Temperature Variability and Mortality in Urban and Rural China: An Application of Spatiotemporal Index

Temperature variability (TV) is a potential trigger for death in urban areas, but there is little evidence of this in rural areas. In addition, a typical TV index only considers the temporal changes of temperature and ignores its spatial variability, which should be considered due to the effects of human mobility. In this study, we collected daily data on fine-gridded hourly temperatures and >2 million deaths that occurred in Zhejiang province, China from 2009 to 2015. A spatiotemporal TV index was developed by calculating the standard deviation of the hourly temperatures from multi-site records. A three-stage analysis was performed to estimate the mortality risks and mortality burdens of TV. Stratified analyses were performed by cause-specific mortality, urban/rural district, age and gender. Significant associations were found between TV and all types of targeted diseases, age groups, and genders. Percentage increase in mortality associated with a 1 °C increase in TV at 0–7 exposure days we...