Multivariate Meta-Analysis of Temperature-Related Mortality in Mexican Metropolitan Areas: Socioeconomic and Geographical Vulnerabilities

Mikhail Maksimenko, University of Bologna, University of Florence
Itza Olguin Zuniga , Vienna Institute of Demography of Austrian Academy of Science

Climate change and rising heat exposure pose significant risks to human health; however, these risks are unevenly distributed. Mexico provides such case, given its geographic diversity and uneven socioeconomic development. This study assesses how the impact of heat and cold on mortality varies across Mexican metropolitan areas, with emphasis on geographic and socioeconomic determinants. A three-stage analysis was performed. First, temperature–mortality associations were estimated for 89 metropolitan areas (1998–2022) using time-series quasi-Poisson regression with distributed lag non-linear models (DLNMs). Second, meta-regression was used to pool estimates and derive best linear unbiased predictions (BLUPs), used for the calculation of heat- and cold-attributable fractions (AFs). Third, effect modification by geographic factors, household-level adaptations, and indicators of socioeconomic context was evaluated. The overall minimum mortality temperature (MMT) was 22.7°C. Relative risks (RR) were slightly higher for extreme cold (RR=1.15, 95%CI: 1.12–1.19) than for extreme heat (RR=1.12, 95%CI: 1.09–1.15). Cold-related mortality burden was greater in temperate and arid climates, highland areas, and regions with higher heating prevalence, while heat-related burden was higher in tropical areas and those with higher air conditioning adoption. No consistent associations were observed for contextual socioeconomic indicators. Geographic and climatic conditions primarily shape temperature-related mortality in Mexico. Household adaptations appear to reflect adjustment to prevailing exposures rather than mitigation of risks, while broader socioeconomic effects were likely masked by geographic heterogeneity Findings underscore geography’s critical role in temperature-related mortality and provide baseline for projections of future climate impacts

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 Presented in Session P6. Health, Mortality, and Ageing 2