Climate Change, Heat Exposure and Acute Morbidity in a Native American Population

描述（由申请人提供）：气候变化和气候变异性将成为21世纪世纪最重要的环境和公共卫生挑战。然而，关于特定人群将如何应对气候压力因素，在信息和理解方面仍然存在巨大差距。这项研究的首要目标是建立热浪和慢性疾病的结果之间的联系和动态，在中南部俄克拉荷马州的奇克索人。具体目标是：（一）重建从1949年至今影响奇克索国家管辖区的热浪模式，并调查热浪频率和严重程度的时间趋势;（二）分析热浪活动期间奇克索社区内特定原因急性发病率和死亡率的时空分布;及（iii）根据慢性病患病率、人口属性及社区环境特征，描述及绘制与高温有关的发病率及死亡率的风险。这项研究的结果将促进我们对未来气候如何影响慢性病的理解，特别是在弱势群体中，并为研究区域以外的适应规划和公共卫生工作提供信息。该项目利用了独特的气候和健康数据库，以及研究人群研究自身健康差异的强烈愿望。该研究将使用统计方法重建热浪的气候学，开发社区暴露概况，并使用地理信息系统和地理空间分析方法将这些与人口，医疗和社会文化信息联系起来。疾病特定结果的分布将与社区热暴露进行统计和经验比较，以了解疾病如何与社会特征和热浪发生率相关。主要预期成果包括：（a）更好地了解热浪如何影响慢性病的分布和进展;（B）高危亚人群的特征;（c）未来气候变化如何影响弱势人群的预测模型。这项研究的方法、见解和结果将为世界其他地区具有类似可比特征的气候和健康研究提供有用的参考来源。

DESCRIPTION (provided by applicant): Climate change and climate variability will rank among the most important environmental and public health challenges of the 21st century. Yet, there remains significant gap in information and understanding regarding how specific populations will respond to climatic stressors. The overarching goal of this study is to establish the linkages and dynamics between heat waves and chronic diseases outcomes, among the Chickasaw people in south central Oklahoma. Specific aims are to (i) reconstruct heat wave patterns affecting the Chickasaw Nation jurisdictional area from 1949 to the present and investigate temporal trends in the frequency and severity of heat waves; (ii) analyze the spatial and temporal distribution of cause-specific acute morbidity and mortality within Chickasaw communities during periods of heat wave activity; and (iii) to characterize and map the risk for heat-related morbidity and mortality according to chronic disease prevalence, population attributes, and community environmental characteristics. The findings of this study will advance our understanding of how future climate might impact chronic diseases especially among vulnerable groups, as well as inform adaptation planning and public health efforts beyond the study area. The project takes advantage of access to unique climate and health databases and a strong desire on the part of the study population to research their own health disparity. The study will reconstruct the climatology of heat waves using statistical methods, develop community exposure profiles, and link these with demographic, medical, and social-cultural information using GIS and geospatial analytical methods. The distribution of disease specific outcomes will be statistically and empirically compared with the community heat exposures to learn how disease may be related to both social characteristics and incidences of heat waves. The major expected outcomes include (a) improved understanding of how heat waves impact the distribution and progression of chronic diseases, (b) the characteristics of at- risk sub populations, and (c) predictive model of how future climate change could impact vulnerable populations. The methodology, insights, and results of this study will constitute a useful reference source for other studies on climate and health in other parts of the world with similar comparable characteristics.