Titre du document / Document title

Socioeconomic differentials in the temperature: mortality relationship in São Paulo, Brazil. Commentary

Auteur(s) / Author(s)

GOUVEIA Nelson ⁽¹⁾ ; HAJAT Shakoor ⁽²⁾ ; ARMSTRONG Ben ⁽²⁾ ; KEATINGE W. R. (Commentateur) ⁽³⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, BRESIL
⁽²⁾ London School of Hygiene and Tropical Medicine, London, ROYAUME-UNI
⁽³⁾ Queen Mary University of London Medical Sciences Building, Mile End Road, London E1 4NS, ROYAUME-UNI

Résumé / Abstract

Background We investigated the impact of environmental temperature on mortality in Sao Paulo, Brazil, and examined differences in the temperature-mortality relationship with respect to cause, age group, and socioeconomic position (SEP). Methods Generalized additive Poisson regression models adjusted for non-temperature related seasonal factors (including air pollution) were used to analyse daily mortality counts for selected causes from 1991 to 1994. Individuals were classified by the aggregate SEP of their area of residency. These were analysed as potential modifiers of the temperature-mortality relationship. Results Among the elderly we observed a 2.6% increase in all-cause mortality per degree increase in temperature above 20°C, and a 5.5% increase per degree drop in temperature below 20°C, after adjustment for confounding. Relationships were similar in children, but somewhat weaker in adults. Cold effects were present for deaths due to cardiovascular disease (CVD), respiratory, and other causes, with effects being greatest in the respiratory group. Heat effects were not found for CVD deaths in adults, but otherwise varied little by cause of mortality. There was little evidence for a modification of the mortality effects of cold or heat by SEP. Conclusions These findings show that the U-shaped pattern of the temperature-mortality relationship found in cooler northern countries occurs also in a sub-tropical city. In addition, the relative effects of temperature were similar in each socioeconomic grouping.

Revue / Journal Title

International journal of epidemiology   ISSN 0300-5771   CODEN IJEPBF 

Source / Source

2003, vol. 32, n^o3, pp. 390-399 [10 page(s) (article)] (43 ref.)

Langue / Language

Anglais

Editeur / Publisher

Oxford University Press, Oxford, ROYAUME-UNI  (1972) (Revue)

Mots-clés anglais / English Keywords

Public health ; America ; South America ; Environmental effect ; Human ; Prognosis ; Mortality ; Brazil ; Temperature ; Socioeconomic status ;

Mots-clés français / French Keywords

Santé publique ; Amérique ; Amérique du Sud ; Effet environnement ; Homme ; Pronostic ; Mortalité ; Brésil ; Température ; Statut socioéconomique ;

Mots-clés espagnols / Spanish Keywords

Salud pública ; America ; America del sur ; Efecto medio ambiente ; Hombre ; Pronóstico ; Mortalidad ; Brasil ; Temperatura ; Estatuto socioeconómico ;

Mots-clés d'auteur / Author Keywords

Temperature ; heat ; cold ; mortality ; socioeconomic position ; epidemiology ;

Localisation / Location

INIST-CNRS, Cote INIST : 16214, 35400011861367.0100