The influence of socioeconomic and environmental determinants on acute myocardial infarction (AMI) mortality from the spatial epidemiological perspective

Environ Sci Pollut Res Int. 2022 Sep;29(42):63494-63511. doi: 10.1007/s11356-022-19825-4. Epub 2022 Apr 23.

Abstract

Plenty of epidemiological approaches have been explored to detect the effects of environmental and socioeconomic factors on acute myocardial infarction (AMI) mortality. Whereas, identifying the influence of potential affecting factors on AMI mortality based on a spatial epidemiological perspective was strongly desired. Moreover, the interaction effects of two potential factors on the diseases were always neglected previously. Here, the Geodetector and geographically & temporally weighted regression model (GTWR) combined with multi-source spatiotemporal datasets were introduced to quantitatively determine the relationship between AMI mortality and potential influencing factors across Xi'an during 2014-2016. Besides, Moran's I was adopted to diagnose the spatial autocorrelation of AMI mortality. Some findings were achieved. The number of AMI mortality cases increased from 5075 in 2014 to 6774 in 2016. Air pollutants, meteorological factors, economic status, and topography factors exhibited a significant effect on AMI mortality. The AMI mortality demonstrated an obvious spatial autocorrelation feature during 2014-2016. POP and PE represented the most obvious impact on AMI mortality, respectively. Moreover, the interaction of any two factors was larger than that of the single factor on AMI mortality, and the factors with the strongest interaction vary according to lag groups and ages. The effects of factors on AMI mortality were POP (- 628.925) > PE (140.102) > RD (79.145) > O3 (- 58.438) > E_NH3 (42.370) for male, and POP (- 751.206) > RD (132.935) > E_NH3 (58.758) > PE (- 45.434) > O3 (- 21.256) for female, respectively. This work reminds the local government to continuously control air pollution, strengthen urban planning, and improve the health care of the rural areas for alleviating AMI mortality. Meanwhile, the scheme of the current study supplies a scientific reference for examining the effects of potential impact factors on related diseases using the spatial epidemiological perspective.

Keywords: AMI; GTWR; Geodetector; Influential factors; Moran’s I; Spatial heterogeneity.

MeSH terms

  • Air Pollutants* / analysis
  • Air Pollution*
  • Female
  • Humans
  • Male
  • Meteorological Concepts
  • Myocardial Infarction* / epidemiology
  • Socioeconomic Factors

Substances

  • Air Pollutants