Assessing and Addressing Heat-health Vulnerability in Ahmedabad, India

项目摘要 阿赫梅达巴德是印度古吉拉特邦一个发展迅速的大城市，夏季气温经常超过 40摄氏度阿赫梅达巴德市政公司（AMC）非常关注市民对高温的脆弱性， 气候变化，并渴望更多地了解特别脆弱的人群， 知情的公共卫生适应工作。对这一干旱地区的热脆弱性知之甚少， 尽管这个调查团和AMC已经做了初步的家庭脆弱性调查， 调查.这项工作已经开始揭示公众对健康，疾病和风险因素的看法，但真正的 与热有关的疾病负担仍然未知。 该提案的目标是探讨热病负担，脆弱性因素和应对方案， 阿赫梅达巴德，以促进AMC的适应努力。拟议的项目将评估热的负担 通过几种方法，包括使用现有社区卫生工作者的前瞻性队列研究， 外联方案;评估公共卫生和卫生保健提供部门的能力;建立关系 卫生部门和气象服务部门之间的合作，以改善高温观察预警活动。 该项目的具体目标如下：战略目标1：评估阿赫梅达巴德的中暑负担 利用回顾性和前瞻性的方法，并在现有的外联和监测基础设施的基础上， 目的是制定一个综合征监测计划; SA 2：评估和建立适应能力， 阿赫梅达巴德的公共卫生和医疗保健提供系统，通过对医疗保健服务的回顾性分析， 管理中暑患者，与城市和公共卫生官员进行需求评估，并进行培训 公共卫生和卫生保健工作者预防、识别和治疗中暑; SA 3： 与AMC和古吉拉特邦气象部门合作，开发和校准高温监视和警报 系统的AMC，使用响应函数从SA 1和概率集合温度预报， 本地区 我们已经召集了一个由美国和印度科学家组成的财团，他们在环境流行病学方面具有专长， 脆弱性评估，医学，公共卫生和卫生系统管理，气候科学，以及早期 预警系统开发。拟议的工作包括广泛的能力建设， 环境卫生科学家、公共卫生工作者和卫生保健人员。

PROJECT SUMMARY Ahmedabad is a large, rapidly growing city in Gujarat, India, where summer temperatures regularly exceed 40¿C. The Ahmedabad Municipal Corporation (AMC) is very concerned about citizens' vulnerability to heat as the climate changes and eager both to learn more about particularly vulnerable populations and to initiate informed public health adaptation efforts. Relatively little is known about heat vulnerability in this arid region, though this consortium of investigators and AMC have already done a preliminary household vulnerability survey. This work has begun to shed light on public perceptions of health, illness, and risk factors, but the true burden of heat-related illness remains unknown. The goal of this proposal is to explore the heat illness burden, vulnerability factors, and response options in Ahmedabad in order to facilitate AMC's adaptation efforts. The proposed project will assess the burden of heat illness via several methods, including a prospective cohort study using an existing community health worker outreach program; assess capacity in the public health and health care delivery sectors; and build relationships between the health sector and the meteorological services sector to improve heat watch warning activities. The project addresses the following specific aims: SA1: To assess the burden of heat illness in Ahmedabad using retrospective and prospective methods and building on existing outreach and surveillance infrastructure, with the aims of developing a syndromic surveillance program; SA2: To assess and build adaptive capacity in Ahmedabad's public health and health care delivery systems through retrospective analyses of the medical management of patients with heat illness, needs assessment with city and public health officials, and training of public health and health care workers on preventing, recognizing, and treating heat illness; and SA3: To work with AMC and the Gujarati Meteorological Department to develop and calibrate a heat watch and warning system for the AMC, using response functions from SA1 and probabilistic ensemble temperature forecasts for the region. We have assembled a consortium of US and Indian scientists with expertise in environmental epidemiology, vulnerability assessment, medicine, public health and health system administration, climate science, and early warning system development. The proposed work includes extensive capacity building for Indian environmental health scientists, public health workers, and health care staff.