Reducing Social Disparities of Heatwave Impacts in a Changing Climate

描述(由申请人提供)： 项目描述。摘要：气候变化预计将增加热浪的频率和强度，而高温已经是美国与天气有关的死亡的主要原因之一。高温对某些人群的影响不成比例，包括非裔美国人、拉丁裔、城市居民、糖尿病患者、老年人和穷人。热浪对健康方面的社会差异的贡献是转化性研究的一个重要目标，因为存在若干预防干预措施。热浪健康预警系统(HHWS)、通过植树和其他措施缓解热岛以及地方政府管理的其他项目都是基于证据的干预措施，旨在提高生活质量、促进环境可持续发展，并在热浪期间保护公众健康。随着越来越多的证据表明气候变化加速，需要更广泛地实施这些计划。该项目旨在提供关于如何将卫生保健服务和其他循证干预措施转化为其他环境，以更好地保护公众健康和减少社会差距，从而促进更广泛和有效地采用这些干预措施的见解。一个拥有流行病学、社会学、健康教育、统计学、气象学、应用公共卫生以及地方行动和治理专业知识的多学科团队将在美国四个城市(密歇根州底特律、纽约州纽约、宾夕法尼亚州费城和亚利桑那州凤凰城)进行一项混合方法研究。这些城市在实施HHWS和气候变化适应计划方面处于不同的阶段，包括不同的人口，他们在高温暴露和与高温相关的健康影响方面存在种族/民族和社会经济差异。将使用定性方法，与四个城市的主要利益攸关方进行半结构化访谈：潜在目标人口(城市居民，主要是年龄较大的和具有不同种族/民族背景的)和这些干预措施的实施者(代表公共卫生、天气、社会和环境服务的政府官员等)。面谈将评估阻碍或促进循证干预措施翻译的因素。使用定量方法，该小组将使用最先进的流行病学和气象学方法来评估HHWS干预的触发因素，调查如何使当前干预措施的翻译对用户群体更有效和更容易理解，并传达对人口亚群的具体影响。这项努力将解决公共卫生官员和媒体对HHWS系统的可用性、可靠性和易解性的问题。我们将分析这四个城市的历史数据(-2000年)，比较逐日天气参数(温度、热量指数和气团类型)以及它们与考虑空气污染的人口组每日超额死亡率之间的差异程度。通过社区行动计划，来自结果评估的建议将与来自美国一系列社区和公众的相关当局分享，因此这些研究结果将转化为实践，以帮助实现消除健康方面的社会差异的目标。 公共卫生相关性： 相关性：热暴露会导致疾病和死亡，由于全球气候变化，热浪的频率正在增加。这项研究将探讨如何更好地将旨在减少热浪对健康影响的社会差异的循证干预措施(例如，热浪健康警报系统、植树和对建筑环境的修改)转化为其他环境。其目标是鼓励广泛采用有效的当地计划，以在热浪期间预防疾病和拯救生命。

DESCRIPTION (provided by applicant): Project Description. Abstract: Climate change is projected to increase the frequency and intensity of heatwaves, and heat is already one of the principal weather-related causes of mortality in the U.S. Heat affects certain populations disproportionately, including African Americans, Latinos, city-dwellers, diabetics, the elderly and the poor. The contribution of heatwaves to social disparities in health is an important target for translational research since several preventive interventions exist. Heatwave health warning systems (HHWS), heat island mitigation through tree planting and other measures, and other programs administered by local governments are evidence-based interventions that improve quality of life, foster environmental sustainability, and protect public health during heatwaves. With increasing evidence for accelerated climate change, wider implementation of these programs is needed. This project aims to provide insights into how HHWS and other evidence- based interventions can be translated to other settings to better protect public health and reduce social disparities, thus fostering their more widespread and effective adoption. A multi-disciplinary team, with expertise in epidemiology, sociology, health education, statistics, meteorology, applied public health, and local action and governance, will conduct a mixed-method study in four U.S. cities (Detroit, MI; New York, NY; Philadelphia, PA; and Phoenix, AZ). These cities are at varying stages in implementing HHWS and climate change adaptation programs and include diverse populations with documented racial/ethnic and socio-economic disparities in heat exposure and heat-related health effects. Using qualitative methodology, semi-structured interviews will be undertaken with main stakeholders in the four cities: potential target populations (city residents, predominantly older and of diverse racial/ethnic backgrounds) and implementers of these interventions (government officials representing public health, weather, social and environmental services, among others). The interviews will assess the factors that inhibit or facilitate the translation of the evidence-based interventions. Using quantitative methods, the team will use state-of-the-art epidemiology and meteorology methods to evaluate the triggers of HHWS interventions, investigating ways to make translation of current interventions more effective and easier to understand for the user groups, and communicating specific impacts on population subgroups. This effort will address the availability, reliability and ease of interpretation of HHWS systems by public health officials and the media. We will analyze historical data (1989-2000) in the four cities, comparing daily weather parameters (temperature and heat indices and air mass types) and the degree to which they differ in their associations with excess daily mortality by population group, accounting for air pollution. Through the community action plan, recommendations from the evaluation of results will be shared with relevant authorities from a range of U.S. communities and the public so these research findings will be translated into practice to help achieve the goal of eliminating social disparities in health. PUBLIC HEALTH RELEVANCE: Relevance: Heat exposure can cause illness and death, and heatwaves are increasing in frequency because of global climate change. This research will explore how to better translate evidence-based interventions intended to reduce social disparities in the health impacts of heatwaves (e.g. heatwave health warning systems, tree planting and modifications to the built environment) to other settings. The goal is to encourage the widespread adoption of effective local programs to prevent illness and save lives during heatwaves.