Citation

Odame EA, Li Y, Zheng S, Vaidyanathan A, Silver K. Int. J. Environ. Res. Public Health 2018; 15(8): e15081597.

Affiliation

Department of Environmental Health, East Tennessee State University, Johnson City, TN 37614, USA. silver@etsu.edu.

Copyright

(Copyright © 2018, MDPI: Multidisciplinary Digital Publishing Institute)

DOI

10.3390/ijerph15081597

PMID

30060529

Abstract

Most epidemiological studies of high temperature effects on mortality have focused on urban settings, while heat-related health risks in rural areas remain underexplored. To date there has been no meta-analysis of epidemiologic literature concerning heat-related mortality in rural settings. This study aims to systematically review the current literature for assessing heat-related mortality risk among rural populations. We conducted a comprehensive literature search using PubMed, Web of Science, and Google Scholar to identify articles published up to April 2018. Key selection criteria included study location, health endpoints, and study design. Fourteen studies conducted in rural areas in seven countries on four continents met the selection criteria, and eleven were included in the meta-analysis. Using the random effects model, the pooled estimates of relative risks (RRs) for all-cause and cardiovascular mortality were 1.030 (95% CI: 1.013, 1.048) and 1.111 (95% CI: 1.045, 1.181) per 1 °C increase in daily mean temperature, respectively. We found excess risks in rural settings not to be smaller than risks in urban settings. Our results suggest that rural populations, like urban populations, are also vulnerable to heat-related mortality. Further evaluation of heat-related mortality among rural populations is warranted to develop public health interventions in rural communities.

Language: en

Keywords

heat-related; meta-analysis; mortality; rural; systematic review; vulnerability