Climate change is causing the surface temperature to rise and the extreme weather events to increase in frequency and intensity, which will pose potential threats to the survival and health of residents. Beijing is facing multiple challenges such as coping with climate change, urbanization, and population aging, which puts huge decision-making pressure on decision maker. However, few studies that systematically consider the health effects of climate change, urbanization, and population aging for China. Based on the distributed lag nonlinear model (DLNM) and 13 global climate models in the Coupled Model Intercomparison Project Phase 6 (CMIP6), this study obtained the temporal and spatial distribution of surface temperature through statistical downscaling methods, and comprehensively explored the independent and comprehensive effects of urbanization and population aging on the projection of future temperature-related cardiovascular disease (CVD) mortality in the context of climate and population change. The results showed that only improving urbanization can reduce future temperature-related CVD mortality by 1.7-18.3%, and only intensified aging can increase future temperature-related CVD mortality by 48.8-325.9%. Taking into account the improving urbanization and intensified aging, future temperature-related CVD mortality would increase by 44.1-256.6%, and the increase was slightly lower than that of only intensified aging. Therefore, the intensified aging was the biggest disadvantage in tackling climate change, which would obviously magnify the mortality risks of temperature-related CVD in the future. Although the advancement of urbanization would alleviate the adverse effects of the intensified aging population, the mitigation effects would be limited. Even so, Urbanization should be continued to reduce health risks for residents. These findings would contribute to formulate policies related to mitigate climate change and reduce baseline mortality rate (especially the elderly) in international mega-city - Beijing. In addition, relevant departments should improve the medical health care level and optimize the allocation of social resources to better cope with and adapt to climate change.

Panel studies show a consistent association between increase in the cardiovascular hospitalizations with air pollutants in economically developed regions, but little evidence in less developed inland areas. In this study, a time-series analysis was used to examine the specific effects of major air pollutants [particulate matter less than 10 microns in diameter (PM₁₀), sulfur dioxide (SO₂), and nitrogen dioxides (NO₂)] on daily hospital admissions for cardio-cerebrovascular diseases in Lanzhou, a heavily polluted city in China. We examined the effects of air pollutants for stratified groups by age and gender, and conducted the modifying effect of seasons on air pollutants to test the possible interaction. The significant associations were found between PM₁₀, SO₂ and NO₂ and cardiac disease admissions, SO₂ and NO₂ were found to be associated with the cerebrovascular disease admissions. The elderly was associated more strongly with gaseous pollutants than younger. The modifying effect of seasons on air pollutants also existed. The significant effect of gaseous pollutants (SO₂ and NO₂) was found on daily hospital admissions even after adjustment for other pollutants except for SO₂ on cardiac diseases. In a word, this study provides the evidence for the detrimental short-term health effects of urban gaseous pollutants on cardio-cerebrovascular diseases in Lanzhou.

Background: Evaluation of the adverse health effects of PM₁₀ pollution (particulate matter less than 10 microns in diameter) is very important for protecting human health and establishing pollution control policy. Population exposure estimation is the first step in formulating exposure data for quantitative assessment of harmful PM₁₀ pollution. Methods: In this paper, we estimate PM₁₀ concentration using a spatial interpolation method on a grid with a spatial resolution 0.01° × 0.01°. PM₁₀ concentration data from monitoring stations are spatially interpolated, based on accurate population data in 2000 using a geographic information system. Then, an interpolated population layer is overlaid with an interpolated PM₁₀ concentration layer, and population exposure levels are calculated. Combined with the exposure-response function between PM₁₀ and health endpoints, economic costs of the adverse health effects of PM₁₀ pollution are analyzed. Results: The results indicate that the population in Lanzhou urban areas is distributed in a narrow and long belt, and there are relatively large population spatial gradients in the XiGu, ChengGuan and QiLiHe districts. We select threshold concentration C₀ at: 0 μg m^-3 (no harmful health effects), 20 μg m^-3 (recommended by the World Health Organization), and 50 μg m^-3 (national first class standard in China) to calculate excess morbidity cases. For these three scenarios, proportions of the economic cost of PM₁₀ pollution-related adverse health effects relative to GDP are 0.206%, 0.194% and 0.175%, respectively. The impact of meteorological factors on PM₁₀ concentrations in 2000 is also analyzed. Sandstorm weather in spring, inversion layers in winter, and precipitation in summer are important factors associated with change in PM₁₀ concentration. Conclusions: The population distribution by exposure level shows that the majority of people live in polluted areas. With the improvement of evaluation criteria, economic damage of respiratory disease caused by PM₁₀ is much bigger. The health effects of Lanzhou urban residents should not be ignored. The government needs to find a better way to balance the health of residents and economy development. And balance the pros and cons before making a final policy.