Abstract:
Background: Numerous studies have reported a strong association between temperature
and mortality. Additional insights can be gained from investigating the effects of
temperature on years of life lost (YLL), considering the life expectancy at the time of
death.
Objectives: The goal of this work was to assess the association between temperature and
YLL at seven low-, middle-, and high-income sites.
Methods: We obtained meteorological and population data for at least nine years from
four Health and Demographic Surveillance Sites in Kenya (western Kenya, Nairobi),
Burkina Faso (Nouna), and India (Vadu), as well as data from cities in the United States
(Philadelphia, Phoenix) and Sweden (Stockholm). A distributed lag nonlinear model was
used to estimate the association of daily maximum temperature and daily YLL, lagged 0-
14 d. The reference value was set for each site at the temperature with the lowest YLL.
Results: Generally, YLL increased with higher temperature, starting day 0. In Nouna, the
hottest location, with a minimum YLL temperature at the first percentile, YLL increased
consistently with higher temperatures. In Vadu, YLL increased in association with heat,
whereas in Nairobi, YLL increased in association with both low and high temperatures.
Associations with cold and heat were evident for Phoenix (stronger for heat), Stockholm,
and Philadelphia (both stronger for cold). Patterns of associations with mortality were
generally similar to those with YLL.
Conclusions: Both high and low temperatures are associated with YLL in high-, middle-,
and low-income countries. Policy guidance and health adaptation measures might be
improved with more comprehensive indicators of the health burden of high and low
temperatures such as YLL.