Impact of Environmental Exposure on Chronic Diseases in China and Assessment of Population Health Vulnerability

Although numerous epidemiological studies have demonstrated a relationship between environmental factors and chronic diseases, there is a lack of comprehensive population health vulnerability assessment studies from the perspective of environmental exposure, population sensitivity and adaptation on a regional scale. To address this gap, this study focused on six high-mortality chronic diseases in China and constructed an exposure-sensitivity-adaptability framework-based index system using multivariate data. The constructed system effectively estimated health vulnerability for the chronic diseases. The R-square between vulnerability and mortality rates for respiratory diseases and malignant tumors exceeded 0.7 and was around 0.6 for the other four chronic diseases. In 2020, Chongqing exhibited the highest vulnerability to respiratory diseases. For heart diseases, vulnerability values exceeding 0.5 were observed mainly in northern and northeastern provinces. Vulnerability values above 0.5 were observed in Jiangsu, Shanghai, Tianjin, Shandong and Liaoning for cerebrovascular diseases and malignant tumors. Shanghai had the highest vulnerability to endogenous metabolic diseases, and Tibet exhibited the highest vulnerability to digestive system diseases. The main related factor analysis results show that high temperature and humidity, severe temperature fluctuations, serious air pollution, high proportion of middle-aged and elderly population, as well as high consumption of aquatic products, red meat and eggs increased health vulnerability, while increasing per capita educational resources helped reduce vulnerability.