Environmental Extremes and the Health of the Rural Elderly

项目摘要 该项目研究极端环境事件对老年人身心健康的影响， 重点是这些影响如何在农村-城市连续体中变化。极端环境事件 - 如洪水，野火和飓风-频率和严重程度都在增加（Hayhoe等人2018） 而农村居民由于医疗保险覆盖率较低而特别脆弱（Cohen et al. 2021年）和更少的医疗保健。农村地区的医生密度要低得多（马查多等人，2021） 持续的医院关闭意味着更长的运输时间，包括紧急护理（GAO 2021）。事实上， 农村居民已经受到“农村死亡惩罚”，因为他们的寿命已经较低， 与城市同行相比，他们的预期（米勒和Vasan 2021）。我们将联合收割机的物理和 心理健康来自国家健康访谈调查，历史天气数据，联邦应急管理局灾难声明， 极端环境事件的规模和范围的背景，然后将其与 基于美国农业部的农村-城市连续体的农村性。我们强调的是 环境事件与农村老年人健康的关系 年轻人和城市居民。另一个令人感兴趣的是社会支持和联系的潜力 保护自己在城市地区，社会隔离被发现在灾害中的死亡率中发挥作用， 1995年芝加哥热浪中老年人的死亡（Klinenberg 2015）。然而，农村地区 具有相对较强的社会联系（Henning-Smith et al. 2019），因此我们研究了 这种联系在灾害发生时使农村老年人受益的可能性。总之，这个项目是第一个 并为制定保护老年人健康的计划和政策提供重要信息 在环境极端事件不断增加的背景下。

PROJECT SUMMARY This project examines the physical and mental health impacts of extreme environmental events on the elderly, with an emphasis on how these impacts vary across the rural-urban continuum. Extreme environmental events — such as floods, wildfires, and hurricanes — are increasing in frequency and severity (Hayhoe et al. 2018) and rural residents are especially vulnerable given their lower levels of health insurance coverage (Cohen et al. 2021) and lesser access to health care. Physician density is much lower in rural areas (Machado et al. 2021) and ongoing hospital closures mean longer transport times, including for emergency care (GAO 2021). In fact, rural dwellers are already subject to the “rural mortality penalty” in that they already have lower life expectancies compared to their urban counterparts (Miller and Vasan 2021). We combine data on physical and mental health from the National Health Interview Survey, historical weather data, FEMA disaster declarations, and background on the scale and scope extreme environmental events and then link these to indicators of ruralness based on the USDA’s rural-urban continuum. We emphasize the connections between extreme environmental events and health for the rural elderly by contrasting the association for this group with that for younger individuals and urban dwellers. Of additional interest is the potential for social support and connection to be protective. In urban areas, social isolation has been found to play a role in mortality in disasters such as the loss of elderly life in the Chicago heat wave of 1995 (Klinenberg 2015). However, rural areas are characterized by relatively stronger social bonds (Henning-Smith et al. 2019) and we therefore examine the possibility of such connections benefiting the rural elderly in times of disaster. In all, this project is the first of its kind and provides information important for the development of programs and policies to protect elderly health in the context of rising environmental extremes.