The urban heat anomaly has been suggested as a representative risk factor for human health in metropolitan areas, but few studies have measured a quantitative increase in risk due to the urban heat anomaly on heat-related mortality in the summer season or assessed the role of various types of land-use/land-cover (LULC), which may contribute to the urban heat anomaly. In this study, we evaluated the association between the urban heat anomaly and heat-related mortality risk in the summer and the potential roles of multiple types of LULC indicators. We used district-level time-series and cadastral data from 51 urban districts in the national capital region of South Korea. We applied a two-stage analysis. In the first stage, we estimated the district-specific heat-related mortality risk by using a distributed lag non-linear model. In the second stage, we used a meta-analysis to pool the estimates across all districts and calculate the association between the urban heat anomaly/LULC indicators and heat-related mortality risk. We found that the higher urban heat anomaly was related to lower vegetation and higher urban surface indicators, and the urban heat anomaly was positively associated with the heat-related mortality risk. The association between the urban heat anomaly and the heat-related mortality risk was more pronounced in the elderly (age ≥ 65 years) and female population than in the non-elderly and male population. We also found that the LULC indicators affected the heat-related mortality only through the urban heat anomaly. Our findings indicate that urban areas may be more vulnerable to heat-related mortality risk as determined by the urban heat anomaly. These results suggest a need for urban heat mitigation strategies such as increased vegetation or surface albedo to help reduce heat-related mortality risk.

有人建议将城市热异常作为大城市地区人类健康的代表危险因素，但很少有研究测量出城市热异常在夏季导致的与热有关的死亡率方面的定量增加或评估了各种因素的作用。土地使用/土地覆盖类型（LULC）的类型，可能会导致城市热异常。在这项研究中，我们评估了夏季城市热异常和与热相关的死亡风险与多种类型的LULC指标的潜在作用之间的关联。我们使用了来自韩国国家首都地区51个市区的区级时间序列和地籍数据。我们进行了两阶段分析。在第一阶段，我们通过使用分布滞后非线性模型来估计与地区相关的与热相关的死亡风险。在第二阶段元-分析以汇总所有地区的估计值，并计算城市热异常/ LULC指标与热相关的死亡风险之间的关联。我们发现，较高的城市热异常与较低的植被和较高的城市表面指标有关，而城市热异常与与热相关的死亡风险呈正相关。与非老年人和男性相比，老年人（≥65岁）和女性人群中城市热异常与与热相关的死亡风险之间的关联更为明显。我们还发现，LULC指标仅通过城市热异常影响与热有关的死亡率。我们的发现表明，根据城市热量异常，城市地区可能更容易遭受与热量相关的死亡风险。