Investigating Health Effects of Climate-Related Disasters in the United States

摘要 尽管与气候有关的自然灾害频繁发生（例如，飓风，洪水），很少有人知道如何 这些灾害影响到各种原因造成的人类死亡率和发病率。确定各种原因的健康风险的研究 死亡率和发病率，包括心血管和呼吸系统风险，将为灾害规划提供信息， 反应此外，气候变化有可能改变与气候有关的灾害的模式， 了解与当前气候相关灾害相关的健康风险， 与未来气候变化相关的风险。然而，关于灾害对所有原因、 心血管和呼吸系统的死亡率和发病率很难与目前的灾害流行病学进行 方法.大多数灾害流行病学要么侧重于快速识别与灾害相关的健康风险， 作为灾害响应的一部分，或仅调查医疗机构分类的健康结果 调查人员称之为“灾难相关”。在本补助金的培训阶段，安德森博士将开发统计 调查气候相关灾害对全因、心血管和呼吸系统的影响的方法 通过结合目前的方法和两种类型的分析概念的健康结果：事件分析和 环境时间序列分析（Aim 1）。在赠款的独立阶段，她将应用这些 量化气旋风暴（飓风、热带风暴和热带低气压）对所有人影响的方法- 原因，心血管和呼吸死亡率和医疗保险住院在美国（目标2）。为 在这项分析中，她将把来自国家卫生统计中心的国家日常卫生数据集 和医疗保险账单与风暴数据从国家气候数据中心的风暴数据和 南卡罗来纳州的空间灾害事件和损失数据库进行多年，多社区 分析气旋风暴对健康的影响。她还将确定气旋风暴的健康风险 每一次风暴造成的基础设施破坏都会对目标3进行修正。为了做到这一点，她将与一个合作- 指导对与气候相关灾害相关的基础设施风险进行建模的人员，并使用这两种模型， 基础设施风险和公用事业公司和州交通部门的数据，以量化 与风暴相关的健康风险会改变其对全因、心血管和呼吸系统疾病的影响 医疗保险住院。根据安德森博士的过去，她非常适合进行这项研究 研究经验，投资温度和空气污染对全因健康结果的影响， 国家研究，2）她的访问，通过导师，共同导师，和她的研究机构，广泛的 国家卫生和基础设施数据; 3）她获得世界一流的指导，培训和课程 统计方法和灾害风险。拟议的研究和培训将使安德森博士能够 在与气候有关的自然灾害流行病学领域建立独立的职业生涯。

Abstract Despite the frequency of climate-related natural disasters (e.g., hurricanes, floods), little is known about how such disasters affect all-cause human mortality and morbidity. Research identifying health risks for all-cause mortality and morbidity, including cardiovascular and respiratory risks, would inform disaster planning and response. Furthermore, climate change is likely to change patterns of climate-related disasters, making it critical to understand health risks associated with current climate-related disasters to fully understand health risks associated with future climate change. However, research on the effects of disasters on all-cause, cardiovascular, and respiratory mortality and morbidity is difficult to conduct with current disaster epidemiology methods. Most disaster epidemiology either focuses on quickly identifying the health risks associated with a single disaster as part of disaster response or investigates only health outcomes classified by a medical examiner as “disaster-related”. During the training phase of this grant, Dr. Anderson will develop statistical methods to investigate the effects of climate-related disasters on all-cause, cardiovascular, and respiratory health outcomes by combining current methods and concepts from two types of analysis: episode analysis and environmental time series analysis (Aim 1). During the independent phase of the grant, she will apply these methods to quantify effects of cyclonic storms (hurricanes, tropical storms, and tropical depressions) on all- cause, cardiovascular, and respiratory mortality and Medicare hospitalizations in the United States (Aim 2). For this analysis, she will link national datasets of daily health data from the National Center for Health Statistics and Medicare billing with storm data from the National Climatic Data Center's Storm Data and the University of South Carolina's Spatial Hazard Events and Losses Database to conduct a multi-year, multi-community analysis of the health effects of cyclonic storms. She will also determine how the health risks of cyclonic storms are modified by the infrastructure damage caused by each storm (Aim 3). To do this, she will work with a co- mentor who models infrastructure risks associated with climate-related disasters, and use both these models of infrastructure risk and data from utility companies and state departments of transportation to quantify how the health risk associated with a storm modifies its effects on all-cause, cardiovascular, and respiratory morbidity and Medicare hospitalizations. Dr. Anderson is well suited to perform this research based on 1) her past research experience investing the effects of temperature and air pollution on all-cause health outcomes in national studies, 2) her access, through mentors, co-mentors, and her research institution, to extensive national health and infrastructure data; and 3) her access to world-class mentorship, training, and coursework in statistical methods and disaster risks. The proposed research and training will allow Dr. Anderson to establish an independent career as a leader in the epidemiology of climate-related natural disasters.