Climate & Health Actionable Research and Translation Center

图表：研究项目-总结 高环境温度是公认的对人类健康的环境危害。总体目标 本项目的主要目的是研究与生理易感性相关的因素以及沿着暴露途径的因素 这可能导致与热有关的疾病的差异。该项目还旨在绘制多个 健康的社会决定因素（SODH）领域，可以改变个人的能力，以减轻热暴露， 帮助确定可行的干预战略。目标1将量化热量与 2013年至2021年期间，佐治亚州亚特兰大市的急诊科（艾德）就诊。艾德访问是一个重要的， 未充分研究的热相关发病率结果。我们将建立一个地理编码的电子医疗数据库， 格雷迪纪念医院和埃默里医疗中心四家医院的记录。我们会评估病人- 水平效果调节器（例如，年龄、性别、无家可归、保险状况、共病情况和家庭 药物），以及与住宅建筑环境相关的改性剂（例如，建筑类型，建筑年份 和绿色空间）。Aim 2将对来自格雷迪和埃默里的400名参与者进行配对病例对照研究 医院检查与热有关的艾德就诊的风险因素，这些因素不能通过医疗记录获得，例如 暴露的方式和原因我们将开发一个调查工具和结构化面试，以评估 人口统计学、生理/健康状况、社区和个人SDOH，以及知识、态度和 围绕影响易感性和暴露于热的假设因素的实践。定性分析将 用于将病例中经历的暴露途径和挑战置于情境中并加以理解 导致他们在ED上的演讲。为了解决在理解热暴露方面的知识差距， 目标3将描述120个生活在资源不足社区的个人的温度暴露， 对个人、室内和室外暴露于温度、湿度的情况进行48小时连续监测 和空气质量。我们将描述个人，室内和室外温度之间的绝对差异， 以及识别人口统计学、行为学、社会经济学、时间-活动-位置和建筑环境 造成这些暴露差异的因素。我们会将调查结果和监测结果反馈给 给参与者。在所有目标中，我们将与社区合作伙伴合作，以确定其他突出的风险因素， 开展调查和面谈，并确定参与者以供征聘。总的来说，该项目将提供及时的 关于城市环境中热量对健康的不利影响的知识， 社区.拟议的研究项目与中心评估如何 气候变化威胁着城市社区的健康。此外，该项目的调查结果、数据和 基础设施将为气候和健康研究的能力建设和转化提供机会。

CHART: RESEARCH PROJECT – SUMMARY High ambient temperature is a well-recognized environmental hazard to human health. The overarching goal of this project is to examine factors related to physiologic susceptibility and factors along exposure pathways that may lead to disparities in heat-related illnesses. The project also aims to map features within multiple social determinants of health (SODH) domains that can alter an individual’s ability to mitigate heat exposure to help identify actionable intervention strategies. Aim 1 will quantify disparities in associations between heat and emergency department (ED) visits in Atlanta, GA during the period 2013 to 2021. ED visit is an important and understudied heat-related morbidity outcome. We will compile a database of geocoded electronic medical records from the Grady Memorial Hospital and four hospitals within Emory Healthcare. We will assess patient- level effect modifiers (e.g., age, sex, homelessness, insurance status, co-morbid conditions, and home medication), and modifiers that are related to the residential built environment (e.g., building type, building year and green space). Aim 2 will conduct a matched case-control study of 400 participants from Grady and Emory hospitals to examine risk factors for heat-related ED visits that are not captured through medical records, such as how and why exposure occurred. We will develop a survey tool and structured interview to assess demographic, physiological/health status, neighborhood and individual SDOH, and knowledge, attitudes, and practices around factors hypothesized to impact susceptibility and exposure to heat. Qualitative analysis will be used to contextualize and understand the exposure pathways and challenges experienced among the cases leading to their presentation at the ED. To address knowledge gaps in the understanding of heat exposures, Aim 3 will characterize temperature exposure for 120 individuals living in under-resourced communities by conducting 48-hour continuous monitoring of personal, indoor and outdoor exposure to temperature, humidity and air quality. We will characterize absolute differences between personal, indoor, and outdoor temperatures, as well as identify demographic, behavioral, socioeconomic, time-activity-location, and built environment factors contributing to these differences in exposures. We will disseminate findings and monitoring results back to participants. In all Aims, we will engage with community partners to determine additional salient risk factors, develop surveys and interviews, and identify participants for recruitment. Overall, the project will provide timely knowledge on the adverse health effects of heat in an urban setting with a focus on under-resourced communities. The proposed research project is highly aligned with the Center’s theme of assessing how climate change threatens the health of urban communities. Moreover, the project’s findings, data, and infrastructure will provide opportunities for capacity building and translation in climate and health research.