{
  "abstract": "BackgroundChildhood respiratory mortality in China has fallen by over 90% in three decades alongside sustained national warming, yet national long-run evidence on temperature and child respiratory mortality is lacking.\n\nMethodsWe linked Global Burden of Disease (GBD) 2021 mortality estimates for China -- lower respiratory infections (LRI), ages 0-19, and asthma, ages 0-24, 1990-2021 -- with C-LSAT 0.5{degrees} gridded temperature data (1990-2019), aggregated nationally and to five climate zones. Four annual indicators (mean temperature, diurnal temperature range, seasonal amplitude, interannual variability) entered regressions of log mortality rates with Newey-West standard errors. A bootstrapped (500 resamples) quadratic model probed the minimum mortality temperature (MMT), with PM2.5-adjusted analyses and future-exposure, permutation, and detrended falsification tests.\n\nResultsLRI deaths fell by 96.3% (330,194 in 1990 to 12,098 in 2021; 95% uncertainty interval 9,669-14,891) and asthma deaths by 94.9% (3,287 to 167), while mean temperature rose 0.364 {degrees}C per decade and diurnal temperature range narrowed 0.092 {degrees}C per decade. Baseline coefficients were large (mean temperature -1.696, SE 0.174; diurnal temperature range +2.408, SE 0.336; seasonal amplitude -0.162, SE 0.082; interannual variability +2.924, SE 1.514, per 1 {degrees}C in log rate), but the future-exposure test failed and detrending nullified every coefficient: the associations are trend-level, and short-cycle causal effects are not identifiable. Nor was the national MMT identifiable -- observed temperature support spans only 6.66-8.13 {degrees}C, and the nominal turning point of 35.84 {degrees}C is an extrapolation artifact (quadratic term p = 0.963). Within the observed range, warming and declining mortality moved in the same direction.\n\nConclusionsThe 96% decline in childhood respiratory mortality cannot be attributed to warming. China sits on the low-temperature side of the optimum, and the marginal direction of future warming requires stronger designs to establish. The falsification framework offers a discipline for climate-health inference in China.",
  "abstract_shown": true,
  "affiliations": [
    "National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "name": "D. Li"
    },
    {
      "name": "Y. Miao"
    },
    {
      "name": "Y. Zhang"
    },
    {
      "name": "H. Chen"
    },
    {
      "name": "X. Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "C. Shen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2b936vhkkx6bp.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.08.31.26361879",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.08.31.26361879v1.full",
  "id": "2b936vhkkx6bp",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.08.31.26361879v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "epidemiology"
    ],
    [
      "openalex",
      "2307|Climate Change and Health Impacts"
    ]
  ],
  "openalex": "W7206217617",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.08.31.26361879v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-31",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/2b936vhkkx6bp.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:35Z",
      "native_id": "10.64898/2026.08.31.26361879",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.08.31.26361879v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:epidemiology",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Warming, thermal variability, and the 96% decline in childhood respiratory-infection mortality in China: a national time-series analysis of the Global Burden of Disease Study 2021 and the C-LSAT high-resolution climate dataset",
  "title_text": "Warming, thermal variability, and the 96% decline in childhood respiratory-infection mortality in China: a national time-series analysis of the Global Burden of Disease Study 2021 and the C-LSAT high-resolution climate dataset",
  "type": "preprint",
  "updated_at": "2026-10-30T12:17:35Z",
  "url": "https://research.draconitic.com/paper/2b936vhkkx6bp",
  "venue": "medRxiv",
  "versions": []
}