Staying cool in a changing climate: Reaching vulnerable populations during heat events
Staying cool in a changing climate: Reaching vulnerable populations during heat events
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DOI：
10.1016/j.gloenvcha.2012.12.011
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发表时间：
2013-04-01
影响因子：
8.9
通讯作者：
Parker, Edith A.
中科院分区：
文献类型：
--
作者：
Sampson, Natalie R.;Gronlund, Carina J.;Parker, Edith A.
预计全球高温天气事件的频率和强度将增加，威胁人类健康，特别是老年人、穷人和慢性病患者的健康。目前的文献表明，应急准备计划，热健康预警系统和相关干预措施可能无法达到或支持那些最容易受到热事件影响的人的行为改变。使用定性的多个案例研究设计，我们全面研究了这些人群的做法，以保持凉爽，在炎热的天气（“降温行为”）在美国四个城市记录的种族/民族和社会经济差异和不同的热准备策略：凤凰城，亚利桑那州;底特律，密歇根州;纽约市，纽约;和费城，宾夕法尼亚州。基于半结构化的深入访谈，我们进行了173社区成员和组织领导人在2009-2010年期间，我们评估了为什么弱势群体做或不参与促进健康的行为在家里或在他们的社区在高温事件，询问热相关的威胁和脆弱性的看法和社会支持的作用。虽然弱势群体经常认识到热量的潜在健康威胁，但许多人忽视或与风险因素无关，或依赖于生活在或访问温暖气候的经验作为保护因素。许多人采取基本的冷却行为，但也采取了不知不觉的有害行为，如不正确使用风扇和加热和冷却系统。与空调使用和制冷中心出勤率等常见推广行为相关的决策是复杂的，这些资源通常在经济上，物理上或文化上无法获得。受访者表示，人际关系、代际关系通常但不总是具有保护作用，其中同伴关系是促进高温事件期间老年人降温行为的一种宝贵机制。为了防止在日益变化的气候中热发病率和死亡率的差异，我们注意到当地环境的影响，我们通过分享代表弱势群体的社区成员和与他们合作最密切的领导人的观点和言论，广泛地告知热准备计划，干预措施和信息。(C)2013爱思唯尔有限公司保留所有权利。
The frequency and intensity of hot weather events are expected to increase globally, threatening human health, especially among the elderly, poor, and chronically ill. Current literature indicates that emergency preparedness plans, heat health warning systems, and related interventions may not be reaching or supporting behavior change among those most vulnerable in heat events. Using a qualitative multiple case study design, we comprehensively examined practices of these populations to stay cool during hot weather ("cooling behaviors") in four U.S. cities with documented racial/ethnic and socio-economic disparities and diverse heat preparedness strategies: Phoenix, Arizona; Detroit, Michigan; New York City, New York; and Philadelphia, Pennsylvania. Based on semi-structured in-depth interviews we conducted with 173 community members and organizational leaders during 2009-2010, we assessed why vulnerable populations do or do not participate in health-promoting behaviors at home or in their community during heat events, inquiring about perceptions of heat-related threats and vulnerability and the role of social support. While vulnerable populations often recognize heat's potential health threats, many overlook or disassociate from risk factors or rely on experiences living in or visiting warmer climates as a protective factor. Many adopt basic cooling behaviors, but unknowingly harmful behaviors such as improper use of fans and heating and cooling systems are also adopted. Decision-making related to commonly promoted behaviors such as air conditioner use and cooling center attendance is complex, and these resources are often inaccessible financially, physically, or culturally. Interviewees expressed how interpersonal, intergenerational relationships are generally but not always protective, where peer relationships are a valuable mechanism for facilitating cooling behaviors among the elderly during heat events. To prevent disparities in heat morbidity and mortality in an increasingly changing climate, we note the implications of local context, and we broadly inform heat preparedness plans, interventions, and messages by sharing the perspectives and words of community members representing vulnerable populations and leaders who work most closely with them. (C) 2013 Elsevier Ltd. All rights reserved.