Environmental and social inequities in continental France: an analysis of exposure to heat, air pollution, and lack of vegetation.

BACKGROUND: Cumulative environmental exposures and social deprivation increase health vulnerability and limit the capacity of populations to adapt to climate change. OBJECTIVE: Our study aimed at providing a fine-scale characterization of exposure to heat, air pollution, and lack of vegetation in continental France between 2000 and 2018, describing spatiotemporal trends and environmental hotspots (i.e., areas that cumulate the highest levels of overexposure), and exploring any associations with social deprivation. METHODS: The European (EDI) and French (FDep) social deprivation indices, the normalized difference vegetation index, daily ambient temperatures, particulate matter (PM2.5 and PM10), nitrogen dioxide, and ozone (O3) concentrations were estimated for 48,185 French census districts. Reference values were chosen to characterize (over-)exposure. Hotspots were defined as the areas cumulating the highest overexposure to temperature, air pollution, and lack of vegetation. Associations between heat overexposure or hotspots and social deprivation were assessed using logistic regressions. RESULTS: Overexposure to heat was higher in 2015-2018 compared with 2000-2014. Exposure to all air pollutants except for O3 decreased during the study period. In 2018, more than 79% of the urban census districts exceeded the 2021 WHO air quality guidelines. The evolution of vegetation density between 2000 and 2018 was heterogeneous across continental France. In urban areas, the most deprived census districts were at a higher risk of being hotspots (odds ratio (OR): 10.86, 95% CI: 9.87-11.98 using EDI and OR: 1.07, 95% CI: 1.04-1.11 using FDep). IMPACT STATEMENT: We studied cumulative environmental exposures and social deprivation in French census districts. The 2015-2018 period showed the highest overexposure to heat between 2000 and 2018. In 2018, the air quality did not meet the 2021 WHO guidelines in most census districts and 8.6 million people lived in environmental hotspots. Highly socially deprived urban areas had a higher risk of being in a hotspot. This study proposes for the first time, a methodology to identify hotspots of exposure to heat, air pollution, and lack of vegetation and their associations with social deprivation at a national level.

Seasonal changes and decrease of suicides and suicide attempts in France over the last 10 years.

The objective of this study was to examine the evolution of suicides and suicide attempts over the last 10 years in France. We analyzed the number of deaths by suicide and suicide attempts in metropolitan France (2009-2018) from French national databases, on a daily, weekly or monthly basis. Seasonal variation in suicide rates was modeled using a cosinor function. Based on this model, we determined the association of suicides and suicide attempts with geographic characteristics, age, gender, means used and psychiatric disorders. The number of suicides and suicide attempts decreased over the last ten years in France (mean decrease of 14.49% and 11.69% per year). We observed a significant and recurrent seasonal pattern of suicides and suicide attempts in France, with a peak in spring. The suicide and suicide attempt rates were higher in the northern departments of France. Suicides were more frequent for men (75%) and middle-age individuals (45-54 years old), while suicide attempts were more frequent for women (62%) and young adults and middle-age individual (15-19 and 40-49 years old). Nearly two-thirds of the patients who attempted suicide suffered from comorbid psychiatric disorders. Mood disorders was the most frequent comorbid psychiatric disorder (54%). Voluntary drug intoxication was the most common means of suicide attempt (80%), and hanging was the most common means of suicide (54%). The number of suicides and suicide attempts decreased in France over the last 10 years, with large and recurrent seasonal variations. These findings could be used to alert and adjust prevention policies, as well as developing preventive strategies such as chronotherapeutics.

Impact of meteorological factors on alcohol use disorders: A study in emergency departments.

No data exist on the influence of meteorological factors on alcohol use disorders (AUD). The aim of this study was to investigate the relationship between meteorological factors and AUD. All patients who were admitted to an emergency department (ED) in the Paris-region for an alcohol-related condition were included using the Oscour® database over the period January 1, 2015 to December 31, 2019. Meteorological data were collected by Météo-France (French Weather service). All data were aggregated by week. We performed Pearson correlations between weather variables and the number of ED visits for AUD. We observed 98,748 ED visits for alcohol-related conditions over the study period. We found significant positive correlations between the number of alcohol-related ED visits and the mean temperature (r = 0.55; p = 1.87e -5, 95% Confidence Interval (CI) = 0.33, 0.72) and the duration of sunlight (r = 0.42; p = .0015, 95% CI = 0.17, 0.62). Negative correlations were also found significant with rain (r = -0.40; p = .0014, 95% CI = -0.62, -0.18), humidity (r = -0.41; p = .0023, 95% CI = -0.62, -0.16) and wind speed (r = -0.40; p = .0031, 95% CI = -0.60, -0.14). Emergency visits for AUD seem to increase with the temperature and duration of sunlight, and decrease with rain, humidity and wind speed. Further studies are needed on a larger scale and taking into account potential confounding factors to confirm these findings.