The global, regional, and national burden of disease attributable to non-optimal temperatures in children
AI Summary
In 2021 non-optimal temperatures caused global child mortality 2.14 per 100 000 and DALYs 190.40 per 100 000; high temperatures predominated, infants worst affected.
From 1990 to 2021 global temperature-related child mortality declined significantly (EAPC -3.46%), yet road injuries and interpersonal violence burdens increased.
Burden is geographically clustered and inequitable; absolute inequality improved but relative inequality rose, requiring tailored health and climate adaptation interventions.
BACKGROUND: Climate change has increased our exposure to non-optimal temperatures, a significant threat to child health. However, comprehensive assessments of the global, regional, and national burden of disease attributable to non-optimal temperatures in children remain limited. This study aims to estimate the burden and temporal trends of child mortality and disability-adjusted life years (DALYs) attributable to non-optimal temperatures from 1990 to 2021.
METHODS: Data were obtained from the Global Burden of Disease Study 2021 (GBD 2021). The burden attributable to non-optimal temperatures (including both low and high temperatures) in children aged 0-14 years was analyzed by region, country, age group, sex, and Sociodemographic Index (SDI). The estimated burden was presented as counts and rates with 95% uncertainty intervals (UIs). In addition, the burden was estimated using population-attributable fractions (PAFs) based on the comparative risk assessment framework, which quantifies the proportion of disease burden that could be avoided if exposure were reduced to the theoretical minimum-risk exposure level. We assessed disparities across regions and SDI levels to evaluate health inequalities. Temporal trends from 1990 to 2021 were assessed using the estimated annual percentage change (EAPC) with 95% confidence intervals (CIs).
RESULTS: In 2021, non-optimal temperatures caused a global mortality rate of 2.14 (95% UI: 0.22-4.12) per 100,000 and a DALYs rate of 190.40 (95% UI: 22.95-363.09) per 100,000 in children. High temperature was the predominant risk factor, with its burden particularly prominent in low-SDI regions (e.g., Western Sub-Saharan Africa, South Asia). Lower respiratory infections were the leading cause of death and DALYs loss. The burden was highest among infants under one year of age. From 1990 to 2021, the global temperature-related mortality rate in children declined significantly (EAPC: -3.46%, 95% CI: -3.91% to -3.02%). However, the burden related to road injuries (EAPC: 6.23%) and interpersonal violence (EAPC: 2.78%) increased against the overall trend. Inequality analysis revealed that although absolute inequality improved, relative inequality intensified, and the low-temperature-related burden gradually became more concentrated among high-SDI groups.
CONCLUSIONS: Child health threats from non-optimal temperatures are cause-specific, geographically clustered, and inequitable. Although the global burden has decreased, it is worsening in specific regions and for certain diseases. Future interventions should be precisely tailored and integrate health systems with climate adaptation.
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