Disasters, solar energy, and chronic disease management in aging Puerto Ricans

A.项目摘要 2017年9月，飓风玛丽亚袭击了波多黎各(PR)，这是一个人口众多的美国领土 320万美国公民。这一事件达到了PR的4级飓风级别，并造成了 美国历史上最长的停电。两年后，电网更进一步 在该岛南部发生的一系列地震中受损。一些社区仍然 经历完全缺电，大多数人面临频繁的停电。这个 电力供应中断对人们健康的影响已经消失 在加勒比海地区，极端事件的强度预计会增加。 通过直接使用太阳能实现的能源独立已经开始出现在公关中 通过社区组织的工作。一个典型案例是Casa Pueblo(CP)，一个 引领能源运动的非营利性社区组织 岛上的独立。位于农村小镇Adjutas的CP已经开始提供 向社区成员提供太阳能电池板。他们已经在必要的地点通电 毗邻社区(如小型食品市场、餐馆)和个别老年人之家 人口和患有能源依赖型慢性疾病的人--如肾脏疾病， 呼吸道疾病和糖尿病--目的是改善清洁发展机制在该岛频繁的 停电。 回应PAR-19-250(环境对衰老的影响：极端的影响 关于老龄化人口的天气和灾害事件)我们目前正在进行一个项目 从理论上了解#年灾害和气候复原力卫生方针框架 为了探索使地方政府机构、社区和 个人在他们的环境中适应能源独立，从而解决他们的 对清洁发展机制的影响。以下是这项研究目前的目标： 目标1-通过我们与CP的合作伙伴关系，探索 社区和老龄人口(≥50年)在适应的同时生活在慢性病中 能源独立(例如，引进技术、培训其使用、获得 通电的公共点)，以便更好地理解公共特征(例如， 集体认同、感知的个人主义)会阻碍或促进肾病患者的清洁发展机制 疾病、呼吸道疾病和糖尿病。 目标2--从多层次角度系统地记录文件(即，个人、 社区和结构性)感知到的采用能源的障碍和促进者 公关中的独立策略。 目标3-针对个人的复原力相关变量(例如，自我效能、 积极的态度、知识、利他主义)、公共的(例如，情感联系、团体 成员资格)，以及结构性(即停电、地理变量)水平，可以促进 在需要以电力为基础的治疗(即肾脏)的老龄人口中有效的清洁发展机制 疾病、呼吸系统疾病、糖尿病)。 为了达到提议的目标，我们将进行详细的民族志研究。 观察/绘制CP，我们将以社区为基础进行多层次的分析 通过45次深入的半结构化定性访谈实现能源独立性 慢性病患者≥50年，可以使用CP的一系列太阳能设备，以及 定性访谈将与政策部门、行政部门或 在可持续能源和灾后恢复领域工作的技术水平。此外, 我们将在阿朱塔斯镇对345名慢性病患者进行抽样调查 他们直接、间接和无法获得独立的能源。我们的研究将 促进关于社区作用的政策制定和传播 在管理技术依赖型慢性疾病方面的参与度和能源独立性 在美国和加勒比地区易受能源影响的老龄化人口中 不安全和自然灾害。

A. Project Abstract On September 2017 Hurricane María hit Puerto Rico (PR), a US territory populated by 3.2 million American citizens. The event reached PR as a category 4 hurricane and caused the longest electric power outage in US history. Two years later the electric grid was further damaged by a series of earthquakes in the southern part of the Island. Some communities still experience a complete lack of electricity, and most face frequent power outages. The implications of this interrupted access to electricity on the population’s health have gone unexplored in the Caribbean, where extreme events are expected to increase in intensity. Energy independence through direct access to solar power has begun to appear in PR through the work of community organizations. One model case is that of Casa Pueblo (CP), a non-profit community organization that has spearheaded the movement for energy independence on the Island. Located in the rural town of Adjuntas, CP has begun to provide solar panels to members in the communities. They have electrified essential locations in adjacent communities (e.g., small food markets, restaurants) and individual homes of elderly populations and those with energy-dependent chronic conditions – such as renal disease, respiratory disease, and diabetes – with the aim of improving CDM during the Island’s frequent power outages. In response to PAR-19-250 (Environmental Influences on Aging: Effects of Extreme Weather and Disaster Events on Aging Populations) we currently carrying out a project theoretically informed by a framework on disaster and climate-resilience approaches to health in order to explore the multilevel factors that enable local government agencies, communities, and individuals to adapt to energy independence in their settings, and thereby address their implications for CDM. These are the study’s current aims: Aim 1 – Through our partnership with CP, explore the process experienced by communities and the aging population (≥50 years) living with chronic diseases while adapting to energy independence (e.g., introduction of the technology, training on its use, access to energized communal points) in order to better understand how communal characteristics (e.g., collective identity, perceived individualism) can hinder or foster CDM among those with renal disease, respiratory disease, and diabetes. Aim 2 – Systematically document from a multilevel perspective (i.e., individual, community and structural) the perceived barriers and facilitators for adopting energy independence strategies in PR. Aim 3 – Document resilience related variables at the individual (e.g., self-efficacy, positive attitudes, knowledge, altruism), communal (e.g., emotional connection, group membership), and structural (i.e., power outages, geographical variables) levels that can foster effective CDM among aging populations in need of electricity-based treatments (i.e., renal disease, respiratory disease, diabetes). To achieve the proposed aims we will conduct a detailed ethnographic observation/mapping of CP, we will engage in a multilevel analysis of the community-based energy independence through 45 tiered in-depth semi-structured qualitative interviews with chronic disease patients ≥50 years with a range of access to CP’s solar installations, and qualitative interviews will be conducted with individuals engaged at the policy-, administrative- or technical-levels working within the field of sustainable energy and disaster recovery. In addition, we will administer a survey to a sample of 345 chronic disease patients in the town of Adjuntas who have direct, indirect and no access to independent energy sources. Our research will contribute to policy development and dissemination regarding the role of community engagement and energy independence in managing technology-dependent chronic diseases among aging populations in the United States and the Caribbean that are vulnerable to energy insecurity and natural disasters.