Chronic Diseases and Associated Risk Factors Among Adults in Puerto Rico After Hurricane Maria.
Chronic Diseases and Associated Risk Factors Among Adults in Puerto Rico After Hurricane Maria.
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DOI：
10.1001/jamanetworkopen.2021.39986
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发表时间：
2022-01-04
影响因子：
13.8
通讯作者：
Rodríguez-Orengo JF
中科院分区：
文献类型：
--
作者：
Mattei J;Tamez M;O'Neill J;Haneuse S;Mendoza S;Orozco J;Lopez-Cepero A;Ríos-Bedoya CF;Falcón LM;Tucker KL;Rodríguez-Orengo JF
飓风玛丽亚前后生活在波多黎各的成年人的慢性病患病率及其相关危险因素是多少？这项横断面研究使用了 2015 年和 2019 年进行的 2 项研究中 825 名参与者的数据，发现飓风玛丽亚之后，波多黎各成年人中不健康生活方式行为和多种慢性病的患病率在统计上显着升高。飓风过后，人们观察到社会支持更高、抑郁症状更低、感知压力更低。这些发现表明，随着突发公共卫生事件的激增，需要不断努力来维持健康的行为、积极的情绪健康和较低的慢性病发病率。这项横断面研究评估了飓风玛丽亚前后生活在波多黎各的成年人的慢性病患病率及其相关危险因素。随着突发公共卫生事件变得越来越普遍，识别自然灾害可能引发的不利身心健康状况至关重要。缺乏关于 2017 年玛丽亚飓风是否影响波多黎各成年人疾病负担的数据。旨在估计 2017 年玛丽亚飓风前后生活在波多黎各的成年人中慢性病及其相关危险因素的患病率。这项横断面研究使用了之前两项横断面研究的数据，包括 2015 年进行的飓风玛丽亚波多黎各饮食、生活方式和疾病评估 (PRADLAD) 研究，以及飓风玛丽亚波多黎各心理社会、环境和疾病观察研究慢性病趋势 (PROSPECT)，于 2019 年进行。参与者包括居住在波多黎各的 30 至 75 岁成年人。对 2020 年 4 月至 10 月的数据进行了分析。使用经过验证的问卷获得了有关社会人口统计学、生活方式、心理社会因素以及医学诊断状况的自我报告数据。人体测量学一式三份进行测量。两项研究均使用相似的方案获得数据。对所有研究参与者和返回 PROSPECT 的 87 名 PRADLAD 参与者的特征进行了对比。两个队列共纳入 825 名参与者，其中 380 名 PRADLAD 参与者和 532 名 PROSPECT 参与者。在 2019 年的 PROSPECT 研究中，平均 (SD) 年龄为 53.7 (10.8) 岁，363 名参与者 (68.2%) 出生时被指定为女性，169 名参与者 (31.8%) 出生时被指定为男性。在 2019 年的队列中，360 名参与者（67.7%）拥有大学或更高学历，205 名参与者（38.5%）报告年收入超过 20001 美元，263 名参与者（49.5%）有工作。研究之间的大多数社会人口统计学变量相似，但飓风后收入和就业率有所提高。在主要分析中，与2015年的参与者相比，2019年的参与者有更高的腹部肥胖（389名参与者[73.2%] vs 233名参与者[61.3%]）、久坐（236名参与者[44.4%] vs 136名参与者[35.8%]）、酗酒（95名参与者[17.9%] vs 46名参与者[12.1%]）和社会支持（平均 [SD] 分数，26.9 [7.2] vs 24.7 [7.1]），但抑郁症状较低（169 名参与者 [31.7%] vs 200 名参与者 [52.6%]）和感知压力（平均 [SD] 分数，19.3 [9.5] vs 21.7 [7.7]）。与2015年相比，2019年高血压（252名参与者[47.3%] vs 149名参与者[39.2%]）、关节炎（172名参与者[32.3%] vs 97名参与者[25.6%]）、高胆固醇（194名参与者[36.4%] vs 90名参与者[23.8%]）、高甘油三酯（123名参与者）的比例较高[23.1%] vs 56名参与者[14.7%]）、眼病（94名参与者[17.6%] vs 48名参与者[12.7%]）、脂肪肝疾病（68名参与者[12.8%] vs 29名参与者[7.5%]）和骨质疏松症（74名参与者[13.9%] vs 20名参与者[5.2%]）。对 87 名返回参与者的二次分析显示了类似的结果。在这项横断面研究中，飓风玛丽亚过后，波多黎各成年人中不健康行为和慢性病的患病率较高，需要进行长期研究。心理社会因素虽有所好转，但仍需关注。随着自然灾害的加剧，工作重点应集中于持续监测健康结果，促进健康行为、积极情绪健康和疾病控制，特别是在健康状况不佳风险较高的人群中。
What was the prevalence of chronic diseases and their associated risk factors among adults living in Puerto Rico before and after Hurricane Maria? This cross-sectional study using data from 825 participants in 2 studies conducted in 2015 and 2019 found statistically significantly higher prevalence of unhealthy lifestyle behaviors and multiple chronic conditions among adults in Puerto Rico after Hurricane Maria. Higher social support, lower depressive symptoms, and lower perceived stress were observed after the hurricane. These findings suggest that as public health emergencies upsurge, continuous efforts will be necessary to sustain healthy behaviors, positive emotional health, and low rates of chronic diseases. This cross-sectional study assesses the prevalence of chronic diseases and their associated risk factors among adults living in Puerto Rico before vs after Hurricane Maria. As public health emergencies become more prevalent, it is crucial to identify adverse physical and mental health conditions that may be triggered by natural disasters. There is a lack of data on whether Hurricane Maria in 2017 influenced the disease burden of adults in Puerto Rico. To estimate the prevalence of chronic diseases and their associated risk factors among adults living in Puerto Rico before and after Hurricane Maria in 2017. This cross-sectional study used data from 2 previous cross-sectional studies, including the pre–Hurricane Maria Puerto Rico Assessment on Diet, Lifestyles and Disease (PRADLAD) study, conducted in 2015, and the post–Hurricane Maria Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT), conducted in 2019. Participants included adults aged 30 to 75 years residing in Puerto Rico. Data were analyzed from April to October 2020. Self-reported data were obtained on sociodemographic, lifestyle, and psychosocial factors and medically diagnosed conditions using validated questionnaires. Anthropometrics were measured in triplicate. Data were obtained using similar protocols in both studies. Characteristics were contrasted for all participants across studies and for 87 PRADLAD participants who returned to PROSPECT. A total of 825 participants from both cohorts were included, with 380 PRADLAD participants and 532 PROSPECT participants. In the 2019 PROSPECT study, the mean (SD) age was 53.7 (10.8) years, and 363 participants (68.2%) were assigned female at birth and 169 participants (31.8%) were assigned male at birth. In the 2019 cohort, 360 participants (67.7%) had college education or higher, 205 participants (38.5%) reported annual income greater than $20 001, and 263 participants (49.5%) were employed. Most sociodemographic variables were similar between studies, except for higher income and employment after the hurricane. In the main analysis, participants in 2019, compared with participants in 2015, had higher abdominal obesity (389 participants [73.2%] vs 233 participants [61.3%]), sedentarism (236 participants [44.4%] vs 136 participants [35.8%]), binge drinking (95 participants [17.9%] vs 46 participants [12.1%]), and social support (mean [SD] score, 26.9 [7.2] vs 24.7 [7.1]) but lower depressive symptoms (169 participants [31.7%] vs 200 participants [52.6%]) and perceived stress (mean [SD] score, 19.3 [9.5] vs 21.7 [7.7]). In 2019, compared with 2015, there were higher rates of hypertension (252 participants [47.3%] vs 149 participants [39.2%]), arthritis (172 participants [32.3%] vs 97 participants [25.6%]), high cholesterol (194 participants [36.4%] vs 90 participants [23.8%]), high triglycerides (123 participants [23.1%] vs 56 participants [14.7%]), eye disease (94 participants [17.6%] vs 48 participants [12.7%]), fatty liver disease (68 participants [12.8%] vs 29 participants [7.5%]), and osteoporosis (74 participants [13.9%] vs 20 participants [5.2%]). Secondary analysis for the 87 returning participants showed similar results. In this cross-sectional study, a higher prevalence of unhealthy behaviors and chronic conditions was noted among adults in Puerto Rico after Hurricane Maria, warranting long-term studies. Psychosocial factors were better, but still need attention. As natural disasters intensify, efforts should focus on continuous surveillance of health outcomes and promoting healthy behaviors, positive emotional health, and disease control, particularly in populations with higher risk for poor health.
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作者：
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DOI：
10.1073/pnas.1907826116
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2019-10-22
影响因子：
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