Daily Temperatures and Child Hospital Admissions in Aotearoa New Zealand: Case Time Series Analysis

The influence of global climate change on temperature-related health outcomes among vulnerable populations, particularly young children, is underexplored. Using a case time series design, we analysed 647,000 hospital admissions of children aged under five years old in New Zealand, born between 2000 and 2019. We explored the relationship between daily maximum temperatures and hospital admissions across 2139 statistical areas. We used quasi-Poisson distributed lag non-linear models to account for the delayed effects of temperature over a 0-21-day window. We identified broad ICD code categories associated with heat before combining these for the main analyses. We conducted stratified analyses by ethnicity, sex, and residency, and tested for interactions with long-term temperature, socioeconomic position, and housing tenure. We found J-shaped temperature-response curves with increased risks of hospital admission above 24.1 °C, with greater sensitivity among Māori, Pacific, and Asian compared to European children. Spatial-temporal analysis from 2013-2019 showed rising attributable fractions (AFs) of admissions associated with increasing temperatures, especially in eastern coastal and densely populated areas. Interactive maps were created to allow policymakers to prioritise interventions. Findings emphasize the need for child-specific and location-specific climate change adaptation policies, particularly for socioeconomically disadvantaged groups.