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

项目摘要 波多黎各（PR）因自然灾害对其电网造成的破坏而面临频繁停电。 波多黎各老年人（≥50岁）在自然灾害期间是一个脆弱的群体，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相比， 在美国的团体。停电会增加这些差距，并提高发病率和死亡率，由于共同 病态研究表明，能源独立对健康有积极影响。能源 通过直接获得太阳能独立发电已经开始出现在公关通过非工作， 盈利社区组织Casa Pueblo（CP）。我们建议从多层次的角度探讨 使地方政府机构、社区和个人能够适应能源独立的因素 在他们的环境中，以及他们通过这些目标对慢性病管理的影响：目标1 -通过我们的 与CP合作，探索社区和老龄化人口（≥50岁）所经历的过程 患有慢性疾病，同时适应能量独立（例如，技术的引进， 培训其使用，获得通电的公共点），以便更好地了解公共 特性（例如，集体认同，感知的个人主义）可能会阻碍或促进CDM的人， 肾病、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、社区和结构性）的障碍和促进因素， PR中的能源独立策略。目标3 -在个人层面上记录与弹性相关的变量 (e.g.,自我效能、积极态度、知识、利他主义），社区（例如，情感联系、团体 成员资格），和结构（即，停电、地理变量）水平，以促进有效的清洁发展机制 在需要基于电的治疗的老龄人群中（即，肾脏疾病，呼吸系统疾病， 糖尿病）。为达致目标1及2，我们会进行：（a）详细的民族志观察/普查， 涉及30个月的沉浸式和持续的机构交流和（B）对 基于社区的能源独立性，通过对年龄≥50岁的个人进行45次分层深入访谈， 进入CP太阳能装置的范围：1）直接进入（n=15），间接进入（n=15）和无进入 （n=15）。此外，我们还将对从事政策、行政和管理工作的个人进行定性访谈， 或在可持续能源和灾后恢复领域工作的技术水平（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，他们有直接的， 间接和无法获得独立的能源。我们的研究将有助于政策制定， 传播社区参与和能源独立在管理慢性病中的作用 在美国和加勒比地区的老龄人口中， 灾害加剧了卫生不公平现象。

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.