Photo (from left to right): Shafkat J and Cauchi JP (both from Faculty of Health at Queensland University of Technology, Australia), Galdies C (Institute of Earth Systems, University of Malta), England K (Ministry for Health, Malta), and Eastwood Wraith D (Faculty of Health at Queensland University of Technology, Australia).
Maltese and Australian researchers have teamed up to examine the effect of temperatures on local mortality rates, focusing on respiratory and circulatory-related deaths. The results, which have now been published in peer-reviewed scientific Journals show that currently in Malta cold temperatures are more likely to be strongly associated with mortality than high temperatures. However, this is set to change with a warming climate, with higher average temperature potentially tipping the balance onto higher heat-mortality deaths.
Implications for policy
The breakthrough findings of these studies have implications both for public health policy and for climate-related adaptation in general. In Malta, public health authorities issue warnings to critical health sectors whenever extreme cold weather or heatwaves are forecast. However, there are few actions taken or policies integrated into building regulations pertaining to temperature and insulation, and these are rarely enforced.
Additionally, Malta’s climate is set to become much warmer, with implications for the local population. With widening income disparities, with some sectors of the population being less able to afford adaptations such as heating/air-conditioning systems, and a rising cost of living and inflation, this can lead to increasing health risks affecting the more vulnerable sectors of the population. Lower-income individuals may have little choice but to opt out of effective temperature regulation devices, placing them at increased risk of negative health outcomes.
The findings
Medical statistics show a total of 7,679 respiratory- and 32,847 circulatory-related deaths in Malta between 1992 and 2017. A time-series analysis associating mortality with average daily temperatures in Malta found that there is a higher risk for cold-related respiratory mortality compared to heat-related effects, with a similar picture for circulatory-related deaths.
Compared to median average temperatures, ‘extreme cold’ was strongly related to deaths for both ischaemic heart disease (85% higher risk) and cerebrovascular disease (280% higher risk) in cardiovascular deaths, and for respiratory deaths in general (124% increase). Interestingly, respiratory death statistical associations were found for males across all age groups but not for females.
However, the degree of respiratory death seems to decrease over time, with a lower association of respiratory deaths to cold temperatures for the period 2010-2017. This may point to better household heating over time, better overall health care services or positive changes in building type. For circulatory deaths, however, especially ischaemic heart disease related deaths, the studies show strong and significant associations both for cold temperatures (97% increase) and hot temperatures (233%) for the period 2010-2017 which were not present in previous timelines.
This may point to local changes in weather patterns becoming more extreme over time in line with warming trends in the Mediterranean region due to climate change, putting vulnerable people at risk of extreme temperature effects that contribute to death.
These two important local studies were conducted by Jahan Shafkat and John Paul Cauchi from the Faculty of Health, Queensland University of Technology in Australia, Charles Galdies from the Institute of Earth Systems, University of Malta, Kathleen England from Malta’s Ministry for Health, and by Darren Wraith also from Queensland University of Technology, Australia.
The two studies have been published by the academic Journals Elsevier’s Climate Risk Management and Springer’s Respiratory Research.
