Exploring urban-rural differences in health risks from extreme temperatures

By Kejia Hu, PhD Candidate at Zhejiang University, China and IIASA Young Scientists Summer Program (YSSP) 2016 participant 

Kejia Hu, an alumna of the IIASA Young Scientists Summer Program, discusses a recent study on how extreme temperatures affect the health risks experienced by urban and rural communities in China. 

Hot and cold temperatures are associated with increased risks of cause-specific mortality, in other words, deaths that result from, for instance, cardiovascular and respiratory conditions. Due to the urban heat island effect – where an urban heat island is a city or metropolitan area that is significantly warmer than its surrounding rural areas due to human activity – it is commonly assumed that urban residents are at a higher risk of exposure to extreme heat than their rural neighbors are. Very few studies have explored the urban-rural differences of temperature-related health risks, often because of the lack of sufficient meteorological and health data in rural areas.

Today, 45% of the global population – nearly 3.4 billion people – still live in rural regions, and based on the UN’s World Urbanization Prospects 2018, there will still be more than 3 billion people living in these areas by 2050, despite current trends such as urbanization.

This made us wonder whether there could be a rural-urban gap in extreme temperature induced health risk. We decided to conduct a study to address this question in Zhejiang province in eastern China employing high spatial resolution data on temperature, death registrations, air pollution, and population density across 89 counties in Zhejiang from 2009 to 2015.

Based on an epidemiological analysis of more than 2 million death cases, we found that rural residents are more sensitive to both cold and hot temperatures than urban residents, and that extreme temperatures especially affect the elderly. Our results indicate that extreme cold temperatures increased the mortality rate by 98% for rural populations, and by 47% for urban populations, while extremely hot temperatures increased the mortality rate by 18% for rural populations and by 14% for urban populations. When considering both human exposure and vulnerability, the attributable deaths from cold and hot temperatures were 4.8 and 2.6 times higher in rural than in urban areas, respectively.

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But why do rural populations tend to have higher mortality risks in the face of both cold and heat? Our results suggest that age, education, income, access to health care services and air conditioners, and the types of occupations that residents in these areas engage in, are among the potential sources. We found that counties with higher percentages of elderly and agricultural employment, lower levels of education, lower income levels, fewer hospital beds, and fewer air conditioners, had higher mortality risks related to both heat and cold. This could mean that socioeconomic vulnerability may play an important role – even more important than temperature in the determinants of temperature-related health risks.

Ours is the first study to find an urban–rural disparity in both heat and cold mortality risks. Importantly, it challenges the general assumption in previous studies in developed countries that urban residents are at a higher risk to extreme high temperatures. Our findings suggest that previous studies, which mostly investigated exposure-response associations using data from urban areas, may have underestimated the mortality burden for the entire population.

Although the Chinese government have standards in place regarding thermal comfort in residential buildings and highly recommend that they are implemented for rural houses, unfortunately, until now, this has only been enforced for urban apartments in China. In addition, due to lower income, rural households are more likely to fall into “fuel poverty” compared to urban households, which will limit the use of air conditioners for rural people. Targeted measures such as financial assistance for paying electricity bills will help build rural residents’ resilience to extreme temperatures.

Our findings have important implications for policy, particularly in developing countries. Overall, no single action will be enough to reduce the temperature-related mortality risks in rural areas. More efforts should be made to narrow the urban-rural gaps that persist in access to health care by, for example, increasing investment in health care facilities and health care professionals in rural areas. Improving rural people’s general awareness of temperature related risks, such as to popularize preventive knowledge and to develop early warning systems is also needed to prevent temperature-related deaths.


Hu K, Guo Y, Hochrainer-Stigler S, Liu W, See L, Yang X, Zhong J, Fei F, et al. (2019). Evidence for Urban–Rural Disparity in Temperature–Mortality Relationships in Zhejiang Province, China. Environmental Health Perspectives 127 (3): e037001. [pure.iiasa.ac.at/15773]

Note: This article gives the views of the author, and not the position of the Nexus blog, nor of the International Institute for Applied Systems Analysis.

Eat healthy and sustainably, don’t leave yourself behind

By Barbara Willaarts, researcher with the IIASA Water Program

On World Water Day 2019, IIASA researcher Barbara Willaarts tells us more about how our dietary choices can contribute towards reaching the UN’s Sustainable Development Goal 6: Water for all by 2030.

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The theme chosen for World Water Day 2019 is “Leaving no one behind”. As the UN emphasizes, this year is very much about reminding ourselves that there are still considerable efforts required to provide clean water, sanitation, and hygiene for all people across the globe.

While there is no question about the fact that we should push our governments and decision makers to pursue the fundamental human right of access to clean water, bringing forward the sustainable development water agenda – specifically Sustainable Development Goal (SDG) 6 : Water for all by 2030 – requires that action is taken on multiple fronts. Securing access and sanitation, is a top priority, but how we manage the water we have access to, is also fundamental.

The first key message here is that a lot of the actions that are required to overcome many of the global water challenges like water scarcity, pollution, and ecosystem degradation, actually do not require expensive government interventions. Many rely on us, on the choices that we make as citizens and consumers in our day-to-day activities. What we wear, how we eat, or what we buy and where we buy it, are daily personal decisions, and these can make a huge difference when it comes to achieving the sustainable development agenda and in particular, SDG6.

In the past years I have conducted various research projects looking into the footprints of our lifestyles, particularly in western societies. The aim behind these investigations was not only to quantify impacts to raise awareness, but also to use this information to define benchmarks for sustainable consumption.

Being Dutch, it is not strange that I have developed my professional career in the water sector, and living in Spain (the most arid country in the EU) for many years has only deepened my interest in looking into drivers of and solutions to global water scarcity. Anyone working in this field will quickly agree that exploring solutions to water scarcity problems very often implies looking at solutions related to the way we produce and consume agricultural products.

There is a bunch of interesting literature out there assessing solutions to increase the efficiency of agricultural production systems and pathways to reduce its environmental footprint. Approaching the food problem from a consumption perspective, however, is an arena that researchers only recently started to explore. This is promising because, firstly, the benefits of improving consumption patterns might outweigh those achieved through efficiency gains. Secondly, this science often conveys messages that are easy to grasp and implement, for example, eat meat only once a week, buy local, and eat five a day of vegetables and fruits. Lastly, it also empowers citizens as the main actors of the social change that is required to meet the sustainability agenda.

With that said, I would like to reflect on a recent study led by colleagues from the Polytechnic University of Madrid and the Food and Agricultural Organization, that I was involved in. The research in question is about the water and nutritional implications of shifting diets, and we used Spain as a case study. The choice of the case study was driven by the fact that Spain, like other Mediterranean countries, is often recognized and valued for its fresh, locally grown, and healthy diets. The reality is however that, while it has been so for many years, things across the Mediterranean, and particularly in Spain, have changed substantially after the 70s as a result of a number of drivers including increasing migration to cities, incorporation of more women into the labor force, work-life imbalance, and food trade openness.

According to the results of our study, the dietary shift in Spain is such that current diets resemble an inverted food pyramid, with households eating 15% more meat, beverages, and sugar products and 37% less fruits and vegetables on a daily basis than what is actually recommended by the Mediterranean dietary guidelines. The effect of this shift is that today, Spain ranks fifth in the EU of countries with the highest prevalence of obesity and overweight.

These dietary shifts have all sorts of nutritional and environmental implications. From a nutritional perspective, current diets contain 17% more kilocalories (Kcal) – meaning units of energy – than the recommended intake, as well as a 36% higher content of macro-nutrients like fats and proteins.  On the other extreme, the intake of essential micro-nutrients like vitamins and minerals has decreased sharply by 40%.

From a water perspective, the observed dietary shifts have increased the water footprint of food consumption by 34%, which is equivalent to seven times the daily per capita consumption of domestic water. An interesting finding here is that current dietary patterns are not just more water intense, but also more international, since over 40% of water “eaten” is from imported food products. This basically means that the Spanish food basket is no longer local but is increasingly being filled with foreign land, biodiversity, and water resources.

Spain is not a unique case and it is very likely that similar trends are occurring across other European and developed countries. This clearly evidences that what we eat matters a lot – to our health and to our environment. Most importantly, you and I have the capacity to make the difference. Eat healthy, eat sustainably, and don’t leave yourself behind!


Blas A, Garrido A, Unver O, & Willaarts B (2019). A comparison of the Mediterranean diet and current food consumption patterns in Spain from a nutritional and water perspective. Science of the Total Environment 664: 1020-1029.

Note: This article gives the views of the author, and not the position of the Nexus blog, nor of the International Institute for Applied Systems Analysis.

15 years of Egypt membership at IIASA

Tom Danaher, IIASA external relations officer, interviews Mahmoud Sakr, President of the Egyptian Academy of Scientific Research and Technology (ASRT) and IIASA council member for Egypt, about achievements and challenges that Egypt has faced in the last 15 years, and how IIASA research will help Egypt and ASRT in the future.

Mahmoud Sakr, President of the Egyptian Academy of Scientific Research and Technology (ASRT) and IIASA council member for Egypt

What have been the highlights of the Egypt-IIASA membership until now?

In 2018 IIASA and ASRT signed a roadmap outlining our collaboration priorities for the next five years, which includes a focus on capacity development. Another highlight was an ASRT training workshop in Cairo with IIASA researchers in 2018, which focused on the introduction of water modeling and projects. We also did a 2007 study focused on population and human capital in Egypt, produced in collaboration with the Cairo Demographic Center, as well as seven scientists participating in the IIASA Young Scientists Summer Program.

What do you think will be the key scientific challenges to face Egypt in the next few years? And how do you envision IIASA helping Egypt to tackle these? 

By being a member of IIASA, we aim to build custom-made models that are relevant to Egyptian issues and challenges, to improve capacity building opportunities in the field of systems analysis for our young researchers, and to establish a regional center for systems analysis in the Arab world. 

While Egypt’s work on renewable energy sources has greatly increased in recent years, it is critical that Egypt continues with its exploration of renewable energy. We believe IIASA is positioned to support Egypt in this area with its sophisticated energy models. Given the country’s lack of agricultural land and water resources, strategies to manage crop irrigation are essential. In Egypt we need to develop policies and strategies that lead to improving the quality of life for all Egyptians through the food-energy-water nexus, while balancing an ever-expanding population. Since IIASA is internationally recognized in this area and has global models which have been used in the Nile basin, we believe IIASA can help Egypt strengthen evidence-based decision making and policy development in this area.

While working hard to improve the quality of life for its citizens, advances are often outpaced by the fast growth in population. This is another core strength of IIASA, and its work can help in bettering citizens lives.

As the president, what is your vision for ASRT?

ASRT’s key aims are to further develop Egyptian society and economic growth, by providing scientific solutions to country specific problems, and to those of a regional and international interest to Egypt. This is accomplished through providing core facilities for scientific publishing, supercomputing and e-science, supporting local industry in Egypt via technology transfer, empowering young women in science, technology and innovation, and establishing national and international scientific research networks to support Egypt. Since joining ASRT in 2014 my main aim has been to restructure and focus on the science, technology, and innovation indicators and policies within Egypt. I am also passionate about promoting and empowering young researchers in science and technology. I have supervised several technological roadmaps and strategic studies relating to the Sustainable Development Strategy: Egypt Vision 2030.

You mentioned the 2018 IIASA-ASRT roadmap which includes a focus on capacity development. Why is training the next generation of systems analysts so important?

For us to achieve the goals I have outlined, it is essential to train the next generation of scientists effectively and ensure they have a good basic knowledge of systems analysis before applying it to real-life challenges.

One way to tackle this could be through developing online courses, whereby IIASA would assist with a consortium of other institutes and universities in setting the curriculum. We would hope that future applications of the IIASA Young Scientists Summer Program and the IIASA Postdoctoral Program would increase, based on the availability of these online courses.

Since former YSSPers and postdoctoral fellows are the torchbearers of systems analysis in their home countries, this direct mentorship is essential to develop real expertise in systems analysis and to empower participants to independently implement what they have learned in their own decision-making roles.

On a lighter note, what was the last book that you read and would you recommend it?

Egyptian Tales, Translated from the Papyri, Project Gutenberg, 8 by W. M. Flinders Petrie. After a long day of work, dealing with high caliber scientists and government officials, I need to relax, and there is nothing more relaxing than the ancient tales of pharaonic Egypt. I certainly recommend reading it, though; it’s a little bit long. It can be downloaded via the internet.

About ASRT and Mahmoud Sakr

ASRT was established in 1971 by the Egyptian government to develop science and technology in Egypt and today it is a national thinktank. Mahmoud Sakr holds a professorship in plant biotechnology and was previously the Head of Genetic Engineering and Biotechnology at the National Research Center and the co-founder and director of the Center of Excellence for Advanced Sciences. He has held several international positions including secretary general of the Arab Biotechnology Association at the Federation of Arab Scientific Research Councils (FASRC) and has been the editor-in-chief of various scientific journals.
More Information

More information on IIASA and Egypt collaborations. This article gives the views of the authors, and not the position of the Nexus blog, nor of the International Institute for Applied Systems Analysis.

Closing funding gaps and building bridges with the IIASA network

By Marzena Anna Adamczuk, Development Officer, Office of Sponsored Research, IIASA

YSSP Fund recipients from 2011 to 2018

The 27 fellows smiling at you from the photograph are all part of the IIASA global network of system thinkers thanks to the Young Scientists Summer Program (YSSP) Fund. The YSSP Fund accepts donations from the IIASA community and directs the proceeds to support young scholars who are not eligible to receive a stipend from an IIASA National Member Organization.

The IIASA experience has had a profound influence on the lives of previous recipients, and has brought them closer to answering some of their most pertinent research questions. J. Luke Irwin (2018 YSSP Fund), for example, was able to explore which jobs and skills are the least automation resilient and how policymakers and academic institutions should address future unemployment caused by automation. Another previous beneficiary of the fund, Diana Erazo (2016 YSSP Fund), looked at the transmission dynamics of Chagas disease – one of the most neglected tropical diseases in Latin America – and the most efficient strategies to contain it.

Since its inception in 2011, the YSSP Fund has opened the IIASA door to 27 young researchers from Ethiopia, Thailand, India, China, Colombia, Brazil, and many other countries. All these scholars have since become an important part of the IIASA worldwide network, enriching the institute’s research portfolio and planting the seeds of their newly acquired systems analysis expertise in their home countries.

This bridge-building and door-opening capacity of the YSSP Fund is what inspires many members of the IIASA family to support it every year. Ever since I was appointed as development officer at IIASA in 2014, I have been privileged to accept donations from former IIASA directors, eminent researchers, and renowned experts in a variety of fields. We are all united in our belief that supporting the YSSP Fund is a great investment in future generations of researchers and an important token of trust in IIASA and its flagship capacity-building program.

Many of our alumni donors are former YSSP fellows, who appreciate the impact the program has had on their careers. One of them is Petr Aven, who was part of the first YSSP cohort in 1977 and still remembers this experience as the best time of his life. Some of our alumni, who were themselves recipients of the YSSP Fund scholarship, see it as their duty and privilege to give back. One of our most distinguished donors, Dr. Roger Levien, former director of IIASA and the founder of the YSSP, hopes that his donations will help build a bridge between IIASA and Pardee RAND Graduate School, of which he is an alumnus as well. The motivation behind our most recent pledge from Professors Jyoti and Kirit Parikh is to expose young minds to systems analysis and to promote research-based policymaking.

After the annual fundraising campaign is over and the IIASA network lives up to the challenge for yet another year, I find it very gratifying to be able to channel the support coming from the IIASA community to the YSSP Fund recipients. My favorite time of the year is June when I get to meet the lucky recipients of the scholarships, learn all about their plans and ambitions for the summer at IIASA, and see how motivated they are to make the most of their time at the institute.

However, the real satisfaction kicks in when I see the YSSP Fund fellows thrive in their post-IIASA careers. With immense support from our alumni officer and the Communication Department, we take great pride in sharing their successes with the IIASA worldwide community. We see it as a token of gratitude to both the donors, who opened the IIASA door to them, as well as to their IIASA supervisors, who generously shared their expertise and continue to mentor them after their summer at the institute is over.

Speaking of successes, Gbemi Samuel (2017 YSSP Fund), the first Nigerian to ever participate in the program has recently published a well-received article in the Journal of African Population Studies describing her research on estimating how many children under five could be prevented from dying if women in Nigeria used cleaner fuels to cook their family meals. Lu Liu, a 2016 YSSP Fund recipient published her first-authored paper in Environmental Research Letters and had a poster presentation at the AGU Fall Meeting in Washington D.C. We are also very proud of Zhimin Mao’s (2015 YSSP Fund) post-IIASA career, starting from her IIASA Peccei Award in 2015 and leading up to her current position at the World Bank. We can hardly wait to boast about the successes and accomplishments of our 2018 YSSP Fund fellows and hope they will stay in touch.

Every donation to the YSSP Fund goes a long way. Help us close more funding gaps this summer and support the next generation of system thinkers!

2018 YSSP Fund recipients: (L-R) Ekaterina Antsygina, Luke Irwin, Sara Turner, Fabio Diuana, Ankita Srivastava, Muhammad Nurariffudin, Fumi Harahap

Support the 2019 YSSP Fund

Note: This article gives the views of the author, and not the position of the Nexus blog, nor of the International Institute for Applied Systems Analysis.

Finding community at the AGU Fall Meeting

By Lu Liu, postdoctoral research associate at Rice University, USA and IIASA YSSP 2016 participant

I have been attending the American Geophysical Union (AGU) Fall Meeting since 2013 when I was working with the Joint Global Change Research Institute. Ever since then, the AGU Fall Meeting has become one of my most anticipated events of the year where I get to share my research and make new friends.

The first time I attended the AGU Fall Meeting, I was overwhelmed with the size and scale of this conference. There are more than 20,000 oral and poster presentations throughout the week, and the topics cover nearly 30 different themes, from earth and space science, to education and public affairs. I was thrilled to see my research being valued and discussed by people from various backgrounds, and I was fascinated by other exciting research and rigorous ideas that emerged at the meeting.

Lu Liu at 2018 AGU poster session

Lu Liu at 2018 AGU poster session

At this year’s AGU, I presented my poster Implications of decentralizing urban water supply infrastructure via direct potable water reuse (DPR) in a session titled Water, Energy, and Society in Urban Systems. In a nutshell, my poster presents a quantitative model that evaluates the cost-benefits of direct potable water reuse in a decentralized water supply system. The concept of decentralization in an urban water system has been discussed in previous literature as an effective approach towards sustainable urban water management. Besides the social and technical barriers in implementing decentralization, there is a lack of analytical and computational tools necessary for the design, characterization, and evaluation of decentralized water supply infrastructure. My study bridges the gap by demonstrating the environmental and economic implications of decentralizing urban water infrastructure via DPR using a modeling framework developed in this study. The quantitative analysis suggests that with the appropriate configuration, decentralized DPR could potentially alleviate stress on freshwater and enhance urban water sustainability and resilience at a competitive cost. More about this research and my other work can be found here: https://emmaliulu.wixsite.com/luliu.

At the AGU Fall Meeting, I engaged in various opportunities to reconnect with old colleagues and build new professional relationships. What’s better than running into my former YSSP supervisors and IIASA colleagues after two years since I left the YSSP? Although my time spent at IIASA was short, I hold IIASA and the YSSP very close to my heart because the influence this experience has had on my professional and personal life is profound.

I will continue to attend the AGU Fall Meeting for the foreseeable future. After all, we all want to feel a sense of belonging and acceptance in a community, and I am glad I already found mine.


Note: This article gives the views of the author, and not the position of the Nexus blog, nor of the International Institute for Applied Systems Analysis.