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

描述(申请人提供)：气候变化和气候变化将是21世纪最重要的环境和公共卫生挑战之一。然而，关于特定人群将如何应对气候应激源，在信息和理解方面仍存在重大差距。这项研究的首要目标是在俄克拉荷马州中南部的奇卡索人中建立热浪和慢性病后果之间的联系和动态。具体目标是：(I)重建从1949年到现在影响Chickasaw国家辖区的热浪模式，并调查热浪频率和严重程度的时间趋势；(Ii)分析热浪活动期间Chickasaw社区内特定原因的急性发病率和死亡率的时空分布；以及(Iii)根据慢性病患病率、人口属性和社区环境特征，描述和绘制与热有关的发病率和死亡率的风险。这项研究的结果将增进我们对未来气候可能如何影响慢性疾病，特别是对弱势群体的影响的理解，并为研究领域以外的适应规划和公共卫生努力提供信息。该项目利用了获得独特的气候和健康数据库的优势，以及研究人群研究自己健康差距的强烈愿望。这项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从统计和经验上与社区的热暴露进行比较，以了解疾病可能如何与社会特征和热浪事件有关。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与健康的其他研究提供有用的参考资料。

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.