Disasters, solar energy, and chronic disease management in aging Puerto Ricans

项目概要 波多黎各（PR）由于自然灾害对其电网造成破坏，经常面临停电。 波多黎各老年人（≥50 岁）是自然灾害期间的弱势群体，因为他们更有可能 与其他非西班牙裔白人和其他西班牙裔人相比，患有多种慢性健康问题 美国的团体。停电会增加这些差异，并由于共同原因而提高发病率和死亡率。 病态的条件。研究表明，能源独立对健康有积极影响。能源 通过直接获得太阳能的独立性已经开始出现在公关中，通过非政府组织的工作 利润社区组织 Casa Pueblo (CP)。我们建议从多层次的角度探讨 使地方政府机构、社区和个人适应能源独立的因素 其环境，以及通过以下目标对慢性病管理的影响： 目标 1 – 通过我们的 与CP合作，探索社区和人口老龄化（≥50岁）经历的过程 患有慢性疾病，同时适应能源独立（例如，引进技术， 有关其使用、获取通电公共点的培训），以便更好地了解公共 特征（例如，集体认同、感知的个人主义）可能会阻碍或促进具有以下特征的人的清洁发展机制 肾脏疾病、呼吸系统疾病和糖尿病。目标 2 – 从多层次系统地记录 视角（即个人、社区和结构）采用的感知障碍和促进因素 公关中的能源独立策略。目标 3 – 记录个人层面的复原力相关变量 （例如，自我效能、积极态度、知识、利他主义）、社区（例如，情感联系、群体 成员资格）和结构（即停电、地理变量）水平，可以促进有效的清洁发展机制 需要电力治疗的老年人群（即肾脏疾病、呼吸系统疾病、 糖尿病）。为了实现目标 1 和 2，我们将进行： (a) 对 CP 进行详细的人种学观察/绘图， 涉及 30 个月的沉浸式持续机构交流以及 (b) 对 通过对 50 岁以上的个人进行 45 次分层深度访谈，实现基于社区的能源独立 CP 太阳能装置的访问范围： 1) 直接访问 (n=15)、间接访问 (n=15) 和无访问 (n=15)。此外，我们还将对参与政策、行政管理的个人进行定性访谈。 或可持续能源和灾难恢复领域的技术水平（n=15）。为了实现目标 3、我们将对 Adjuntas 镇的 345 名老年人进行调查，他们有直接、 间接且无法获得独立能源。我们的研究将有助于政策制定和 宣传社区参与和能源独立在管理慢性病方面的作用 美国和加勒比海地区老龄化人口中易患的疾病 灾害加剧了健康不平等。

Project Summary Puerto Rico (PR) faces frequent power outages due to damage caused by natural disasters to its electric grid. Aging Puerto Ricans (≥50 years) are a vulnerable population during natural disasters as they are more likely to have multiple chronic health conditions when compared to other non-Hispanic whites and other Hispanic groups in the US. Power outages can increase these disparities, and elevate morbidity and mortality due to co- morbid conditions. Research has demonstrated that energy independence has positive health impacts. Energy independence through direct access to solar power has begun to appear in PR through the work of the non- profit community organization Casa Pueblo (CP). We propose to explore, from a multilevel perspective, the factors that enable local government agencies, communities and individuals to adapt to energy independence in their settings, and their implications for chronic disease management via these aims: Aim 1 – Through our partnership with CP, explore the process experienced by communities and the aging population (≥50 years) living with chronic diseases while adapting to energy independence (e.g., introduction of the technology, training on its use, access to energized communal points) in order to better understand how communal characteristics (e.g., collective identity, perceived individualism) can hinder or foster CDM among those with renal disease, respiratory disease, and diabetes. Aim 2 – Systematically document from a multilevel perspective (i.e., individual, community and structural) the perceived barriers and facilitators for adopting energy independence strategies in PR. Aim 3 – Document resilience related variables at the individual level (e.g., self-efficacy, positive attitudes, knowledge, altruism), communal (e.g., emotional connection, group membership), and structural (i.e., power outages, geographical variables) levels that can foster effective CDM among aging populations in need of electricity-based treatments (i.e., renal disease, respiratory diseases, diabetes). To achieve Aim 1 and 2, we will conduct: (a) a detailed ethnographic observation/mapping of CP, involving 30 months of immersive and ongoing institutional exchange and (b) a multilevel analysis of the community-based energy independence through 45 tiered in-depth interviews with individuals ≥50 years with a range of access to CP’s solar installations: 1) direct access (n=15), indirect access (n=15) and no access (n=15). In addition, we will conduct qualitative interviews with individuals engaged at the policy-, administrative- or technical-levels working within the field of sustainable energy and disaster recovery (n=15). To achieve Aim 3, we will administer a survey to a sample of 345 aging persons in the town of Adjuntas who have direct, indirect and no access to independent energy sources. Our research will contribute to policy development and dissemination regarding the role of community engagement and energy independence in managing chronic diseases among aging populations in areas of the United States and the Caribbean that are vulnerable to health inequities magnified by disasters.