Temperature Related Mortality in A Tropical Climate Country: A Time Series Analysis

Extreme high and low temperatures negatively affect human health, thereby increasing mortality rates. We analysed the relationship between temperature and mortality in the tropical climate areas of two northern Peninsular Malaysia states. This ecological study was conducted using daily mortality and meteorological data from 2005-2019 in the states of Kedah and Kelantan. A generalised linear model with a distributed lag non-linear model was used to analyse the relationship between temperature and mortality. The cumulative effects of high temperature (90-99th percentile) and low temperature (1-10th percentile) on mortality (all-cause) were stratified by age (0-14, 15-64, and ≥65 years), sex and cause of death (cardiovascular and respiratory). The best model was selected using the Quasi-Akaike Information Criterion. Short lags were more significantly linked to high temperature-related deaths, while long lags were more strongly linked to low temperature-related deaths. Mortality related to high temperatures showed a stronger association with short lags, while mortality related to low temperatures showed a stronger association with longer lags. Extreme high and low temperatures were associated with a significantly increased mortality risk, especially among vulnerable groups such as the elderly, females and patients with respiratory or cardiovascular diseases. These findings can serve as a basis for formulating effective policies and intervention measures to mitigate the impact of temperature on health at the local and regional levels.