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Environmental variable importance for under-five mortality in Malaysia: A random forest approach.

Vera Ling Hui Phung1, Kazutaka Oka1, Yasuaki Hijioka1

  • 1Center for Climate Change Adaptation, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan.

The Science of the Total Environment
|July 15, 2022
PubMed
Summary

Environmental factors like heat and haze significantly impact under-five mortality in Malaysia. Maximum temperature, heat waves, and PM10 pollution were key contributors to child deaths, particularly for natural causes.

Keywords:
ChildrenConditional permutation importanceEnvironmental factorFeature selectionMortalityUnder-five

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Area of Science:

  • Environmental Epidemiology
  • Public Health
  • Data Science

Background:

  • Environmental factors are linked to adverse health outcomes, but identifying key exposure variables can be challenging due to limited evidence or collinearity.
  • Traditional methods for determining environmental exposure variables may be insufficient when prior knowledge is scarce or statistical challenges arise.

Purpose of the Study:

  • To investigate the relative importance of environmental variables on under-five mortality in Malaysia.
  • To apply a machine learning approach to identify key weather and air pollution factors influencing child mortality.

Main Methods:

  • Utilized a conditional permutation importance via random forest (CPI-RF) approach for variable importance evaluation.
  • Employed Boruta selection for preliminary variable screening, followed by CPI-RF analysis on retained variables.
  • Conducted analyses on daily under-five mortality data (2014-2016) considering different mortality causes and data structures, with 10-fold cross-validation for robust importance values.

Main Results:

  • Heat-related variables (maximum temperature, heat waves) and temperature variability were identified as prominent factors.
  • Haze-related variables, including PM10 and fire hotspots, also showed significant associations with under-five mortality.
  • Important environmental variables were consistent for all-cause and natural-cause mortality but differed for external-cause mortality.

Conclusions:

  • Heat, temperature variability, and haze are consistently important environmental factors for all- and natural-cause under-five mortalities in Malaysia.
  • These environmental factors were not consistently prominent for external-cause under-five mortality.
  • The study highlights the critical role of environmental exposures in child mortality and the utility of advanced statistical methods in identifying these links.