Scottish Longitudinal Study
Development & Support Unit

Current Projects

Project Title:

Climate Change, Air Pollution, and Ethnic Inequalities in Health: Analysis and Projection Based on Longitudinal Register Data from Scotland

Project Number:



Mary Abed Al Ahad (University of St Andrews)
Professor Hill Kulu (University of St Andrews)
Professor Frank Sullivan (University of St Andrews)
Dr. Urska Demsar (University of St Andrews)

Start Date:



This research project aims to study the effects of air pollution and extreme weather events on population health and mortality in the general population and across ethnic groups in Scotland. In addition, this research project aims to project future health behaviour and mortality patterns in response to changes in weather and air pollution in Scotland. Thus, the main research questions of the project are: 1. What are the effects of NO2, Ozone, PM2.5, PM10, SO2 and carbon monoxide air pollution on all cause hospital admissions and mortality in the general population and by ethnic subgroups in Scotland? 2. What are the effects of climate change in terms of temperature, precipitation, heat waves, and cold spells on all cause hospital admissions and mortality in the general population and by ethnic subgroups in Scotland? 3. How many additional hospital visits and how many deaths we can expect if the frequency of heat waves and cold spells and the concentration of NO2, Ozone, PM2.5, PM10, SO2 and carbon monoxide air pollutants increase further in Scotland?

Climate change and increased environmental pollution have brought renewed interest in environmental effects on human health and mortality. Recent research shows that long-term exposure to environmental pollution leads to increased mortality from cardiovascular diseases, respiratory diseases, and lung cancer, as well as to adverse birth outcomes (Cesaroni et al. 2013; Beelen et al. 2014; Dibben and Clemens 2015; Richardson et al. 2013). Another stream of studies show that climate change manifested with extremely hot and cold weather increase mortality from heart and respiratory diseases with older people being more vulnerable to sudden changes in temperature than younger individuals (Arbuthnott and Hajat 2017; Anderson and Bell 2009; Baccini et al. 2011; Huynen et al. 2001; Langford and Bentham 1995). Some studies have shown higher mortality from natural (or non-accidental) causes for females during heat waves and cold spells; others have reported elevated mortality among working-age males who are more likely to work outdoors (Kysely et al. 2009; Zhou et al. 2014). Although previous research has advanced our understanding of environmental effects on population health and mortality, it has suffered from a number of shortcomings. First, little research (if any) has examined whether and how environmental effects on population health vary by race and ethnicity (Parker et al. 2018). Most research focuses on age differences, whereas potential ethnic inequalities have not been examined. Previous studies show that in industrialized countries many ethnic minorities have low SES and they are more likely to live in neighbourhoods with higher environmental pollution, e.g. measured by the concentration of particular matter (PM2.5) (Grey et al. 2013). Further, ethnic minorities often have poorer housing conditions than the majority population; thus higher suffering from extreme weather conditions. Second, most studies focus on relating environmental events to mortality; little research has simultaneously investigated mortality and various (objective) health measures (e.g. hospitalization). Third, little (if any) research has examined how air pollution and extreme weather events simultaneously influence population health and mortality. It is likely that pollution and extreme temperatures, if they happen together, e.g. in big cities, have a pronounced negative effect on individuals’ health. Finally, little research has been conducted to project how health behaviour and mortality patterns change with predicted climate changes. How many additional hospital admissions and how many deaths we can expect if the frequency of extreme weather events increases further?


Anderson, B. G. and Bell M. L. 2009. Weather-related mortality: how heat, cold, and heat waves affect mortality in the United States, Epidemiology 20:2, 205-213.
Arbuthnott, K. G. and Hajat, S. 2017. The health effects of hotter summers and heat waves in the population of the United Kingdom: a review of the evidence, Environmental Health 16: 1-13.
Baccini, M., Kosatsky, T. and Analitis, A. 2011. Impact of heat on mortality in 15 European cities: attributable deaths under different weather scenarios, Journal of Epidemiology and Community Health 65:1, 64-70.
Beelen, R., Stafoggia, M., Raaschou-Nielsen, O. et al. 2014. Long-term exposure to air pollution and cardiovascular mortality: an analysis of 22 European cohorts, Epidemiology 25: 3, 368-378.
Cesaroni, G., Badaloni, C., Gariazzo, C. et al. 2013. Long-term exposure to urban air pollution and mortality in a cohort of more than a million adults in Rome, Environmental Health Perspectives 121: 3, 324-331.
Dibben, C. and Clemens, T. 2015. Place of work and residential exposure to ambient air pollution and birth outcomes in Scotland, using geographically fine pollution climate mapping estimates, Environmental Research 140, 535-541.
Grey, S.C., Edwards, S. E. and Miranda, M. L. 2013. Race, socioeconomic status, and air pollution exposure in North Carolina. Environmental Research 126: 152-158.
Huynen, M. M.T. E., Martens, P. and Schram, D. 2001. The impact of heat waves and cold spells on mortality rates in the Dutch Population, Environmental Health Perspectives 109: 5, 463-470.
Kysely, J., Pokorna, L., Kyncl, J. et al. 2009. Excess cardiovascular mortality associated with cold spells in the Czech Republic, BMC Public Health 9: 19.
Langford, |. H. and Bentham, G. 1995. The potential effects of climate-change on winter mortality in England and Wales, International Journal of Biometeorology 38: 3, 141-147.
Parker, J. D., Kravets, N., Vaidyanathan, A. 2018. Particulate matter air pollution exposure and heart disease mortality risks by race and ethnicity in the United States 1997 to 2009. National Health Interview Survey with mortality follow-up through 2011. Circulation 137: 16, 1688- 1697.
Richardson, E. A., Pearce, J., Tunstall, H, et al. 2013, Particulate air pollution and health inequalities: a Europe-wide ecological analysis, International Journal of Health Geographics 12: 34.
Zhou, M. G., Wang, L.J., Liu, T. et al. 2014, Health impact of the 2008 cald spell on mortality in subtropical China: the climate and health impact national assessment study (CHINAs), Environmental Health 13: 60.

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