Socioeconomic Status May Slightly Modify Climate Effect on Mortality from Chronic Obstructive Pulmonary Disease in Taiwan:

ISEE-0087 Background: Mortality from cardiovascular and respiratory diseases have been associated with ambient temperature and other climate conditions, but less is known about the effect socioeconomic status (SES) has on this climate mortality relationship. This study measures whether the area gross domestic product (GDP) and education level, in interaction with weather status are associated with mortality from chronic obstructive pulmonary disease (COPD) for the period 1980–2006 in Taiwan. Methods: Computerized data of vital statistics, weather, air pollution, and SES were obtained from the offices of Executive Yuan. Data analyses first measured the monthly average mortality to observe the seasonality of the deaths, followed by the correlation coefficients between air pollution factors and SES potentially associated with mortality from COPD. Significant factors were included in the step down Poisson regression model with significant weather variables. Results: During the study period, the mortality from COPD was approximately 2 times greater in males than females (73.0 vs. 35.4 per 1000). The mortality was higher in cold months than the warm months. There was a V-shape association between mortality rates and temperatures, with the lowest rate of 56.1 per 1000 at the daily mean of 25–29 degrees C and the highest rate of 71.8 per 1000 at <15 degrees C. The relative risk (RR) of deaths was 1.4 (95% confidence interval (CI) 1.3–1.5) greater in the lower temperature days. No other weather variable was significant in the Poisson analysis. However, people in the low GDP areas were at higher risk than people in the high GDP area (RR = 1.10, 95% CI 1.02–1.14). Conclusions: Our findings suggest that COPD patients in Taiwan are sensitive to climate change with greater risk of death in cold days. And the risk may also increase in areas with lower SES status.