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From Climate Exposure to Health Resilience: Validation of the Moderating Role of Urban Development Level and Social Equity
Background: The dual role of urbanization in modulating extreme climate event (ECE)-disease relationships remains poorly understood. While urbanization may reduce certain disease burdens, it could amplify ECE exposure risks, potentially worsening health impacts.
Method: Utilizing data from 13,442 adults (≥45 years) in the 2018 China Health and Retirement Longitudinal Study, we assessed chronic disease risks using logistic regression and quantified urbanization's role. Climate Physical Risk Index (CPRI) data were derived from NOAA archives, with urbanization levels measured via DMSP nighttime light imagery. Analytical approaches included: 1) qgcomp mixture modeling for ECE effects; 2) interaction analysis of urbanization-CPRI-disease pathways; 3) spatiotemporal trend estimation (1993-2023) using least squares regression; and 4) multi-level modeling of urbanization-CPRI linkages.
Result: There is ample evidence to suggest a significant positive correlation between CPRI and seven diseases. Urbanization significantly changes the role of CPRI in diseases, and higher levels of urbanization alleviate the adverse effects of CPRI on the seven diseases. CPRI and urbanization are showing an increasing trend year by year, and there is a positive correlation between the two. Represented by coastal cities, the growth of CPRI is attributed to the urbanization level accounting for more than 30%.
Conclusion: Urbanization exhibits dual effects: mitigating climate-related disease burdens while accelerating ECE intensification. This paradox underscores the need for climate-resilient urban planning strategies.
Keywords: climate extremes, social equity, urbanisation
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