Climate Change, Summer Temperature, and Heat-Related Mortality in Finland: Multicohort Study with Projections for a Sustainable vs. Fossil-Fueled Future to 2050.

BACKGROUND: Climate change scenarios illustrate various pathways in terms of global warming ranging from "sustainable development" (Shared Socioeconomic Pathway SSP1-1.9), the best-case scenario, to 'fossil-fueled development' (SSP5-8.5), the worst-case scenario. OBJECTIVES: We examined the extent to which increase in daily average urban summer temperature is associated with future cause-specific mortality and projected heat-related mortality burden for the current warming trend and these two scenarios. METHODS: We did an observational cohort study of 363,754 participants living in six cities in Finland. Using residential addresses, participants were linked to daily temperature records and electronic death records from national registries during summers (1 May to 30 September) 2000 to 2018. For each day of observation, heat index (average daily air temperature weighted by humidity) for the preceding 7 d was calculated for participants' residential area using a geographic grid at a spatial resolution of 1km×1km. We examined associations of the summer heat index with risk of death by cause for all participants adjusting for a wide range of individual-level covariates and in subsidiary analyses using case-crossover design, computed the related period population attributable fraction (PAF), and projected change in PAF from summers 2000-2018 compared with those in 2030-2050. RESULTS: During a cohort total exposure period of 582,111,979 summer days (3,880,746 person-summers), we recorded 4,094 deaths, including 949 from cardiovascular disease. The multivariable-adjusted rate ratio (RR) for high (≥21°C) vs. reference (14-15°C) heat index was 1.70 (95% CI: 1.28, 2.27) for cardiovascular mortality, but it did not reach statistical significance for noncardiovascular deaths, RR=1.14 (95% CI: 0.96, 1.36), a finding replicated in case-crossover analysis. According to projections for 2030-2050, PAF of summertime cardiovascular mortality attributable to high heat will be 4.4% (1.8%-7.3%) under the sustainable development scenario, but 7.6% (3.2%-12.3%) under the fossil-fueled development scenario. In the six cities, the estimated annual number of summertime heat-related cardiovascular deaths under the two scenarios will be 174 and 298 for a total population of 1,759,468 people. DISCUSSION: The increase in average urban summer temperature will raise heat-related cardiovascular mortality burden. The estimated magnitude of this burden is >1.5 times greater if future climate change is driven by fossil fuels rather than sustainable development. https://doi.org/10.1289/EHP12080.

Extreme urban-rural temperatures in the coastal city of Turku, Finland: Quantification and visualization based on a generalized additive model.

Fundamental knowledge on the determinants of air temperatures across spatial and temporal scales is essential in climate change mitigation and adaptation. Spatial-based statistical modelling provides an efficient approach for the analysis and prediction of air temperatures in human-modified environments at high spatial accuracy. The aim of the study was firstly, to analyse the environmental factors affecting extreme air temperature conditions in a coastal high-latitude city and secondly, to explore the applicability of generalized additive model (GAM) in the study of urban-rural temperatures. We utilized air temperature data from 50 permanent temperature logger stations and extensive geospatial environmental data on different scales from Turku, SW Finland. We selected five temperature situations (cases) and altogether 12 urban and natural explanatory variables for the analyses. The results displayed that (i) water bodies and topographical conditions were often more important than urban variables in controlling the spatial variability of extreme air temperatures, (ii) case specificity of the explanatory variables and their scales should be considered in the analyses and (iii) GAM was highly suitable in quantifying and visualizing the relations between urban-rural temperatures and environmental determinants at local scales. The results promote the use of GAMs in spatial-based statistical modelling of air temperature in future.