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<p>Using the Global Burden of Disease (GBD) 2021 framework, this study analyzed global trends in environmental heat and cold exposure (EHCE) from 1990 to 2021, evaluated SDI-related inequalities, and projected baseline epidemiological trends to 2035. Data were derived from the Global Burden of Disease (GBD) Study 2021, covering incidence, prevalence, deaths, and disability-adjusted life years (DALYs) across 204 countries and territories from 1990 to 2021. The slope index of inequality (SII) and concentration index of inequality (CII) were used to quantify absolute and relative SDI-related inequalities in EHCE burden, respectively. The Bayesian age-period-cohort (BAPC) model was used to generate baseline projections to 2035. Compared with 1990, the age-standardized incidence, prevalence, death, and DALY rates of EHCE all declined in 2021. In 2021, EHCE accounted for more than 3.42&#xa0;million incident cases, 36,023.55 deaths, and 1,683,247.50 DALYs globally. Children, adolescents, older adults, and males experienced a disproportionate burden. SDI-related patterns showed persistent inequalities: incidence and prevalence remained concentrated in higher-SDI settings, whereas death and DALY burdens increasingly shifted toward lower-SDI settings. Based on the BAPC projection curves, by 2035 the ASIR, ASPR, ASDR, and age-standardized DALY rate were estimated to decline to approximately 37.50, 133.00, 0.29, and 14.20 per 100,000 population, respectively. These projections should be interpreted as baseline estimates rather than climate-scenario-based forecasts. Although the age-standardized EHCE burden has declined, EHCE remains a substantial health burden with marked age, sex, and SDI-related inequalities. The findings support targeted climate-health adaptation, especially for children, older adults, males, and populations in lower-SDI settings.</p>

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Global burden of environmental heat and cold exposure 1990–2021 projected to 2035 reveals temporal trends and socio-demographic inequalities

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月3日

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  • Xingyi Jin,
  • Rui Wang,
  • Da Pan,
  • Ruipeng Wu,
  • Niannian Wang,
  • Jiayue Xia,
  • Shaokang Wang,
  • Guiju Sun

摘要

Using the Global Burden of Disease (GBD) 2021 framework, this study analyzed global trends in environmental heat and cold exposure (EHCE) from 1990 to 2021, evaluated SDI-related inequalities, and projected baseline epidemiological trends to 2035. Data were derived from the Global Burden of Disease (GBD) Study 2021, covering incidence, prevalence, deaths, and disability-adjusted life years (DALYs) across 204 countries and territories from 1990 to 2021. The slope index of inequality (SII) and concentration index of inequality (CII) were used to quantify absolute and relative SDI-related inequalities in EHCE burden, respectively. The Bayesian age-period-cohort (BAPC) model was used to generate baseline projections to 2035. Compared with 1990, the age-standardized incidence, prevalence, death, and DALY rates of EHCE all declined in 2021. In 2021, EHCE accounted for more than 3.42 million incident cases, 36,023.55 deaths, and 1,683,247.50 DALYs globally. Children, adolescents, older adults, and males experienced a disproportionate burden. SDI-related patterns showed persistent inequalities: incidence and prevalence remained concentrated in higher-SDI settings, whereas death and DALY burdens increasingly shifted toward lower-SDI settings. Based on the BAPC projection curves, by 2035 the ASIR, ASPR, ASDR, and age-standardized DALY rate were estimated to decline to approximately 37.50, 133.00, 0.29, and 14.20 per 100,000 population, respectively. These projections should be interpreted as baseline estimates rather than climate-scenario-based forecasts. Although the age-standardized EHCE burden has declined, EHCE remains a substantial health burden with marked age, sex, and SDI-related inequalities. The findings support targeted climate-health adaptation, especially for children, older adults, males, and populations in lower-SDI settings.