Greenness and excess deaths from heat in 323 Latin American cities: Do associations vary according to climate zone or green space configuration?

Leah H Schinasi; Maryia Bakhtsiyarava; Brisa N Sanchez; Josiah L Kephart; Yang Ju; Sarav Arunachalam; Nelson Gouveia; Waleska Teixeira Caiaffa; Marie S O'Neill; Iryna Dronova; Ana V Diez Roux; Daniel A Rodriguez

doi:10.1016/j.envint.2023.108230

Greenness and excess deaths from heat in 323 Latin American cities: Do associations vary according to climate zone or green space configuration?

Environ Int. 2023 Oct:180:108230. doi: 10.1016/j.envint.2023.108230. Epub 2023 Sep 25.

Authors

Affiliations

¹ Department of Environmental and Occupational Health, Drexel Dornsife School of Public Health, Philadelphia, USA; Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, USA. Electronic address: lhs36@drexel.edu.
² Institute of Transportation Studies, University of California, Berkeley, CA, USA.
³ Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, USA; Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, USA.
⁴ Department of Environmental and Occupational Health, Drexel Dornsife School of Public Health, Philadelphia, USA; Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, USA.
⁵ School of Architecture and Urban Planning, Nanjing University, Nanjing, China.
⁶ Institute for the Environment, University of North Carolina at Chapel Hill, Chapel Hill, USA.
⁷ Department of Preventive Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil.
⁸ Observatory for Urban Health in Belo Horizonte, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
⁹ Departments of Epidemiology and Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, USA.
¹⁰ Department of Environmental Science, Policy & Management, University of California, Berkeley, USA; Department of Landscape Architecture & Environmental Planning, University of California, Berkeley, USA.
¹¹ Institute of Transportation Studies, University of California, Berkeley, CA, USA; Department of City and Regional Planning and Institute of Transportation Studies, University of California, Berkeley, USA.

Abstract

Green vegetation may protect against heat-related death by improving thermal comfort. Few studies have investigated associations of green vegetation with heat-related mortality in Latin America or whether associations are modified by the spatial configuration of green vegetation. We used data from 323 Latin American cities and meta-regression models to estimate associations between city-level greenness, quantified using population-weighted normalized difference vegetation index values and modeled as three-level categorical terms, and excess deaths from heat (heat excess death fractions [heat EDFs]). Models were adjusted for city-level fine particulate matter concentration (PM_2.5), social environment, and country group. In addition to estimating overall associations, we derived estimates of association stratified by green space clustering by including an interaction term between a green space clustering measure (dichotomized at the median of the distribution) and the three-level greenness variable. We stratified analyses by climate zone (arid vs. temperate and tropical combined). Among the 79 arid climate zone cities, those with moderate and high greenness levels had modestly lower heat EDFs compared to cities with the lowest greenness, although protective associations were more substantial in cities with moderate versus high greenness levels and confidence intervals (CI) crossed the null (Beta: -0.41, 95% CI: -1.06, 0.25; Beta -0.23, 95% CI: -0.95, 0.49, respectively). In 244 non-arid climate zone cities, associations were approximately null. We did not observe evidence of effect modification by green space clustering. Our results suggest that greenness may offer modest protection against heat-related mortality in arid climate zone Latin American cities.

Keywords: Ambient temperature; Climate change; Climate zone; Green space; Mortality; NDVI; Urban heat; Vegetation.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Cities
Desert Climate
Hot Temperature*
Latin America / epidemiology
Parks, Recreational*

Abstract

Publication types

MeSH terms

Grants and funding