Impact of COVID-19 related stay-at-home orders on traffic, traffic-related air pollution, and cardiovascular health in New York City

项目摘要/摘要 据估计，全球每年有420万人死于空气污染。在纽约市(NYC) 与交通相关的空气污染(TRAP)每年造成约320人死亡和870人住院， 与中风和心肌梗死(MI)的风险增加有关；此外，较低的社会经济 身份(SES)群体面临更高的负担。应对冠状病毒病(COVID-)的居家订单 流行病可以被认为是一种交通干预政策；它已经影响了交通拥堵和交通堵塞 达到了前所未有的水平。然而，这种变化并没有在纽约市以精细的时空分辨率进行评估， 挑战其对中风和心肌梗死影响的流行病学研究，包括SES和慢性病的变异 疾病负担(CDB；即高血压、糖尿病、肥胖症患者的比例)。在大流行期间， 中风和心肌梗塞的急诊科就诊人数大幅减少，这可能是由TRAP引发的， 被观察到了。虽然这一下降可能在一定程度上是由于寻求护理的减少，考虑到已知的关联 在TRAP和卒中/MI之间，TRAP的大幅下降可能是这种下降的原因。然而，这已经 还没有在纽约市接受调查。此外，考虑到车队组成可能在 流行病(例如，按比例增加的送货卡车)、拥堵、陷阱和 大流行期间的中风/心肌梗死尚不清楚。为了弥补这些差距，本提案将：(1)评估影响 与新冠肺炎疫情有关的(A)交通拥堵和(B)纽约市陷阱的在家服务订单；以及 通过SES和CDB指数评估拥堵的变化；(2)估计与陷阱相关的急性数量 预计在大流行期间通过改变陷阱可预防的中风和心肌梗死住院治疗，与总数相比 观察卒中/心肌梗死住院情况的变化，并评估SES和CDB的变异性；以及(3)(探索性) 调查大流行期间充血、陷阱、中风和心肌梗塞住院之间的关系。 培训计划的主要目标是为申请者提供以下技能、专业知识和经验 在环境流行病学领域进行严格的公共卫生研究，重点是空气污染 和健康差距研究。培训计划包括正式的教学培训、应用研究 经验、专业发展和口头陈述机会。它将重点开展以下培训 优先事项：(1)因果推断；(2)环境健康差异；(3)#年空气污染暴露评估 大型健康研究；(4)科学口头交流战略；(5)先进生物统计学方法 用于环境健康科学；以及(6)赠款撰写、设计和管理方面的培训。环境问题 哥伦比亚大学梅尔曼公共卫生学院是拟议项目的理想选择，因为该学院 致力于培养学生，提供环境健康科学方面的杰出专业知识和资源 和环境流行病学，以及无与伦比的指导团队为这项提议聚集在一起。

PROJECT SUMMARY/ABSTRACT Globally, air pollution is responsible for an estimated 4.2 million deaths per year. In New York City (NYC), traffic-related air pollution (TRAP) contributes to an estimated 320 deaths and 870 hospitalizations per year and is associated with increased risk of stroke and myocardial infarction (MI); additionally, lower socioeconomic status (SES) groups face a higher burden. Stay-at-home orders in response to the coronavirus disease (COVID- 19) pandemic can be thought of as a traffic intervention policy; it has impacted traffic congestion and TRAP at an unprecedented level. However, this change has not been assessed at fine spatio-temporal resolution in NYC, challenging the epidemiologic study of its impact on stroke and MI, including variation by SES and chronic disease burden (CDB; i.e., proportion of people with hypertension, diabetes, obesity). During the pandemic, substantial decreases in emergency department visits for stroke and MI, which can be triggered by TRAP, have been observed. While this decrease is likely driven in part by reduced care seeking, given known associations between TRAP and stroke/MI, the large decreases in TRAP likely contributed to this decline. However, this has not yet been investigated in NYC. Additionally, given that the vehicle fleet composition has likely shifted during the pandemic (e.g., proportionally more delivery trucks), the relationship between congestion, TRAP, and stroke/MI during the pandemic is not known. To address these gaps, this proposal will: (1) evaluate the impact of stay-at-home orders related to the COVID-19 pandemic on (A) traffic congestion and (B) TRAP in NYC; and assess variation in congestion by indices of SES and CDB; (2) estimate the number of acute TRAP-associated stroke and MI hospitalizations expected to be prevented by altered TRAP during the pandemic, compare to total observed changes in stroke/MI hospitalizations, and assess variability by SES and CDB; and (3) (exploratory) investigate the associations between congestion, TRAP, stroke, and MI hospitalizations during the pandemic. The main goal of the training plan is to provide the applicant with the skills, expertise, and experience to conduct rigorous public health research in the field of environmental epidemiology, with a focus in air pollution and health disparities research. The training plan includes a mix of formal didactic training, applied research experience, professional development, and oral presentation opportunities. It will focus on the following training priorities: (1) causal inference; (2) environmental health disparities; (3) air pollution exposure assessment for large-scale health studies; (4) strategies for oral communication of science; (5) advanced biostatistical methods for environmental health sciences; and (6) training in grant writing, design, and management. The environment of Columbia University Mailman School of Public Health is ideal for the proposed project, given the school's commitment to training students, exceptional expertise and resources available in environmental health sciences and environmental epidemiology, and the unparalleled mentorship team assembled for this proposal.