Causal Mechanisms for Sustainable Adaptation to Adverse Heat and Precipitation Health Effects

项目摘要/摘要 在全球范围内，极端高温和极端降水事件对人类健康有很大影响。适应 根据国家气候评估的结果，气候变化是国家优先考虑的重要气候- 最弱势群体中与变化相关的健康负担。这个坚持不懈且不断增长的公众 由于以下原因，健康问题尤其令人担忧：气温上升和酷热 极端降水事件与气候变化；美国老年人数量的增加。 人口；以及不断增加的城市化。适应和干预策略必须由High 高质量的科学。然而，到目前为止，这一领域的研究受到缺乏精细空间分辨率数据的限制。 影响气候变化脆弱性的各种因素，包括：从疾病到健康后果 死亡；患者特征；温度和降水暴露；以及环境和住房 信息。此外，受影响社区的经验和研究产品的可用性， 包括脆弱性地图，并不总是纳入研究过程，研究也不总是 适当地转化为减少高温的不利影响的行动，特别是对弱势群体。 该项目将通过分析具有精细解析信息的新数据集来填补知识空白 了解社区知识和政策需求。格隆伦德博士将确定既有的健康状况 条件、住房特征和空气污染增加了人们对极端高温死亡的脆弱性， 住院和急诊室就诊，使用了美国6个城市的数据。她将把死亡记录和 将每个城市的医疗保险记录到每日体温暴露的精细模型并公开提供 住房数据。数据和统计方法将使她能够研究这些潜在的漏洞特征 个人和社区的水平。她将解释死亡与死亡之间相互竞争的影响 和发病率事件，并研究热健康影响的社会经济差异是如何调节的，或者 由更直接的机制解释，如住房质量和先前存在的健康状况。基于 根据这些信息，她将为六个城市的每个社区生成高温风险得分，并绘制这些风险地图。 她还将确定住房年限作为管道质量的代表，如何改变 沉淀和胃肠道住院以及急诊室就诊。在密歇根州底特律，她还将与 在研究过程的每一步，以参与性、男女同校的方式与社区合作，这将 确保她的具体研究问题既包含知识，又解决相关需求 参与气候适应规划的当地社区成员和官员。格隆伦德博士有背景 在关于高温对健康影响的流行病学研究中。在获奖的头两年，她将获得 关于空间统计、气候科学和基于社区的参与性研究方法的额外培训 来自高素质的导师。这项研究的结果将帮助城市适应不断变化的气候和 通过向卫生保健提供者和普通公众提供关于哪些健康状况的指导 住房特征增加了对高温的敏感性，并通过告知可持续的气候变化 适应努力。

PROJECT SUMMARY/ABSTRACT Globally, extreme-heat and extreme-precipitation events have a large impact on human health. Adaptation to climate change is a national priority in light of the National Climate Assessment’s findings of significant climate- change-related health burdens among the most disadvantaged populations. This persistent and growing public health problem is especially concerning given the following: increasing temperatures and extreme-heat and extreme-precipitation events with climate change; increasing numbers of elderly individuals in the U.S. population; and increasing urbanization. Adaptation and intervention strategies must be informed by high quality science. However, research in this area to date is limited by a lack of fine spatial resolution data on the full range of factors that play into climate change vulnerability, including: health outcomes ranging from illness to death; patient characteristics; temperature and precipitation exposures; and environmental and housing information. Additionally, the experiences of affected communities and the usability of research products, including vulnerability maps, are not always integrated into the research process, nor is research always adequately translated into actions to reduce adverse effects of heat, particularly for vulnerable populations. This project will fill knowledge gaps through analysis of a novel dataset with finely resolved information informed by community knowledge and policy needs. Dr. Gronlund will identify how pre-existing health conditions, housing characteristics and air pollution increase vulnerability to extreme heat mortality, hospitalization and emergency room visits, using data from 6 U.S. cities. She will link mortality records and Medicare records in each city to a fine-scale model of daily temperature exposure and publicly available housing data. Data and statistical methods will allow her to study these potential vulnerability characteristics at the level of both the individual and the neighborhood. She will account for competing effects between mortality and morbidity events and examine how socioeconomic disparities in heat health effects are mediated, or explained, by more direct mechanisms such as housing quality and pre-existing health conditions. Based on this information, she will generate heat risk scores for each neighborhood in the six cities and map these risks. She will also identify how housing age, as a proxy for plumbing quality, modifies associations between precipitation and gastrointestinal hospitalization and emergency room visits. In Detroit, MI, she will also engage with the community at each step of the research process in a participatory, co-educational manner that will ensure that her specific research questions will both incorporate the knowledge and address relevant needs of local community members and officials involved in climate adaptation planning. Dr. Gronlund has background in epidemiologic research on the health effects of heat. In the first two years of the award, she will obtain additional training in spatial statistics, climate science and community-based participatory research methods from highly qualified mentors. The results from this research will help cities adapt to changing climatic and demographic conditions by providing guidance to health care providers and the general public on which health and housing characteristics increase susceptibility to heat and by informing sustainable climate change adaptation efforts.