International Journal of Biometeorology

, Volume 59, Issue 9, pp 1311–1319 | Cite as

Diurnal temperature range and short-term mortality in large US communities

  • Youn-Hee LimEmail author
  • Colleen E. Reid
  • Jennifer K. Mann
  • Michael Jerrett
  • Ho Kim
Original Paper


Research has shown that diurnal temperature range (DTR) is significantly associated with mortality and morbidity in regions of Asia; however, few studies have been conducted in other regions such as North America. Thus, we examined DTR effects on mortality in the USA. We used mortality and environmental data from the National Morbidity Mortality Air Pollution Study (NMMAPS). The data are daily mortality, air pollution, and temperature statistics from 95 large US communities collected between 1987 and 2000. To assess community-specific DTR effects on mortality, we used Poisson generalized linear models allowing for over-dispersion. After assessing community-specific DTR effects on mortality, we estimated region- and age-specific effects of DTR using two-level normal independent sampling estimation. We found a significant increase of 0.27 % [95 % confidence intervals (CI), 0.24–0.30 %] in nonaccidental mortality across 95 communities in the USA associated with a 1 °C increase in DTR, controlling for apparent temperature, day of the week, and time trend. This overall effect was driven mainly by effects of DTR on cardiovascular and respiratory mortality in the elderly: Mortality in the above 65 age group increased by 0.39 % (95 % CI, 0.33–0.44 %) and 0.33 % (95 % CI, 0.22–0.44 %), respectively. We found some evidence of regional differences in the effects of DTR on nonaccidental mortality with the highest effects in Southern California [0.31 % (95 % CI, 0.21–0.42 %)] and smallest effects in the Northwest and Upper Midwest regions [0.22 % (95 % CI, 0.11–0.33 %) and 0.22 % (95 % CI, 0.07–0.37 %), respectively]. These results indicate a statistically significant association between DTR and mortality on average for 95 large US communities. The findings indicate that DTR impacts on nonaccidental and cardiovascular-related mortality in most US regions and the elderly population was most vulnerable to the effects of DTR.


Diurnal temperature range Elderly NMMAPS Mortality USA 



The authors thank the developers of the National Mortality Morbidity Air Pollution Studies (NMMAPS).

Conflict of interests



This work was supported by the Women Scientist Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (#2012R1A1A3005549).

Supplementary material

484_2014_941_MOESM1_ESM.docx (336 kb)
ESM 1 (DOCX 335 kb)


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Copyright information

© ISB 2014

Authors and Affiliations

  • Youn-Hee Lim
    • 1
    • 2
    Email author
  • Colleen E. Reid
    • 3
  • Jennifer K. Mann
    • 3
  • Michael Jerrett
    • 3
  • Ho Kim
    • 4
  1. 1.Institute of Environmental MedicineSeoul National University of Medical Research CenterSeoulSouth Korea
  2. 2.Environmental Health CenterSeoul National University College of MedicineSeoulKorea
  3. 3.Department of Environmental Health Sciences, School of Public HealthUniversity of CaliforniaBerkeleyUSA
  4. 4.Department of Biostatistics and Epidemiology, Graduate School of Public HealthSeoul National UniversitySeoulKorea

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