Abstract
Exposure to surrounding greenness is associated with reduced mortality in Caucasian populations. Little is known however about the relationship between green vegetation and the risk of death in Asian populations. Therefore, we opted to evaluate the association of greenness with mortality in Taiwan. Death information was retrieved from the Taiwan Death Certificate database between 2006 to 2014 (3287 days). Exposure to green vegetation was based on the normalized difference vegetation index (NDVI) collected by the Moderate Resolution Imagine Spectroradiometer (MODIS). A generalized additive mixed model was utilized to assess the association between NDVI exposure and mortality. A total of 1,173,773 deaths were identified from 2006 to 2014. We found one unit increment on NDVI was associated with a reduced mortality due to all-cause (risk ratio [RR] = 0.901; 95% confidence interval = 0.862–0.941), cardiovascular diseases (RR = 0.892; 95% CI = 0.817–0.975), respiratory diseases (RR = 0.721; 95% CI = 0.632–0.824), and lung cancer (RR = 0.871; 95% CI = 0.735–1.032). Using the green land cover as the alternative green index showed the protective relationship on all-cause mortality. Exposure to surrounding greenness was negatively associated with mortality in Taiwan. Further research is needed to uncover the underlying mechanism.
Highlights
Non-communicable chronic diseases result in a great health burden worldwide
According to statistics provided by the World Health Organization (WHO), cardiovascular-related and respiratory diseases significantly contributed to the disability-adjusted life years (DALY) [1,2]
Earlier studies suggest the burden of major chronic diseases could be reduced by the surrounding greenness [3], and some evidence indicates the interplay between greenness and air pollution on mortality [4,5,6]
Summary
Non-communicable chronic diseases result in a great health burden worldwide. According to statistics provided by the World Health Organization (WHO), cardiovascular-related and respiratory diseases significantly contributed to the disability-adjusted life years (DALY) [1,2]. Ischemic heart disease ranks as the first (for males) and second (for females) in terms of global DALYs. Chronic. Obstructive Pulmonary Disease (COPD), one of the major respiratory diseases, is the sixth leading causes of DALYs for both genders. Lung cancer contributes more than 40,000 DALYs and has the highest ranks among all types of neoplasm. Earlier studies suggest the burden of major chronic diseases could be reduced by the surrounding greenness [3], and some evidence indicates the interplay between greenness and air pollution on mortality [4,5,6]. A study based on U.K. vital statistics found people exposed to higher levels of
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