1990-2021年中国非适宜温度归因疾病负担和健康不平等分析OA

[Background]As climate change intensifies and extreme temperature events become more fre-quent,non-optimal temperature has emerged as a significant contributor to the global disease burden,representing a pressing public health challenge. [Objective]To analyze the disease burden,temporal trends,and health inequalities attributable to non-optimal,high,and low temperatures in China from 1990 to 2021,and to compare these findings with global levels to provide a scientific basis for targeted prevention strategies. [Methods]Using data from the Global Burden of Disease 2021(GBD 2021),we extracted mortality rates and disability-adjusted life year(DALY)rates,and other indicators attributable to non-optimal,high,and low temperatures by sex,age,region,and cause.Joinpoint regression was applied to examine temporal trends.Decomposition analysis identified driving factors of change,while the slope index of inequality(SII)and concentration index(CI)quantified disparities across socio-demographic index(SDI)levels. [Results]From 1990 to 2021,the age-standardized mortality rates(ASMR)and age-standardized DALY rates(ASDR)attributable to non-optimal temperature in China exhibited a downward trend,decreasing from 66.48(95%UI:58.09,76.56)to 32.70(95%UI:27.26,39.26)per 100 000 population,and from 1 219.59(95%UI:1 056.28,1 418.37)to 493.22(95%UI:403.88,609.32)per 100 000 population,respec-tively.Burdens attributable to non-optimal temperature and low temperature were higher than the global average,whereas the high temperature burden was lower.Males consistently experienced higher ASMR and ASDR attributable to non-optimal temperature than females.Cardiovascular diseases,chronic respiratory diseases,and respiratory infections and tuberculosis were the top three causes of non-optimal temperature-attributable burdens.Decomposition analysis revealed that population aging and growth were the primary drivers of increased burden,while epidemiological changes primarily drove the decline.Health inequalities were most predominant be-tween extreme SDI regions but narrowed over time. [Conclusion]Despite the overall decline in burden attributable to non-optimal temperature in China,significant challenges remain,in-cluding high risks from cold exposure,gender disparities,and the compounding effects of an aging population with cardiovascular or res-piratory diseases.Policy makers should prioritize climate change adaptation,focusing on elderly health and regional equity while strengthening the public health workforce.