Investigating Health Effects of Climate-Related Disasters in the United States

说明(申请人提供)：尽管与气候有关的自然灾害(如飓风、洪水)频发，但人们对这类灾害如何影响各种原因造成的人类死亡率和发病率知之甚少。研究确定各种原因造成的死亡率和发病率的健康风险，包括心血管和呼吸风险，将为灾害规划和应对提供信息。此外，气候变化可能会改变与气候有关的灾害的模式，因此了解与当前与气候有关的灾害相关的健康风险，以充分了解与未来气候变化相关的健康风险至关重要。然而，用目前的灾害流行病学方法很难研究灾害对全因、心血管和呼吸系统死亡率和发病率的影响。大多数灾害流行病学要么专注于快速识别与单一灾害相关的健康风险，要么将其作为 灾难应对或只调查被法医归类为“与灾难有关”的健康后果。在这笔赠款的培训阶段，安德森博士将开发统计方法，通过结合两种类型分析的当前方法和概念，调查与气候有关的灾害对所有原因、心血管和呼吸系统健康结果的影响：事件分析和环境时间序列分析(目标1)。在赠款的独立阶段，她将应用这些方法来量化飓风风暴(飓风、热带风暴和热带低气压)对全因、心血管和呼吸系统死亡率以及美国医疗保险住院的影响(目标2)。在这项分析中，她将把国家健康统计和医疗保险账单中心的每日健康数据与国家气候数据中心的风暴数据和南卡罗来纳大学的空间危险事件和损失数据库的风暴数据联系起来，对飓风对健康的影响进行多年、多社区的分析。她还将确定如何通过每次风暴造成的基础设施破坏来改变气旋风暴的健康风险(目标3)。为此，她将与一位共同导师合作，该导师对与气候相关的灾害相关的基础设施风险进行建模，并使用这些基础设施风险模型以及来自公用事业公司和州交通部的数据来量化与风暴相关的健康风险如何改变其对各种原因、心血管和呼吸系统发病率以及医疗保险住院的影响。Anderson博士非常适合进行这项研究，因为1)她过去在国家研究中投资温度和空气污染对各种原因的健康结果的影响的研究经验，2)她通过导师、共同导师和她的研究机构获得广泛的国家健康和基础设施数据，3)她获得世界级的导师、培训和统计方法和灾害风险方面的课程。拟议中的研究和培训将使安德森博士能够建立一个独立的职业生涯，成为与气候有关的自然灾害流行病学的领导者。

DESCRIPTION (provided by applicant): Despite the frequency of climate-related natural disasters (e.g., hurricanes, floods), little is known about how such disasters affect all-cause human mortality and morbidity. Research identifying health risks for all-cause mortality and morbidity, including cardiovascular and respiratory risks, would inform disaster planning and response. Furthermore, climate change is likely to change patterns of climate-related disasters, making it critical to understand health risks associated with current climate-related disasters to fully understand health risks associated with future climate change. However, research on the effects of disasters on all-cause, cardiovascular, and respiratory mortality and morbidity is difficult to conduct with current disaster epidemiology methods. Most disaster epidemiology either focuses on quickly identifying the health risks associated with a single disaster as part of disaster response or investigates only health outcomes classified by a medical examiner as "disaster-related". During the training phase of this grant, Dr. Anderson will develop statistical methods to investigate the effects of climate-related disasters on all-cause, cardiovascular and respiratory health outcomes by combining current methods and concepts from two types of analysis: episode analysis and environmental time series analysis (Aim 1). During the independent phase of the grant, she will apply these methods to quantify effects of cyclonic storms (hurricanes, tropical storms, and tropical depressions) on all- cause, cardiovascular, and respiratory mortality and Medicare hospitalizations in the United States (Aim 2). For this analysis, she will link national datasets of daily health data from the National Center for Health Statistics and Medicare billing with storm data from the National Climatic Data Center's Storm Data and the University of South Carolina's Spatial Hazard Events and Losses Database to conduct a multi-year, multi-community analysis of the health effects of cyclonic storms. She will also determine how the health risks of cyclonic storms are modified by the infrastructure damage caused by each storm (Aim 3). To do this, she will work with a co- mentor who models infrastructure risks associated with climate-related disasters, and use both these models of infrastructure risk and data from utility companies and state departments of transportation to quantify how the health risk associated with a storm modifies its effects on all-cause, cardiovascular, and respiratory morbidity and Medicare hospitalizations. Dr. Anderson is well suited to perform this research based on 1) her past research experience investing the effects of temperature and air pollution on all-cause health outcomes in national studies, 2) her access, through mentors, co-mentors, and her research institution, to extensive national health and infrastructure data; and 3) her access to world-class mentorship, training, and coursework in statistical methods and disaster risks. The proposed research and training will allow Dr. Anderson to establish an independent career as a leader in the epidemiology of climate-related natural disasters.