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Association between Global Solar Radiation and Acute Myocardial Infarction
Mortality: Spatial Regression Model at Municipality Level in Japan

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H. Kato and S. Tanimura 1

Graduate School of Medicine, Mie University, Japan
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Background: Acute myocardial infarction (AMI) is one of the most significant diseases worldwide
including Japan. However, little is known about association between long-term sun exposure and AMI
mortality.

Objective: The objective of this study is to clarify association between long-term sun exposure and
AMI mortality.

Methods: In this study, we employed an ecological study design with a spatial regression model.
Population and the number of AMI deaths in each municipality of Japan from 2013 to 2022 were obtained
from the portal site of Official Statistics of Japan (e-Stat). From this data, we calculated age-adjusted AMI
standard mortality ratio (SMR) separately by sex. Annual average of global solar radiation (GSR) data for
30 years at the municipality level were downloaded from the website of digital national land information of
Japan.
With three types of regression models (ordinary, spatial lag, and spatial error model), we examined the
association between AMI SMRs (dependent variable) and GSRs (independent variable) separately by sex.
No ethical issues were considered because of secondary data analysis with aggregated data.

Results: Using 1,896 eligible municipalities, GSR showed negative association for male as β = −0.53
(p < 0.001), −0.19 (0.126), and −0.61 (0.038) with the ordinary, spatial lag, and spatial error model, respectively.
In contrast, no significant association of GSR was observed in all models for females. All spatial models for
both male and female demonstrated statistically significant parameters of spatial dependency. The Akaike
Information Criterion were employed for model comparison. The best model was identified as the spatial
Poster Presentation Abstracts
error model for male.

Conclusion: For males, long-term sun exposure was found to be negatively associated with death
by acute myocardial infarction, using spatial regression model that adjusted for spatial dependency.
However, no association was given for female. Our findings may be beneficial for advisory of public
health nursing.

Keywords: cardiovascular disease, global solar radiation, spatial regression, sunlight, mortality,
myocardial infarction

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Correspondence: Haruka Kato, Graduate School of Medicine, Mie University, Japan
E-mail: 324M102@m.mie-u.ac.jp

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