Association between drought-related indices and the Number of Deaths in the Desert Adjacent Areas of Western China: A Time Series Study Based on Ecological Vulnerability Assessment

Association between drought-related indices and the Number of Deaths in the Desert Adjacent Areas of Western China: A Time Series Study Based on Ecological Vulnerability Assessment | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Association between drought-related indices and the Number of Deaths in the Desert Adjacent Areas of Western China: A Time Series Study Based on Ecological Vulnerability Assessment Beibei Wang, Xiuqian Li, Xuan Fu, Caifeng Luo, Jinrong Dong, Lili Hu, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8671455/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 16 You are reading this latest preprint version Abstract Objective: To conduct an ecological vulnerability assessment in the ecologically fragile Hexi region of western China, providing a reference basis for promoting the health of residents in ecologically vulnerable areas. Methods: In Wuwei City, located within China's Hexi Corridor and characterized by its proximity to desert regions, an ecological vulnerability evaluation system has been developed employing the Sensitivity-Resilience-Pressure (SRP) model. The Analytic Hierarchy Process-Principal Component Analysis Entropy Weight Combination Model (AHP-PCA) was then applied to analyze the Ecological Vulnerability Comprehensive Index (EVSI) of Wuwei City from 2014 to 2023, followed by classification using the natural breakpoint method. Based on the ecological vulnerability classification, the distributed lag nonlinear model (DLNM) was employed to examine the impact of drought-related indicators (Standardized Precipitation Index (SPI) and temperature-humidity index (THI) ) at each level on population mortality, calculating the cumulative relative risk (CRR). Finally, the synergy index was used to evaluate potential interactions between SPI and THI in impacting mortality rates. Results: (1) An ecological vulnerability assessment index system for Wuwei City was constructed using 13 natural and socio-environmental variables, categorizing ecological vulnerability into highly vulnerable (EVSI > 3.814), moderately vulnerable (2.927 < EVSI ≤ 3.814), and low vulnerability (EVSI ≤ 2.927). (2)The differences in mortality rates among high, medium and low ecologically fragile areas in Wuwei City were statistically significant. (3) Across all ecological vulnerability levels, SPI in moderately vulnerable areas showed the highest cumulative effect on mortality at lag 0 days and cumulative lag 14 days, with CRRs of 1.10 (95% CI: 1.07–1.14) and 1.10 (95% CI: 1.06–1.14), respectively. In low-vulnerability areas, the cumulative effect on mortality was highest when the THI reached 23 on the same day (CRR=1.16, 95% CI: 1.13–1.18), and also when the cumulative THI reached 60 after 21 days (CRR=1.16, 95% CI: 1.11–1.21). Conclusion: The mortality rate of the population varies in different areas with fragile ecological environments, and there is a correlation between ecological environment vulnerability and the risk of population death.In highly ecologically fragile environments, the risk of mortality increases due to extreme drought, with effects persisting longer. When ecological conditions are favorable at low fragility levels, the impact of THI on mortality becomes more pronounced. Ecological Vulnerability Standardized Precipitation Index Temperature-humidity index Mortality Risk Desert Marginal Areas Full Text Additional Declarations No competing interests reported. Supplementary Files Supplementarymaterials.docx Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 07 May, 2026 Reviews received at journal 06 May, 2026 Reviewers agreed at journal 02 May, 2026 Reviewers agreed at journal 01 May, 2026 Reviewers agreed at journal 30 Apr, 2026 Reviews received at journal 22 Mar, 2026 Reviewers agreed at journal 17 Mar, 2026 Reviewers agreed at journal 12 Mar, 2026 Reviewers agreed at journal 02 Feb, 2026 Reviewers agreed at journal 30 Jan, 2026 Reviewers agreed at journal 29 Jan, 2026 Reviewers invited by journal 29 Jan, 2026 Editor invited by journal 28 Jan, 2026 Editor assigned by journal 27 Jan, 2026 Submission checks completed at journal 27 Jan, 2026 First submitted to journal 22 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8671455","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":583143321,"identity":"48b317f1-0e70-46df-a7ba-677257daf5a1","order_by":0,"name":"Beibei Wang","email":"","orcid":"","institution":"Lanzhou University","correspondingAuthor":false,"prefix":"","firstName":"Beibei","middleName":"","lastName":"Wang","suffix":""},{"id":583143322,"identity":"265e0d80-28fe-4d36-ae22-038deeba68c1","order_by":1,"name":"Xiuqian Li","email":"","orcid":"","institution":"Lanzhou 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Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Ecological Vulnerability, Standardized Precipitation Index, Temperature-humidity index, Mortality Risk, Desert Marginal Areas","lastPublishedDoi":"10.21203/rs.3.rs-8671455/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8671455/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective: \u003c/strong\u003eTo conduct an ecological vulnerability assessment in the ecologically fragile Hexi region of western China, providing a reference basis for promoting the health of residents in ecologically vulnerable areas. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003eIn Wuwei City, located within China's Hexi Corridor and characterized by its proximity to desert regions, an ecological vulnerability evaluation system has been developed employing the Sensitivity-Resilience-Pressure (SRP) model. The Analytic Hierarchy Process-Principal Component Analysis Entropy Weight Combination Model (AHP-PCA) was then applied to analyze the Ecological Vulnerability Comprehensive Index (EVSI) of Wuwei City from 2014 to 2023, followed by classification using the natural breakpoint method. Based on the ecological vulnerability classification, the distributed lag nonlinear model (DLNM) was employed to examine the impact of drought-related indicators (Standardized Precipitation Index (SPI) and temperature-humidity index (THI) ) at each level on population mortality, calculating the cumulative relative risk (CRR). Finally, the synergy index was used to evaluate potential interactions between SPI and THI in impacting mortality rates. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e(1) An ecological vulnerability assessment index system for Wuwei City was constructed using 13 natural and socio-environmental variables, categorizing ecological vulnerability into highly vulnerable (EVSI \u0026gt; 3.814), moderately vulnerable (2.927 \u0026lt; EVSI ≤ 3.814), and low vulnerability (EVSI ≤ 2.927). (2)The differences in mortality rates among high, medium and low ecologically fragile areas in Wuwei City were statistically significant. (3) Across all ecological vulnerability levels, SPI in moderately vulnerable areas showed the highest cumulative effect on mortality at lag 0 days and cumulative lag 14 days, with CRRs of 1.10 (95% CI: 1.07–1.14) and 1.10 (95% CI: 1.06–1.14), respectively. In low-vulnerability areas, the cumulative effect on mortality was highest when the THI reached 23 on the same day (CRR=1.16, 95% CI: 1.13–1.18), and also when the cumulative THI reached 60 after 21 days (CRR=1.16, 95% CI: 1.11–1.21). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e The mortality rate of the population varies in different areas with fragile ecological environments, and there is a correlation between ecological environment vulnerability and the risk of population death.In highly ecologically fragile environments, the risk of mortality increases due to extreme drought, with effects persisting longer. When ecological conditions are favorable at low fragility levels, the impact of THI on mortality becomes more pronounced.\u003c/p\u003e","manuscriptTitle":"Association between drought-related indices and the Number of Deaths in the Desert Adjacent Areas of Western China: A Time Series Study Based on Ecological Vulnerability Assessment","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-01 14:23:41","doi":"10.21203/rs.3.rs-8671455/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-05-07T04:33:41+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-06T05:20:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"317158300326976112886603176292123489887","date":"2026-05-02T08:34:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"6268326845472836843495080378658112755","date":"2026-05-01T14:08:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"207143730868358411544688793977898151753","date":"2026-04-30T08:18:57+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-22T15:19:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"231151379158644781188587520958536614871","date":"2026-03-17T06:39:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"238257111848160342144359192094151358297","date":"2026-03-13T02:35:37+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"73661908100551440582703460463746736264","date":"2026-02-02T15:00:15+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"84549299202415852634677896079646312927","date":"2026-01-30T14:59:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"98512207227749542055748828721203949673","date":"2026-01-29T09:19:22+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-29T08:30:23+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-01-28T08:09:26+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-27T13:03:05+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-27T13:02:17+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2026-01-22T15:18:38+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2226e927-029e-43b2-a5c4-c3e2cea7f83c","owner":[],"postedDate":"February 1st, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Revision requested","date":"2026-05-07T04:33:41+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-06T05:20:41+00:00","index":59,"fulltext":""},{"type":"reviewerAgreed","content":"317158300326976112886603176292123489887","date":"2026-05-02T08:34:13+00:00","index":58,"fulltext":""},{"type":"reviewerAgreed","content":"6268326845472836843495080378658112755","date":"2026-05-01T14:08:00+00:00","index":57,"fulltext":""},{"type":"reviewerAgreed","content":"207143730868358411544688793977898151753","date":"2026-04-30T08:18:57+00:00","index":56,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-05-07T04:39:29+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-01 14:23:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8671455","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8671455","identity":"rs-8671455","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}