Extreme Temperature and Mortality by Educational Attainment in Spain, 2012-2018

Area of Science:

• Environmental Health
• Public Health
• Epidemiology

Background:

• Extreme temperatures pose a significant public health threat, increasing mortality rates.
• While age and gender vulnerabilities are well-researched, the role of socioeconomic status (SES) in temperature-related mortality remains underexplored.
• Educational attainment is used as a proxy for SES to investigate its influence on temperature-related mortality.

Purpose of the Study:

• To examine how socioeconomic status, specifically educational attainment, modifies the association between extreme temperatures and mortality in individuals aged over 65.
• To investigate the moderating effect of local climate on the relationship between extreme temperatures, SES, and mortality.

Main Methods:

• Utilized Poisson regression analysis on administrative data from 50 Spanish provinces (2012-2018).
• Matched individual mortality data for those aged over 65 with meteorological data from the E-OBS dataset.
• Stratified analyses were performed based on socioeconomic status (low, medium, high) and local climate characteristics.

Main Results:

• Both hot and cold days were found to increase mortality, consistent with previous research.
• Individuals with low and medium socioeconomic status exhibited a significant positive association between exposure to extreme heat and cold, and mortality.
• High SES individuals did not show a robust association with heat or cold exposure and mortality.
• Local climate significantly moderated these risks: warmer climates amplified risks from cold, while colder climates amplified risks from heat, particularly for low SES individuals.
• Low SES individuals demonstrated heightened vulnerability, being particularly susceptible to heat in colder climates and cold in warmer climates.

Conclusions:

• Educational attainment, as a measure of SES, plays a crucial role in stratifying the mortality risks associated with extreme temperatures.
• The findings underscore the importance of considering local climate context when assessing the health risks of extreme temperatures, especially for vulnerable low SES populations.
• Targeted public health interventions may be necessary to mitigate the disproportionate impact of climate change on vulnerable socioeconomic groups.