Chronic effects of weather fluctuations: population susceptibility and adaptation

天气波动的慢性影响：人群的易感性和适应

• 批准号: 8695767
• 负责人: Antonella Zanobetti
• 金额: $ 24.28万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-19 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8695767
• 关键词: Acute; Affect; Age; Air Conditioning; Area; Atrial Fibrillation; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Characteristics; Chronic; Chronic Disease; Cities; Climate; Code; Congestive Heart Failure; Data; Data Analyses; Disease; Elderly; Enrollment; Environmental Risk Factor; Exposure to; Future; General Population; Health; Heat Waves; Heating; High temperature of physical object; Hospitalization; Humidity; Individual; Intervention; Investigation; Knowledge; Lead; Life Expectancy; Link; Location; Measures; Medicare; Methods; Modeling; Modification; Monitor; Myocardial Infarction; Neurologic; Paper; Persons; Population; Population Characteristics; Poverty; Predisposition; Prevalence; Race; Reporting; Research; Risk; Risk Estimate; Socioeconomic Status; Statistical Methods; Stroke; Structure; Subgroup; Survival Analysis; Technology; Temperature; Testing; Time; United States National Institutes of Health; Variant; Weather; aged; atmospheric chemistry; climate change; cost effective; follow-up; innovation; land use; metropolitan; mortality; nervous system disorder; novel; planetary Atmosphere; pressure; public health relevance; residence; respiratory; sex; socioeconomics; trend; water vapor

DESCRIPTION (provided by applicant): Short-term exposures to higher temperature and heat waves have been associated with adverse acute cardiovascular and respiratory mortality, but less is known about the chronic effects of weather. We propose to evaluate the chronic adverse health risks associated with long-term exposure to fluctuations in the weather parameters in persons aged over 64 years on a national scale, focusing on mortality in all Medicare enrollees, and in subjects with specific cardiovascular and neurological conditions. We will identify how the health risks changed over the years, and use this information to make predictions of how the risks will change under different climate scenarios. In a recent paper we showed that long-term exposure to high day-to-day variability in summer temperatures (defined as the standard deviation of daily levels of summer temperature) might elevate the risk of mortality in different subgroups of susceptible populations of elderly1. In this project we will partner with the Atmospheric Chemistry Modeling Group at Harvard: (1) to estimate the chronic effects associated with long-term exposure to higher day-to-day variability in temperature and in water vapor pressure (WVP) within summer months (June-August) on mortality in all Medicare enrollees; (2) to examine the chronic effects on mortality in subject with specific conditions such as cardiovascular and neurological disease; (3) to identify characteristics of city (e.g. socio-economic status, percent of green space climate zone, population in poverty, percent of population by race, air conditioning prevalence) which modify the risk of dying. Specifically, we will identify whether changes in weather related risk over time and space are associated to changes in urban structure, air conditioning prevalence, and socioeconomic status both within city and across cities, and whether differences in sensitivity to weather variability across locations are related to green space and population characteristics. Importantly, these city level characteristics will be defined on the zip-code level, not the city level, allowing us to capture te impact of true local land use. (4) Finally, we will predict how life expectancy will change with increasing variability of summertime temperatures in a future atmosphere. An innovative aspect of our investigation is that we will focus on less explored weather parameters such as variability in temperature and variability in WVP. We will analyze the data using novel statistical methods (survival models with time-varying factors and meta-regression models). The findings of this national analysis will advance statistical analyses of climate change data and knowledge of the impacts of temperature and humidity variability on life expectancy. By producing results that can be extrapolated to the future, by identifying the covariates that explain the differences in temperature related mortality over time and across cities, we will identify key factors important for adaptation and mitigation strategies. Results of our study will aid NIH by identifying specific cardiovascular disease that might exacerbate risk, which will lead to targeted and cost effective interventions.

描述（由申请人提供）：短期暴露于较高的温度和热浪与不良急性心血管和呼吸道死亡率有关，但对天气的慢性影响知之甚少。我们建议评估与长期暴露于64岁以上国家规模的人的天气参数相关的慢性不良健康风险，重点是所有医疗保险参与者的死亡率，以及患有特定心血管和神经系统状况的受试者。我们将确定多年来健康风险的变化，并使用此信息来预测在不同气候情况下风险将如何变化的预测。在最近的一篇论文中，我们表明，长期暴露于夏季温度（定义为夏季温度水平的标准偏差）的日常变异性可能会提高不同易感的老年人群体的死亡风险。在该项目中，我们将与哈佛大学的大气化学建模组合作：（1）估计与长期暴露于夏季（6月至8月）在所有Medicare招收的死亡率内的长期暴露于较高的日常变化以及水蒸气压力（WVP）的较高差异相关的； （2）检查特定条件的受试者对死亡率的慢性影响 作为心血管和神经系统疾病； （3）确定城市的特征（例如社会经济地位，绿色空间气候区的百分比，贫困人口，人口百分比，种族，空调的普遍存在），以改变死亡的风险。具体而言，我们将确定随着时间和空间与天气相关的风险的变化是否与城市结构，空调的流行率以及城市内部和城市内的社会经济地位的变化有关，以及各个地方对天气变异性的敏感性差异是否与绿色空间和人口特征有关。重要的是，这些城市级别的特征将在邮政编码层面而不是城市级别定义，从而使我们能够捕获真正的当地土地使用的影响。 （4）最后，我们将预测预期寿命如何随着未来气氛中夏季温度的变化而变化。我们调查的一个创新方面是，我们将专注于较少探索的天气参数，例如温度变化和WVP变异性。我们将使用新颖的统计方法（具有时变因子和元回归模型的生存模型）分析数据。该国家分析的发现将提高气候变化数据的统计分析，并了解温度和湿度变异性对预期寿命的影响的知识。通过确定可以解释随时间和整个城市中温度相关的死亡率差异的协变量，我们将确定对适应和缓解策略重要的关键因素来解释与温度相关的死亡率的差异，从而将其推断到未来。我们的研究结果将通过识别特定来帮助NIH 心血管疾病可能会加剧风险，这将导致针对性且具有成本效益的干预措施。