暴露于寒冷的室内温度(<18摄氏度)会增加心血管疾病(CVD)的风险,世卫组织已将其确定为不健康住房的来源。虽然温暖的家庭有可能降低心血管疾病的风险,疾病负担的减轻尚不清楚。如果所有澳大利亚寒冷房屋的温度从假定的平均温度16摄氏度永久升高到20摄氏度,我们模拟了CVD负担减轻带来的人口健康收益。
使用比例多态可生存模型模拟了通过减少CVD来消除冷屋的健康影响。该模型来自澳大利亚和全球疾病负担研究的CVD负担和流行病学数据。根据《澳大利亚住房条件调查》估计,澳大利亚寒冷住房的流行程度。根据已发表的研究估计了室内低温对血压(进而中风和冠心病)的影响。
消除室内寒冷暴露可以在2016年(基准年)仅通过CVD在寒冷的住房中获得每人活着的一个半星期的额外健康生活。这等于0.447(不确定区间:0.064,1.34;3%的贴现率)HALY每1,000人在其余生中通过减少CVD。在2016年至2035年间,健康总收益的8%是可实现的。虽然看似谦虚,收益优于目前推荐的心血管疾病干预措施,包括对5-9%5年心血管疾病风险的成年人的持续饮食建议(每1000人0.017,UI:0.01,0.027)和持续的生活方式计划,成人5-9%5年CVD风险(0.024,UI:0.01,0.027)。
仅通过消除寒冷的住房可以获得心血管健康收益,与现实生活中的生活方式和饮食干预措施相媲美。除了心血管疾病外,根除寒冷的住房还将改善呼吸系统和心理健康,因此潜在的健康收益更大。
Exposure to cold indoor temperature (< 18 degrees Celsius) increases cardiovascular disease (CVD) risk and has been identified by the WHO as a source of unhealthy housing. While warming homes has the potential to reduce CVD risk, the reduction in disease burden is not known. We simulated the population health gains from reduced CVD burden if the temperature in all Australian cold homes was permanently raised from their assumed average temperature of 16 degrees Celsius to 20 degrees Celsius.
The health effect of eradicating cold housing through reductions in CVD was simulated using proportional multistate lifetable model. The model sourced CVD burden and epidemiological data from Australian and Global Burden of Disease studies. The prevalence of cold housing in Australia was estimated from the Australian Housing Conditions Survey. The effect of cold indoor temperature on blood pressure (and in turn stroke and coronary heart disease) was estimated from published research.
Eradication of exposure to indoor cold could achieve a gain of undiscounted one and a half weeks of additional health life per person alive in 2016 (base-year) in cold housing through CVD alone. This equates to 0.447 (uncertainty interval: 0.064, 1.34; 3% discount rate) HALYs per 1,000 persons over remainder of their lives through CVD reduction. Eight percent of the total health gains are achievable between 2016 and 2035. Although seemingly modest, the gains outperform currently recommended CVD interventions including persistent dietary advice for adults 5-9% 5 yr CVD risk (0.017 per 1000 people, UI: 0.01, 0.027) and persistent lifestyle program for adults 5-9% 5 yr CVD risk (0.024, UI: 0.01, 0.027).
Cardiovascular health gains alone achievable through eradication of cold housing are comparable with real-life lifestyle and dietary interventions. The potential health gains are even greater given cold housing eradication will also improve respiratory and mental health in addition to cardiovascular disease.