Disease burden and health inequality attributable to non-optimal temperature exposure in China from 1990 to 2021
- VernacularTitle:1990—2021年中国非适宜温度归因疾病负担和健康不平等分析
- Author:
Yanling HUANG
1
;
Junle WU
2
;
Bin XIAO
2
;
Xiao ZHANG
1
Author Information
- Publication Type:Investigation
- Keywords: non-optimal temperature; disease burden; decomposition analysis; health inequality; age-standardized mortality rate; age-standardized disability-adjusted life year rate
- From: Journal of Environmental and Occupational Medicine 2026;43(5):604-613
- CountryChina
- Language:Chinese
- Abstract: Background As climate change intensifies and extreme temperature events become more frequent, non-optimal temperature has emerged as a significant contributor to the global disease burden, representing a pressing public health challenge. Objective To analyze the disease burden, temporal trends, and health inequalities attributable to non-optimal, high, and low temperatures in China from 1990 to 2021, and to compare these findings with global levels to provide a scientific basis for targeted prevention strategies. Methods Using data from the Global Burden of Disease 2021 (GBD 2021), we extracted mortality rates and disability-adjusted life year (DALY) rates, and other indicators attributable to non-optimal, high, and low temperatures by sex, age, region, and cause. Joinpoint regression was applied to examine temporal trends. Decomposition analysis identified driving factors of change, while the slope index of inequality (SII) and concentration index (CI) quantified disparities across socio-demographic index (SDI) levels. Results From 1990 to 2021, the age-standardized mortality rates (ASMR) and age-standardized DALY rates (ASDR) attributable to non-optimal temperature in China exhibited a downward trend, decreasing from 66.48 (95%UI: 58.09, 76.56) to 32.70 (95%UI: 27.26, 39.26) per 100000 population, and from 1219.59 (95%UI: 1056.28, 1418.37) to 493.22 (95%UI: 403.88, 609.32) per 100000 population, respectively. Burdens attributable to non-optimal temperature and low temperature were higher than the global average, whereas the high temperature burden was lower. Males consistently experienced higher ASMR and ASDR attributable to non-optimal temperature than females. Cardiovascular diseases, chronic respiratory diseases, and respiratory infections and tuberculosis were the top three causes of non-optimal temperature-attributable burdens. Decomposition analysis revealed that population aging and growth were the primary drivers of increased burden, while epidemiological changes primarily drove the decline. Health inequalities were most predominant between extreme SDI regions but narrowed over time. Conclusion Despite the overall decline in burden attributable to non-optimal temperature in China, significant challenges remain, including high risks from cold exposure, gender disparities, and the compounding effects of an aging population with cardiovascular or respiratory diseases. Policy makers should prioritize climate change adaptation, focusing on elderly health and regional equity while strengthening the public health workforce.
