Hsu, Shih-Che; (2024) Spatiotemporal risk assessment of the relationships between outdoor air temperature, household energy use and cardiovascular mortality: a case study of Taipei, Taiwan. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Introduction: There is ample epidemiological evidence of the relationship between exposure to high or low outdoor air temperatures and adverse health impacts. Individuals who are vulnerable to heat or cold may spend a considerable amount of time inside buildings. The research aims of this PhD study are two-fold: (i) to investigate the relationship between outdoor air temperature and cardiovascular mortality in the subtropical urban environment of Taipei City, Taiwan, and (ii) to examine how built environment characteristics and other contextual factors modify this relationship. / Methods: A four-stage health risk assessment framework was developed by applying spatiotemporal methods and using publicly available data in the 12 districts of Taipei City from 2008 to 2020: • Spatiotemporal interpolation was used to estimate local outdoor air temperature at a fine resolution for temperature hazard identification. • Spatiotemporal clustering was used by analysing energy use data to quantify the vulnerability of population to heat and cold. • Spatiotemporal hierarchical linear modelling was used to describe the relationship between cardiovascular mortality, outdoor air temperature, PM2.5, household energy use and local built environment and sociodemographic characteristics. • Spatiotemporal comparisons of paired outdoor-indoor environments were used to explore the influence of built environment and human behaviour on temperature-related health risk indoors. / Results: The local urban temperatures were found to be determined by natural and built environment characteristics, including relative humidity, altitude, green area, and household and population density. With different levels of temperature exposure and household energy use, 33 risk groups were identified based on their different levels of vulnerability to heat. For these groups built environment and sociodemographic characteristics and household energy use were found to act as a moderator, and outdoor PM2.5 as a confounder in the temperature-mortality relationship. The optimum temperature range for Taipei was found to be between 21.4°C and 26.5°C, and indoor air temperature functioned as a mediator of the temperature-mortality relationship. / Conclusion: The findings suggest that built environment characteristics are important when implementing spatiotemporal analyses to assess temperature-related cardiovascular mortality in Taipei. Effectively identifying risk determinants informs public health protection actions. The risk matrix could be used by public health policymakers to visualise climate-related risk in urban environments so as to encourage the adoption of heat mitigation strategies for climate-resilient cities.

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