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Role of temperature, influenza and other local characteristics in seasonality of mortality: a population-based time-series study in Japan
- Source :
- BMJ Open, BMJ Open, Vol 11, Iss 7 (2021)
- Publication Year :
- 2021
- Publisher :
- BMJ Publishing Group, 2021.
-
Abstract
- Objectives: To investigate the extent to which temperature and influenza explained seasonality of mortality in Japan and to examine the association of the seasonality with prefecture-specific characteristics. Design: We conducted time-series analysis to estimate the seasonal amplitude before and after adjusting for temperature and/or influenza-like illness (ILI). Next, we applied linear mixed effect models to investigate the association of seasonal amplitudes with each indicator on prefecture-specific characteristics on climate, demographic and socioeconomic factors and adaptations. Setting: 47 prefectures in Japan Participants: Deaths for all-cause, circulatory, and respiratory disease between 1999 and 2015. Outcome measures: Peak-to-trough ratio (PTR, a measure of seasonal amplitude). Results: The nationwide unadjusted-PTRs for all-cause, circulatory and respiratory mortality were 1.29 (95% CIs: 1.28 to 1.31), 1.55 (95% CI: 1.52 to 1.57) and 1.45 (95% CI: 1.43 to 1.48), respectively. These PTRs reduced substantially after adjusting for temperature but very little after a separate adjustment for ILI. Furthermore, seasonal amplitudes varied between prefectures. However, there was no strong evidence for the associations of PTR with the indicators on prefecture-specific characteristics. Conclusions: Seasonality of mortality is primarily driven by temperature in Japan. The spatial variation in seasonal amplitudes was not associated with prefecture-specific characteristics. Although further investigations are required to confirm our findings, this study can help us gain a better understanding of the mechanisms underlying seasonality of mortality.<br />BMJ Open, 11(7), art. no. e044876; 2021
- Subjects :
- medicine.medical_specialty
Epidemiology
Climate
Population based
030204 cardiovascular system & hematology
preventive medicine
03 medical and health sciences
0302 clinical medicine
Japan
Influenza, Human
medicine
Humans
030212 general & internal medicine
Time series study
Socioeconomic status
business.industry
public health
Outcome measures
Temperature
General Medicine
Seasonality
medicine.disease
Mixed effects
Medicine
Spatial variability
Seasons
business
Demography
Subjects
Details
- Language :
- English
- ISSN :
- 20446055
- Volume :
- 11
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- BMJ Open
- Accession number :
- edsair.doi.dedup.....5e4626bc6afe1171fa99b417688c4636