Study on the association between ambient temperature and mortality using spatially resolved exposure data

We found a 0.19% (95% CI=−0.98, 1.34%) increase in mortality for each 1 °C decrease in temperature below −1 °C and a 2.05% (95% CI=0.87, 3.24%) increase in mortality for each 1 °C increase in temperature above 28 °C, a 79.8% larger effect size for heat compared to the station-based metric. The effect estimates relying on the monitoring stations were 0.09% (95% CI=−0.79, 0.95%) and 1.14% (95% CI=0.08, 1.57%) for the equivalent temperature changes. The estimates were not confounded by PM2.5. Children under 15 years of age had the largest percentage increase per 1 °C increase in temperature (8.19%, 95% CI=−0.38 to 17.49%) followed by Blacks (4.35%, 95% CI=2.22 to 6.53%). Higher education was a protective factor for the effect of extreme temperature on mortality. There was a suggestion that people in less urban areas were more susceptible to extreme temperature. The relationship between temperature and mortality was stronger when using exposure data with more spatial variability than using exposure data based on existing monitors alone.