The reciprocal relation between rising longevity and temperature-related mortality risk in older people, Spain 1980–2018

• Published in: Environment international Vol. 193; p. 109050
• Main Authors: LLOYD, Simon J, STRIESSNIG, Erich, ABURTO, José Manuel, ACHEBAK, Hicham, HAJAT, Shakoor, MUTTARAK, Raya, QUIJAL-ZAMORANO, Marcos, VIELMA, Constanza, BALLESTER, Joan
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.11.2024; Elsevier
• Subjects: Aged; Aged, 80 and over; Climate change; cold; Cold Temperature - adverse effects; Cold-related mortality; environment; Female; heat; Heat-related mortality; Hot Temperature - adverse effects; Humans; Life Expectancy - trends; life tables; Longevity; Male; mortality; Mortality - trends; Older people; people; risk; risk reduction; Spain; Spain - epidemiology; Temperature; Spain; Heat-related mortality; RR; INE; NUTS; AF; CI; DLNM; Longevity; BLUPs; AN; Spain; Climate change; AR; SD; PAF; MMT; Older people; ERF; MMTP; Cold-related mortality; LE; LI
• DOI: 10.1016/j.envint.2024.109050
• ISSN: 0160-4120; 1873-6750

Temperature-related mortality mostly affects older people and is attributable to a combination of factors. We focussed on a key non-temperature factor – rising longevity – and aimed to quantify its reciprocal relation with temperature-related mortality risk in Spain over 1980–2018. We obtained average annual temperature-attributable deaths among people aged 65y+, by sex and age group, for different temperature ranges (extreme cold, moderate cold, moderate heat, and extreme heat), from a previous study. Combining this with population and mortality data as well as life table information, we used: (i) a counterfactual approach to assess the contribution of rising longevity to changes in the absolute risk of temperature-related mortality, and (ii) decomposition to assess the contribution of changes in temperature-related mortality to changes in longevity and its variation (lifespan inequality). Rising longevity led to considerable declines in the absolute risk of temperature-related mortality in females and males across the entire temperature range. For extreme heat, it accounted for about a 30% decrease in absolute risk (half of the total decrease over the study period). For moderate and extreme cold, it accounted for about a 20% fall in absolute risk (a quarter of the total fall). In the opposite direction, changing patterns of temperature-related deaths contributed to higher life expectancy (accounting for > 20% of the total rise in both females and males) but also higher lifespan inequality amongst older people. Most of the influence (about 80%) was via moderate cold, but declines in risk at both moderate and extreme heat led to small rises in life expectancy. Our study points to the benefits of adopting risk-reduction strategies that aim, not only at modifying hazards and reducing exposure, but that also address socially-generated vulnerability among older people. This includes ensuring that lifespans lengthen primarily through increases in years lived in good health.