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Central heating and winter mortality in China: A national study based on 364 Chinese locations
Urban Climate  (IF5.731),  Pub Date : 2021-12-09, DOI: 10.1016/j.uclim.2021.101045
Jianxiong Hu, Weiwei Gong, Peng Yin, Guanhao He, Mingfang Qin, Zhulin Hou, Ruilin Meng, Chunliang Zhou, Yize Xiao, Min Yu, Biao Huang, Xiaojun Xu, Lifeng Lin, Tao Liu, Jianpeng Xiao, Ruying Hu, Donghui Jin, Qinglong Zhao, Wenjun Ma

The association between temperature and mortality has been widely investigated, however, studies on the effects of central heating on mortality risk are sparse. We applied a variant of difference-in-differences (DID) approach to assess the effects of central heating on winter mortality in China, and further analyzed the modification effect of central heating on the temperature-mortality association. Central heating was negatively associated with winter mortality (OR: 0.42, 95% CI: 0.39, 0.46) with higher effects on females and the elderly. Compared with cardiovascular or cerebrovascular diseases, central heating had a much greater effect on respiratory diseases. Every week less in central heating duration was associated with a 3.32% (95% CI: 3.03%, 3.61%) increased risk in total mortality. We found the temperature effect was much more pronounced among the locations without central heating (ER: 5.01%, 95% CI: 4.68%, 5.34%) than those with central heating (ER: 0.01%, 95% CI: −0.74%, 0.75%). The analysis suggests that central heating significantly decreases winter mortality in northern China, which may partly be achieved by attenuating the mortality caused by temperature. Therefore, central heating should be developed in some regions of southern China to reduce the mortality risk of low temperature in winter.