°C, after adjustment for confounding. Relationships were similar in children, but somewhat weaker in adults. Cold effects were present for deaths due to cardiovascular disease (CVD), respiratory, and other causes, with effects being greatest in the respiratory group. Heat effects were not found for CVD deaths in adults, but otherwise varied little by cause of mortality. There was little evidence for a modification of the mortality effects of cold or heat by SEP.
Conclusions These findings show that the U-shaped pattern of the temperature–mortality relationship found in cooler northern countries occurs also in a sub-tropical city. In addition, the relative effects of temperature were similar in each socioeconomic grouping.
Keywords Temperature, heat, cold, mortality, socioeconomic position, epidemiology
Accepted 29 October 2002
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Hashizume, Y. Wagatsuma, T. Hayashi, S. K Saha, K. Streatfield, and M. Yunus The effect of temperature on mortality in rural Bangladesh--a population-based time-series study Int. J. Epidemiol., January 30, 2009; (2009) dyn376v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Bartlett Climate change and urban children: impacts and implications for adaptation in low- and middle-income countries Environment and Urbanization, October 1, 2008; 20(2): 501 - 519. [Abstract] [PDF]
|
|
|
|
 |
|
 V. M. R. Muggeo Modeling temperature effects on mortality: multiple segmented relationships with common break points Biostat., October 1, 2008; 9(4): 613 - 620. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L Bell, M. S O'Neill, N. Ranjit, V. H Borja-Aburto, L. A Cifuentes, and N. C Gouveia Vulnerability to heat-related mortality in Latin America: a case-crossover study in Sao Paulo, Brazil, Santiago, Chile and Mexico City, Mexico Int. J. Epidemiol., August 1, 2008; 37(4): 796 - 804. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. F. Antunes, E. A. Waldman, C. Borrell, and T. M. Paiva Effectiveness of influenza vaccination and its impact on health inequalities Int. J. Epidemiol., December 1, 2007; 36(6): 1319 - 1326. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Hajat, R S Kovats, and K Lachowycz Heat-related and cold-related deaths in England and Wales: who is at risk? Occup. Environ. Med., February 1, 2007; 64(2): 93 - 100. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. M. Muggeo A note on temperature effect estimate in mortality time series analysis Int. J. Epidemiol., October 1, 2004; 33(5): 1151 - 1152. [Full Text] [PDF]
|
|
|
|
|
|
M. Shaw, H. Tunstall, and G. Davey Smith Seeing social position: visualizing class in life and death Int. J. Epidemiol., June 1, 2003; 32(3): 332 - 335. [Full Text] [PDF]
|
|
|
|
|
|
W. Keatinge Commentary: Mortality from environmental factors, but which ones? Int. J. Epidemiol., June 1, 2003; 32(3): 398 - 399. [Full Text] [PDF]
|
|