Study on the challenge and influence of the built thermal environment on elderly health in rural areas: Evidence from Shandong, China

Elderly health is increasingly recognized as a worldwide challenge with the continuous social aging trend. This study aimed to investigate the thermal conditions of the elderly in rural areas of Shandong, China. The thermal sensation and physiological response performances of elderly participants were examined in their own houses. Results show a clear seasonal pattern in cardiovascular disease mortality, cold stress increases the cardiovascular disease risk. The coal-based stoves serve as the main source of home heating and their limited coverage of the room area gave rise to poor quality of thermal comfort. The analysis of skin temperature for those under 65 and above did not reveal any significant difference in response to different indoor temperatures. The regression results confirm that a colder home leads to a rising value of the elderly’s systolic blood pressure, rising by more than 1 mmHg for every 1 ℃ decrease in indoor temperature and thus posing a greater risk of cardiovascular diseases. The systolic blood pressure value of older subjects rise more when they are exposed to decreasing indoor temperatures, possibly due to an age-related decline in their ability to maintain stability of blood pressure. It is noteworthy that the average blood velocity of older subjects reduces less in response to decreasing indoor temperatures, indicating a weakened capacity to resist cold stress and its associated high risk of hypertension. This investigation provides evidence in favor of improving the thermal environment of the elderly and reducing their risk of cardiovascular diseases.