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Daily Temperatures and Child Hospital Admissions in Aotearoa New Zealand: Case Time Series Analysis
Hakkan Lai1, Jeong Eun Lee2, Luke J Harrington3
1Section of Epidemiology and Biostatistics, University of Auckland, Auckland 1023, New Zealand.
Insights
Global climate change increases hospital admissions for young children due to rising temperatures. Vulnerable groups, including Māori and Pacific children, face greater risks, necessitating targeted adaptation policies.
Area of Science:
- Environmental Health
- Pediatrics
- Climate Change Research
Background:
- Global climate change is increasingly linked to adverse health outcomes.
- Temperature-related illnesses in young children are a significant public health concern.
- Existing research has underexplored the specific impacts on vulnerable child populations.
Purpose of the Study:
- To investigate the association between daily maximum temperatures and hospital admissions in children under five years old in New Zealand.
- To identify vulnerable subgroups and geographical areas disproportionately affected by heat-related hospitalizations.
- To inform the development of child-specific climate change adaptation strategies.
Main Methods:
- A case time series design analyzed 647,000 hospital admissions (2000-2019) across 2139 statistical areas.
- Quasi-Poisson distributed lag non-linear models assessed delayed temperature effects (0-21 days).
- Stratified analyses examined ethnicity, sex, residency, and interactions with socioeconomic factors; interactive maps were created.
Main Results:
- J-shaped temperature-response curves indicated increased hospital admission risks above 24.1°C.
- Māori, Pacific, and Asian children showed greater temperature sensitivity than European children.
- Attributable fractions of admissions linked to rising temperatures increased from 2013-2019, particularly in eastern coastal and urban areas.
Conclusions:
- Elevated temperatures pose a significant risk for child hospital admissions in New Zealand.
- Specific ethnic groups and geographical locations require prioritized climate change adaptation measures.
- Child-specific and location-specific policies are crucial for mitigating heat-related health impacts.
Abstract:
The influence of global climate change on temperature-related health outcomes among vulnerable populations, particularly young children, is underexplored. Using a case time series design, we analysed 647,000 hospital admissions of children aged under five years old in New Zealand, born between 2000 and 2019. We explored the relationship between daily maximum temperatures and hospital admissions across 2139 statistical areas. We used quasi-Poisson distributed lag non-linear models to account for the delayed effects of temperature over a 0-21-day window. We identified broad ICD code categories associated with heat before combining these for the main analyses. We conducted stratified analyses by ethnicity, sex, and residency, and tested for interactions with long-term temperature, socioeconomic position, and housing tenure. We found J-shaped temperature-response curves with increased risks of hospital admission above 24.1 °C, with greater sensitivity among Māori, Pacific, and Asian compared to European children. Spatial-temporal analysis from 2013-2019 showed rising attributable fractions (AFs) of admissions associated with increasing temperatures, especially in eastern coastal and densely populated areas. Interactive maps were created to allow policymakers to prioritise interventions. Findings emphasize the need for child-specific and location-specific climate change adaptation policies, particularly for socioeconomically disadvantaged groups.
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