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Muhammad T, Pai M, Maurya C, Srivastava S, Kumar M. Natural and human-made disaster and associated health outcomes among community-dwelling older adults in India: Findings from LASI, 2017-18. PLoS One 2024; 19:e0307371. [PMID: 39024275 PMCID: PMC11257249 DOI: 10.1371/journal.pone.0307371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/03/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Droughts, flash floods, rail accidents, and riots are relatively regular occurrences for those living in many low- and middle-income countries like India. While such natural and human-made disasters put everyone in harm's way, their toll on specific segments of society-like older adults-is the heaviest. Therefore, in this study, we examine (1) the prevalence of natural and human-made disasters in India and (2) the association between natural and human-made disasters and several physical and mental health outcomes among older Indians. METHODS A cross-sectional study was conducted utilizing data come from the 2017-18 wave 1 of the nationally representative Longitudinal Ageing Study in India, comprising a sample of 29,333 older adults (14,120 males and 15,213 females) aged 60 years and above. Multivariate random intercept multilevel logistic regression analysis is used to examine the association between natural and human-made disasters and poor self-rated health, difficulty in activities of daily living, difficulty in instrumental activities of daily living, communicable diseases, non-communicable diseases, depressive symptoms, and psychiatric disorder. RESULTS Overall, 3.58% of older adults reported that they have encountered any type of natural or human-made disaster in the past five years. Compared to those who did not experience any (natural or human-made) disaster, older adults who experienced any disaster had a higher prevalence of poor self-rated health (33.4% vs 23.31%), difficulty in activities of daily living (33.94% vs 23.00%), difficulty in instrumental activities of daily living (60.09% vs 47.70%), communicable diseases (49.57% vs 25.86%), depressive symptoms (17.30% vs 8.06%) and psychiatric disorders (3.42% vs 2.78%). After adjusting for the selected variables and the contextual effect, the odds of poor self-rated health (1.64 [1.40, 1.92]), difficulty in activities of daily living and instrumental activities of daily living (1.89 [1.61, 2.21] and 1.63 [1.40, 1.89]), communicable and non-communicable diseases (2.12 [1.83, 2.46] and 1.38 [1.20, 1.60]), depressive symptoms and psychiatric disorder (1.67 [1.55, 2.05] and 1.52 [1.33, 2.18]) were significantly higher among older adults who experienced a natural or human-made disaster than their counterparts without such an experience. CONCLUSIONS Relative to their non-exposed counterparts, older Indians who survived natural or human-made disasters endured an inflated risk of poor self-rated health, functional difficulties, communicable and non-communicable diseases, depressive symptoms, and psychiatric disorders. As such, post-disaster efforts should be grounded in policies and programs that address disaster-related trauma and diseases and improve the functional, physical, and psychological facets of health among older disaster survivors.
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Affiliation(s)
- T. Muhammad
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Manacy Pai
- Department of Sociology and Criminology, Kent State University, Kent, Ohio, United States of America
| | - Chanda Maurya
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - Manish Kumar
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, India
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Badger MS. The Intersection of Geriatrics, Climate Change, and Wilderness Medicine: Education is Critical. Wilderness Environ Med 2024:10806032241245399. [PMID: 38850046 DOI: 10.1177/10806032241245399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
According to the US Census, for the first time in history, older adults are projected to exceed the number of children by 2035. These seniors are headed to the outdoors in increasing numbers and face unique risks. They benefit from careful pre-event evaluation planning to maintain their health in wilderness environments. Climate change is affecting all of us, but seniors are considered an especially vulnerable group. This vulnerability needs to be addressed not only when older adults head into the wilderness but also when the wilderness "comes to them" in areas where wilderness medicine and disaster medicine overlap. Education of both providers and patients is vital. This article aims to discuss the special needs of older adults/seniors /elders (defined as those over 65 unless otherwise indicated) in the wilderness as well as the vulnerability of older adults to climate change, both during planned wilderness activities and when the wilderness "comes to them" because of climate change, and to identify opportunities for education and adaptation of patients and education of physicians and wilderness and disaster responders to care for these older patients. The PubMed and Google Scholar Database search engines were utilized to review relevant English language publications between 2000 and 2023 that addressed individuals over 65 and explored the overlap of geriatrics (aged over 65), wilderness and disaster medicine, and climate change and create a perspective summary. Because of increased numbers of older adults heading into the wilderness for outdoor activities or having wilderness thrust upon them due to climate change, cross training of all specialties including the fields of emergency, geriatrics, wilderness medicine, and disaster medicine is needed in collaboration with other organizations and search and rescue. Response agencies must recognize that training in wilderness medicine provides a background for practitioners working in dangerous and remote settings and ought to seek out individuals with such skills when placing responders in the field. Climate change is making these intersections and the need for this education more urgent with time.
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Gorsline CA, Lotspeich SC, Belaunzarán-Zamudio PF, Mejia F, Cortes CP, Crabtree-Ramírez B, Severe DP, Rouzier V, McGowan CC, Rebeiro PF. The impact of earthquakes in Latin America on the continuity of HIV care: A retrospective observational cohort study. PUBLIC HEALTH IN PRACTICE 2024; 7:100479. [PMID: 38405231 PMCID: PMC10883833 DOI: 10.1016/j.puhip.2024.100479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/27/2024] Open
Abstract
Objectives As earthquakes occur frequently in Latin America and can cause significant disruptions in HIV care, we sought to analyze patterns of HIV care for adults at Latin American clinical sites experiencing a significant earthquake within the past two decades. Study design Retrospective clinical cohort study. Methods Adults receiving HIV care at sites experiencing at least a "moderate intensity" (Modified Mercalli scale) earthquake in the Caribbean, Central and South America network for HIV epidemiology (CCASAnet) contributed data from 2003 to 2017. Interrupted Time Series models were fit with discontinuities at site-specific earthquake dates (Sept. 16, 2015 in Chile; Apr. 18, 2014 and Sept. 19, 2017 in Mexico; and Aug. 15, 2007 in Peru) to assess clinical visit, CD4 measure, viral load lab, and ART initiation rates 3- and 6-months after versus before earthquakes. Results Comparing post-to pre-earthquake periods, there was a sharp drop in median visit (incidence rate ratio [IRR] = 0.79, 95% confidence interval [CI]: 0.68-0.91) and viral load lab (IRR = 0.78, 95% CI: 0.62-0.99) rates per week, using a 3-month window. CD4 measurement rates also decreased (IRR = 0.43; 95% CI: 0.37-0.51), though only using a 6-month window. Conclusions Given that earthquakes occur frequently in Latin America, disaster preparedness plans must be more broadly implemented to avoid disruptions in HIV care and attendant poor outcomes.
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Affiliation(s)
- Chelsea A. Gorsline
- University of Kansas Medical Center, Department of Medicine, Division of Infectious Diseases, Kansas City, KS, USA
| | - Sarah C. Lotspeich
- Wake Forest University School of Medicine, Department of Statistical Sciences, Winston-Salem, NC, USA
| | | | - Fernando Mejia
- Instituto de Medicina Tropical Alexander von Humboldt de Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Claudia P. Cortes
- Universidad de Chile and Fundacion Arriaran, Santiago de Chile, Chile
| | - Brenda Crabtree-Ramírez
- Departamento de Infectología, Instituto Nacional de Ciencias Medicas y Nutricion, Salvador Zubiran, Mexico City, Mexico
| | | | | | - Catherine C. McGowan
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Diseases, Nashville, TN, USA
| | - Peter F. Rebeiro
- Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Diseases, Nashville, TN, USA
- Vanderbilt University Medical Center, Department of Biostatistics, Nashville, TN, USA
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Chiba I, Nakaya N, Kogure M, Hatanaka R, Nakaya K, Tokioka S, Nakamura T, Nagaie S, Fuse N, Obara T, Kotozaki Y, Tanno K, Kuriyama S, Hozawa A. Associations between housing and psychological damage by earthquake and modifiable risk factors for dementia in general older adults: Tohoku Medical Megabank community-based cohort study. Geriatr Gerontol Int 2024; 24:509-516. [PMID: 38700081 DOI: 10.1111/ggi.14867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/07/2024] [Accepted: 03/22/2024] [Indexed: 05/05/2024]
Abstract
AIM To evaluate the association between housing and psychological damage caused by the Great East Japan Earthquake (GEJE) and modifiable risk factors (MRFs) of dementia for general population of older adults. METHODS This cross-sectional study enrolled 29 039 community-dwelling older adults (mean age 69.1 ± 2.9 years, 55.5% women). We evaluated disaster-related damage (by complete or not complete housing damage) and psychological damage (by post-traumatic stress reaction [PTSR]) after the GEJE using a self-report questionnaire. MRFs encompassed the presence of depression, social isolation, physical inactivity, smoking, and diabetes. We examined the association between disaster-related damage and MRFs using ordinary least squares and modified Poisson regression models adjusted for sociodemographic and health status variables. RESULTS Complete housing damage and PTSR were identified in 2704 (10.0%) and 855 (3.2%) individuals, respectively. The number of MRFs was significantly larger for the individuals with complete housing damage (β = 0.23; 95% confidence interval [CI]: 0.19-0.27) and PTSR (β = 0.60; 95% CI: 0.53-0.67). Prevalence ratios (PRs) for depression and physical inactivity were higher in individuals with complete housing damage. The PRs for all domains of the MRFs were significantly higher in individuals with PTSR. CONCLUSIONS Housing and psychological damage caused by the GEJE were associated with an increased risk factor of dementia. To attenuate the risk of dementia, especially among older victims who have experienced housing and psychological damage after a disaster, multidimensional support across various aspects of MRFs is required. Geriatr Gerontol Int 2024; 24: 509-516.
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Affiliation(s)
- Ippei Chiba
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Mana Kogure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Rieko Hatanaka
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Kumi Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Sayuri Tokioka
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Faculty of Data Science, Kyoto Women's University, Kyoto, Japan
| | - Satoshi Nagaie
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Nobuo Fuse
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Yuka Kotozaki
- Division of Clinical Research and Epidemiology, Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Morioka, Japan
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Kozo Tanno
- Division of Clinical Research and Epidemiology, Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Morioka, Japan
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Atsushi Hozawa
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
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Nakaya K, Nakaya N, Kogure M, Hatanaka R, Chiba I, Kanno I, Nagaie S, Nakamura T, Kanazawa M, Ogishima S, Fuse N, Fukudo S, Hozawa A. Factors Associated With the Prevalence of Irritable Bowel Syndrome: The Miyagi Part of the Tohoku Medical Megabank Project Community-based Cohort Study. J Neurogastroenterol Motil 2024; 30:208-219. [PMID: 38576370 PMCID: PMC10999836 DOI: 10.5056/jnm23090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/28/2023] [Accepted: 10/16/2023] [Indexed: 04/06/2024] Open
Abstract
Background/Aims The objective of this research is to examine factors related to irritable bowel syndrome (IBS) prevalence in a large population-based study. Methods A cross-sectional study was conducted with participants in the Miyagi part of the Tohoku Medical Megabank Project Community-Based cohort study who completed the Rome II Modular Questionnaire. Multivariate odds ratios (ORs) for the presence of IBS and 95% confidence intervals (95% CIs) for the reference group were calculated for each factor. Additionally, a stratified analysis was performed by sex and age group (20-49 years, 50-64 years, and ≥ 65 years). Results Among 16 252 participants, 3025 (18.6%) had IBS, comprising 750 men (15.5%) and 2275 women (19.9%). Multivariate ORs for the presence of IBS decreased significantly with each year of age (OR, 0.98; 95% CI, 0.98-0.99). Moreover, compared with the reference group, ORs for the presence of IBS were significantly higher in individuals whose home was partially damaged by the Great East Japan Earthquake, those with < 16 years of education, those who spent less time walking, those with high perceived stress (1.77, 1.57-2.01), those with high psychological distress (1.58, 1.36-1.82), and those with high symptoms of depression (1.76, 1.60-1.94). In stratified analyses, a significant relationship was found between psychological factors and IBS prevalence in all sex and age groups. Conclusions This large cross-sectional population-based cohort study identified several factors associated with IBS prevalence. Psychological factors were significantly associated with IBS prevalence across all age groups and sexes.
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Affiliation(s)
- Kumi Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Mana Kogure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Rieko Hatanaka
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Ippei Chiba
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Ikumi Kanno
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Satoshi Nagaie
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Faculty of Data Science, Kyoto Women’s University, Kyoto, Japan
| | | | - Soichi Ogishima
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Nobuo Fuse
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shin Fukudo
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Atsushi Hozawa
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
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Shukla M, Amberson T, Heagele T, McNeill C, Adams L, Ndayishimiye K, Castner J. Tailoring Household Disaster Preparedness Interventions to Reduce Health Disparities: Nursing Implications from Machine Learning Importance Features from the 2018-2020 FEMA National Household Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:521. [PMID: 38791736 PMCID: PMC11121406 DOI: 10.3390/ijerph21050521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 05/26/2024]
Abstract
Tailored disaster preparedness interventions may be more effective and equitable, yet little is known about specific factors associated with disaster household preparedness for older adults and/or those with African American/Black identities. This study aims to ascertain differences in the importance features of machine learning models of household disaster preparedness for four groups to inform culturally tailored intervention recommendations for nursing practice. A machine learning model was developed and tested by combining data from the 2018, 2019, and 2020 Federal Emergency Management Agency National Household Survey. The primary outcome variable was a composite readiness score. A total of 252 variables from 15,048 participants were included. Over 10% of the sample self-identified as African American/Black and 30.3% reported being 65 years of age or older. Importance features varied regarding financial and insurance preparedness, information seeking and transportation between groups. These results reiterate the need for targeted interventions to support financial resilience and equitable resource access. Notably, older adults with Black racial identities were the only group where TV, TV news, and the Weather Channel was a priority feature for household disaster preparedness. Additionally, reliance on public transportation was most important among older adults with Black racial identities, highlighting priority needs for equity in disaster preparedness and policy.
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Affiliation(s)
- Meghna Shukla
- College of Nursing, Wayne State University, 5557 Cass Ave, Detroit, MI 48202, USA;
| | - Taryn Amberson
- Castner Incorporated, 1879 Whitehaven Road #150, Grand Island, NY 14072, USA (J.C.)
- Health Systems and Population Health School of Public Health, Department of Health Services Research, University of Washington, 1959 NE Pacific St., Seattle, WA 98195, USA
- Administration for Strategic Preparedness and Response, National Disaster Medical System, 200 Independence Ave., Washington, DC 20201, USA
| | - Tara Heagele
- Hunter-Bellevue School of Nursing, Hunter College, The City University of New York, 425 East 25th Street, Office 427W, New York, NY 10010, USA;
| | - Charleen McNeill
- College of Nursing, University of Tennessee Health Science Center’s, Suite 140C, 874 Union Ave., Memphis, TN 38163, USA;
| | - Lavonne Adams
- Harris College of Nursing & Health Sciences, Texas Christian University, TCU Box 298620, Fort Worth, TX 76129, USA;
| | - Kevin Ndayishimiye
- Castner Incorporated, 1879 Whitehaven Road #150, Grand Island, NY 14072, USA (J.C.)
| | - Jessica Castner
- Castner Incorporated, 1879 Whitehaven Road #150, Grand Island, NY 14072, USA (J.C.)
- Health Policy, Management and Behavior, School of Public Health, University at Albany, 1400 Washington Avenue, Albany, NY 14222, USA
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Amberson T, Heagele T, Wyte-Lake T, Couig MP, Bell SA, Mammen MJ, Wells V, Castner J. Social support, educational, and behavioral modification interventions for improving household disaster preparedness in the general community-dwelling population: a systematic review and meta-analysis. Front Public Health 2024; 11:1257714. [PMID: 38596429 PMCID: PMC11003604 DOI: 10.3389/fpubh.2023.1257714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/22/2023] [Indexed: 04/11/2024] Open
Abstract
Background The efficacy of household emergency preparedness interventions for community-dwelling, non-institutionalized people is largely unknown. Objective To ascertain the state of the science on social support, educational, and behavioral modification interventions to improve all-hazard household disaster preparedness. Design Systematic review and meta-analysis. Methods Databases, trial registers, reports, and websites were searched, and citation trails followed utilizing replicable methods. Individual, cluster, and cross-over randomized controlled trials of non-institutionalized, community-dwelling populations and non-randomized controlled trials, controlled before-after, and program evaluation studies were included. At least two review authors independently screened each potentially relevant study for inclusion, extracted data, and assessed the risk of bias. Risk of bias was assessed using Cochrane's RoB2 tool for randomized studies and ROBINS-I tool for nonrandomized studies. Meta-analyses were applied using a random-effects model. Where meta-analysis was not indicated, results were synthesized using summary statistics of intervention effect estimates and vote counting based on effect direction. The evidence was rated using GRADE. Results 17 studies were included with substantial methodological and clinical diversity. No intervention effect was observed for preparedness supplies (OR = 6.12, 95% 0.13 to 284.37) or knowledge (SMD = 0.96, 95% CI -0.15 to 2.08) outcomes. A small positive effect (SMD = 0.53, 95% CI 0.16 to 0.91) was observed for preparedness behaviors, with very low certainty of evidence. No studies reported adverse effects from the interventions. Conclusion Research designs elucidating the efficacy of practical yet complex and multi- faceted social support, educational, and behavioral modification interventions present substantial methodological challenges where rigorous study design elements may not match the contextual public health priority needs and resources where interventions were delivered. While the overall strength of the evidence was evaluated as low to very low, we acknowledge the valuable and informative work of the included studies. The research represents the seminal work in this field and provides an important foundation for the state of the science of household emergency preparedness intervention effectiveness and efficacy. The findings are relevant to disaster preparedness practice and research, and we encourage researchers to continue this line of research, using these studies and this review to inform ongoing improvements in study designs.
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Affiliation(s)
- Taryn Amberson
- Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Tara Heagele
- Hunter-Bellevue School of Nursing, Hunter College, The City University of New York, New York City, NY, United States
| | - Tamar Wyte-Lake
- Veterans Emergency Management Evaluation Center, Los Angeles, CA, United States
- Department of Family Medicine, Oregon Health and Science University, Portland, OR, United States
| | - Mary Pat Couig
- College of Nursing, University of New Mexico, Albuquerque, NM, United States
| | - Sue Anne Bell
- University of Michigan, Ann Arbor, MI, United States
| | | | - Valerie Wells
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Jessica Castner
- Castner Incorporated, Grand Island, NY, United States
- University at Albany School of Public Health, Albany, NY, United States
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Okuzono SS, Slopen N, Shiba K, Yazawa A, Kondo K, Kawachi I. Do Adverse Childhood Experiences Modify the Association Between Disaster-Related Trauma and Cognitive Disability? Am J Epidemiol 2024; 193:36-46. [PMID: 37442811 PMCID: PMC10773476 DOI: 10.1093/aje/kwad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/17/2023] [Accepted: 07/07/2023] [Indexed: 07/15/2023] Open
Abstract
Identifying subpopulations that are particularly vulnerable to long-term adverse health consequences of disaster-related trauma is needed. We examined whether adverse childhood experiences (ACEs) potentiate the association between disaster-related trauma and subsequent cognitive disability among older adult disaster survivors. Data were from a prospective cohort study of older adults who survived the 2011 Great East Japan Earthquake. The baseline survey pre-dated the disaster by 7 months. We included participants who completed follow-up surveys (2013 and 2016) and did not have a cognitive disability before the disaster (n = 602). Disaster-related traumas (i.e., home loss, loss of friends or pets) and ACEs were retrospectively assessed in 2013. Cognitive disability levels in 2016 were objectively assessed. After adjusting for pre-disaster characteristics using a machine learning-based estimation approach, home loss (0.19, 95% confidence interval (CI): 0.09, 0.28) was, on average, associated with greater cognitive disability. Among individuals with ACEs, home loss was associated with even higher cognitive disability levels (0.64, 95% CI: 0.24, 1.03). Losses of friends (0.18, 95% CI: 0.05, 0.32) and pets (0.13, 95% CI: 0.02, 0.25) were associated with higher cognitive disability levels only among those with ACEs. Our findings suggest that individuals with a history of ACEs may be particularly vulnerable to adverse health consequences related to disasters.
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Affiliation(s)
- Sakurako S Okuzono
- Correspondence to Sakurako S. Okuzono, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 (e-mail: )
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Mohammad Y, Bayram H, Kayalar O, Madonna F, Annesi-Maesano I. Earthquake disaster and respiratory health: lessons from Turkey and Syria in 2023. Eur Respir J 2023; 62:2300534. [PMID: 37918878 DOI: 10.1183/13993003.00534-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/29/2023] [Indexed: 11/04/2023]
Affiliation(s)
- Yousser Mohammad
- Al Sham Private University, Faculty of Medicine and Pharmacy, Damascus and Latakia, Syria
- Centre for Research on Chronic Respiratory Diseases, Tishreen University, Latakia, Syria
| | - Hasan Bayram
- Koç University Research Centre for Translational Medicine (KUTTAM) and Department of Pulmonary Medicine, School of Medicine, Koç University, Istanbul, Turkey
| | - Ozgecan Kayalar
- Koç University Research Centre for Translational Medicine (KUTTAM) and Department of Pulmonary Medicine, School of Medicine, Koç University, Istanbul, Turkey
| | - Fabio Madonna
- University of Salerno, Department of Physics, Salerno, Italy
| | - Isabella Annesi-Maesano
- Institute Desbrest of Epidemiology and Public Health, University of Montpellier and INSERM, Department of Allergic and Respiratory Disease, Montpellier University Hospital, Montpellier, France
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Kitamura Y, Nakai H. Maintaining quality of life and care for cancer survivors experiencing disaster disruptions: a review of the literature. BMC Cancer 2023; 23:701. [PMID: 37495955 PMCID: PMC10373278 DOI: 10.1186/s12885-023-11191-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/19/2023] [Indexed: 07/28/2023] Open
Abstract
Disasters caused by natural phenomena are increasing in frequency and devastation. The growing number of cancer survivors constitute a vulnerable population in their need for continuous and high-level care, a vulnerability that is exacerbated in the event of disasters. Although the evidence base on the needs of cancer survivors is growing, little is known about cancer care in disaster settings. Therefore, we prepared a narrative literature review that outlines existing evidence, identifies knowledge gaps, and clarifies key concepts that are central to the burgeoning area of research into the quality of care for cancer survivors through disasters. As the preponderance of available evidence stresses the importance of careful disaster planning for maintaining care services, this review also provides guidance in developing plans for how to proceed during, and in the aftermath of, disasters.
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Affiliation(s)
- Yoshiko Kitamura
- School of Nursing, Kanazawa Medical University, 1-1 Uchinada, Kahoku, Ishikawa, 920-0265, Japan
| | - Hisao Nakai
- Faculty of Nursing, University of Kochi, 2751-1 Ike, Kochi, 781-8515, Japan.
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Melton CC, De Fries CM, Smith RM, Mason LR. Wildfires and Older Adults: A Scoping Review of Impacts, Risks, and Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6252. [PMID: 37444100 PMCID: PMC10341407 DOI: 10.3390/ijerph20136252] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/15/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023]
Abstract
Climate change is leading to worsening disasters that disproportionately impact older adults. While research has begun to measure disparities, there is a gap in examining wildfire-specific disasters. To address this gap, this scoping review analyzed literature to explore the nexus of wildfires and older adults. We searched peer-reviewed literature using the following inclusion criteria: (1) published in a peer-reviewed journal; (2) available in English; (3) examines at least one topic related to wildfires; and (4) examines how criterion three relates to older adults in at least one way. Authors screened 261 titles and abstracts and 138 were reviewed in full, with 75 articles meeting inclusion criteria. Findings heavily focused on health impacts of wildfires on older adults, particularly of smoke exposure and air quality. While many articles mentioned a need for community-engaged responses that incorporate the needs of older adults, few addressed firsthand experiences of older adults. Other common topics included problems with evacuation, general health impacts, and Indigenous elders' fire knowledge. Further research is needed at the nexus of wildfires and older adults to highlight both vulnerabilities and needs as well as the unique experience and knowledge of older adults to inform wildfire response strategies and tactics.
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Affiliation(s)
| | | | | | - Lisa Reyes Mason
- Graduate School of Social Work, University of Denver, Denver, CO 80210, USA; (C.C.M.); (C.M.D.F.); (R.M.S.)
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Buckley TD, Burnette D. Psychological sense of community, self-rated health and quality of life among older adults in Puerto Rico two years after Hurricane María. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:512-529. [PMID: 36217794 DOI: 10.1080/01634372.2022.2133200] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/26/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
Older adults who experience natural disasters are at risk for immediate and longer-term negative health outcomes and diminished quality of life (QOL), in part due to disruptions to social relationships and protections. We use a risk and resilience framework to examine the protective effects of psychological sense of community (PSOC) on self-rated health (SRH) and QOL for older adults in Puerto Rico 2 years after the devastation of Hurricane María in 2017. Between September 2019 and January 2020, we conducted face-to-face interviews with a nonprobability sample of 154 community-dwelling adults aged 60+ in Puerto Rico. Controlling for covariates, we used multivariate regression to examine the association of PSOC and key social risk factors (mental health, social isolation, and loneliness) with SRH and QOL. Higher levels of PSOC were significantly associated with better SRH and QOL. Regarding risks, worse mental health was significantly associated with lower QOL and SRH, loneliness was significantly related to worse QOL, and social isolation was significantly associated with better SRH and better QOL. PSOC was a protective factor for older adults, suggesting that prevention and intervention efforts should focus on building and sustaining older adults' sense of community in the longer-term wake of natural disasters.
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Affiliation(s)
- Thomas D Buckley
- School of Social Work and Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Denise Burnette
- School of Social Work, Virginia Commonwealth University, Pittsburgh, PA, USA
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Hua CL, Patel S, Thomas KS, Peterson LJ, Andel R, Gordon L, Jester DJ, Dosa DM. The relationship between exposure to Hurricane Harvey and mortality among nursing home residents. J Am Geriatr Soc 2023; 71:888-894. [PMID: 36541058 PMCID: PMC10023296 DOI: 10.1111/jgs.18143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/05/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Nursing home (NH) residents are vulnerable to mortality after natural disasters. We examined NH residents' excess all-cause mortality associated with Hurricane Harvey, a unique disaster with long-lasting flooding effects. We also explored how mortality differed between short-stay and long-stay residents and by chronic conditions. METHODS We conducted a retrospective observational study of Texas NH residents, comparing 30- and 90-day mortality among residents exposed to Hurricane Harvey in August 2017 to residents not exposed in the same location and time period during the previous 2 years. Data came from the Minimum Data Set Assessments and the Medicare Beneficiary Summary File. We used linear probability models to examine the association between hurricane exposure and mortality, adjusting for resident demographics, clinical acuity, and NH fixed effects. Models were stratified by short-stay and long-stay status. We also described differences in mortality by residents' chronic conditions. RESULTS In 2017, 18,479 Texas NH residents were exposed to Hurricane Harvey. Exposure to Hurricane Harvey was not significantly associated with 30-day mortality. However, 7.6% (95% CI: 7.2, 7.9) of long-stay residents died 90 days after exposure to Harvey, compared to 6.3% (95% CI: 6.0, 6.7) during 2015. Apparently, this effect was driven by chronic obstructive pulmonary disease (COPD) as approximately 9.2% of these residents died within 90 days after Harvey landing compared to 7.2% in 2015 (p < 0.01). CONCLUSIONS Hurricane exposure appears to have significant consequences for mortality among long-stay NH residents, which appear to materialize over the long-term (90 days post-hurricane in our study) and may not be apparent immediately (30 days post-hurricane in our study). NH residents with COPD may be particularly vulnerable to increased mortality risk following hurricane exposure. The results highlight the need to pay special attention to mortality risk in NH residents, particularly those with COPD, following hurricane exposure.
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Affiliation(s)
- Cassandra L. Hua
- Center of Innovation in Long-Term Services and Supports, U.S. Department of Veterans Affairs Medical Center, Providence, Rhode Island
- School of Public Health, Brown University, Providence, Rhode Island
| | - Sweta Patel
- School of Public Health, Brown University, Providence, Rhode Island
| | - Kali S. Thomas
- Center of Innovation in Long-Term Services and Supports, U.S. Department of Veterans Affairs Medical Center, Providence, Rhode Island
- School of Public Health, Brown University, Providence, Rhode Island
| | | | - Ross Andel
- Center for Innovation in Healthy and Resilient Aging, Arizona State University
| | - Lily Gordon
- School of Public Health, Brown University, Providence, Rhode Island
| | - Dylan J. Jester
- School of Aging Studies, University of South Florida, Tampa, Florida
- Department of Psychiatry, University of California San Diego, La Jolla, CA. Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - David M. Dosa
- Center of Innovation in Long-Term Services and Supports, U.S. Department of Veterans Affairs Medical Center, Providence, Rhode Island
- School of Public Health, Brown University, Providence, Rhode Island
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
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Inloes JB, Brown A, Rettell Z, Fick DM, Bell SA. Home-Based Care Provider Perspectives on Care Refusal During the COVID-19 Pandemic. J Gerontol Nurs 2023; 49:35-41. [PMID: 36594910 PMCID: PMC11384231 DOI: 10.3928/00989134-20221206-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Acute and chronic disease management continues to shift toward a health care in the home model, yet literature discussing continuity of home-based care services during public health emergencies, such as infectious disease pandemics, is scant. In the current study, we used semi-structured telephone interviews with 27 home-based care providers (HBCPs) from Medicare-certified home health care agencies located in eight U.S. counties to explore older adults' decision making around home-based care service continuation during the coronavirus disease 2019 (COVID-19) pandemic. Four themes emerged, including two related to older adults' decision making around refusal of in-home care and two related to HBCPs' responses to care refusals. Fear of COVID-19 infection motivated older adults to make care-related decisions that were incongruent with their health needs, including refusal of care in the home, despite receiving education from HBCPs. These data highlight a need for tools to help HBCPs better support patients through decision-making processes about care continuation during COVID-19 and future infectious disease pandemics. [Journal of Gerontological Nursing, 49(1), 35-41.].
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Andrade EL, Cordova A, Schagen CRV, Jula M, Rodriguez-Diaz CE, Rivera MI, Santos-Burgoa C. The impact of Hurricane Maria on individuals living with non-communicable disease in Puerto Rico: the experience of 10 communities. BMC Public Health 2022; 22:2083. [PMCID: PMC9664670 DOI: 10.1186/s12889-022-14552-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/04/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Coinciding with the rising non-communicable disease (NCD) prevalence worldwide is the increasing frequency and severity of natural hazards. Protecting populations with NCDs against natural hazards is ever more pressing given their increased risk of morbidity and mortality in disaster contexts. This investigation examined Hurricane Maria’s impacts across ten lower SES municipalities in Puerto Rico with varying community characteristics and hurricane impacts to understand experiences of supporting individuals with NCD management in the six-month period following the hurricane.
Methods
We conducted 40 qualitative interviews with mayors, first responders, faith leaders, community leaders, and municipal employees from 10 municipalities in Puerto Rico. Using QSR NVivo software, we deductively and inductively coded interview transcripts and undertook thematic analysis to characterize community-level hurricane impact and consequences for NCD management, and to identify convergent and divergent themes.
Results
Damages to infrastructure, including healthcare facilities and roadways, complicated the provision of timely health care for NCDs, patient transport, and pharmaceutical/medical supply chain continuity. Lengthy power outages at both healthcare facilities and private residences were barriers to healthcare service delivery, use of medical equipment, and storage of prescription medications with refrigeration, and led to a widespread mental health crisis. Cascading failures such as fuel shortages further compounded these challenges. The consequences of these impacts included the reported exacerbation of health conditions and loss of life among NCD patients.
Conclusions
Study findings identify contributors to morbidity and mortality among individuals with NCDs following Hurricane Maria. With the growing frequency of catastrophic disasters from natural hazards, the experiences of communities that endured these impacts offer important lessons regarding policies and practices to better support community disaster resilience and address the evolving preparedness needs of NCD patients.
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Pascal M. [Adaptation to extreme weather event is key to protection of human health]. Rev Mal Respir 2022; 39:719-725. [PMID: 36088183 DOI: 10.1016/j.rmr.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/18/2022] [Indexed: 10/14/2022]
Abstract
Extreme weather events (EWE) are the most direct and visible example of how climate change threatens human health. Notwithstanding the diversity of EWEs, they all have recurrent impacts on mortality, morbidity and mental health. These impacts largely depend on exposure conditions, on the response measures implemented, and on socio-economic determinants. Forest fires and heat waves are the EWEs in all likelihood presenting the highest risks for respiratory health, and they are likely to rapidly evolve over the coming years. Since 2004, more than 10,000 excess deaths have been recorded during heat waves in France, 76 % of them after 2015. Pronounced synergies between extreme heat and air pollution are now documented in the literature. In addition to appropriate behaviours and medical care during EWEs, adaptation must now focus on long-term interventions, the objectives being to reduce exposure, to improve the quality of our environment and to reinforce social ties.
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Affiliation(s)
- M Pascal
- Santé publique France, 12, rue du Val d'Osne, Saint Maurice, France.
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17
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Dassieu L, Develay E, Beauchet O, Quesnel-Vallée A, Godard-Sebillotte C, Tchouaket E, Puzhko S, Karunananthan S, Archambault P, Launay C, Holyoke P, Sauriol C, Galery K, Sourial N. Implementing a Telehealth Support Tool for Community-Dwelling Older Adults During the COVID-19 Pandemic: A Qualitative Investigation of Provider Experiences. J Aging Soc Policy 2022:1-18. [PMID: 35994512 DOI: 10.1080/08959420.2022.2111166] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/19/2022] [Indexed: 10/15/2022]
Abstract
During the COVID-19 pandemic, policymakers had to quickly offer telehealth services to address older adults' needs. This study aimed to understand the experiences of providers who implemented a telephone-based telehealth tool named Socio-Geriatric Evaluation (ESOGER), which assessed health and social isolation risks in community-dwelling older adults in Quebec (Canada). This qualitative study used 20 semi-structured online/phone interviews with health and social service providers coming from publicly-funded healthcare facilities and community organizations. We included adopters and non-adopters of the telehealth tool. Interviews were audio-recorded and transcribed verbatim. We used reflexive thematic analysis to interpret the data. Three dimensions of providers' practice influenced the tool's implementation: service organization, working conditions, and interactions with older adults. Participants reported that the tool fostered continuity of care, provided guidance for their pandemic-related new tasks, and helped identify and support socially isolated older adults. Challenges to implementation included limited appropriateness of the telehealth tool for diverse services, feasibility barriers to adopting a new tool amid the health crisis, and acceptability challenges with some older adults. Despite relevance of the telehealth tool for providers, organizational, professional, and interactional barriers could hinder implementation success. Participatory approaches to telehealth may be promising avenues for future policies in this field.
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Affiliation(s)
- Lise Dassieu
- Senior Postdoctoral Researcher, Department of Biomedical Sciences, Université de Montréal, and Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Elise Develay
- Research Professional, Research Centre, Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Olivier Beauchet
- Professor, Department of Medicine, Université de Montréal, and Research Center of the Institut Universitaire en Gériatrie de Montréal, Montreal, Quebec, Canada
| | - Amélie Quesnel-Vallée
- Professor, Department of Sociology and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Claire Godard-Sebillotte
- Assistant Professor, Division of Geriatrics, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Eric Tchouaket
- Professor, Department of Nursing Sciences, Université du Quebec en Outaouais, Saint-Jérôme, Quebec, Canada
| | - Svetlana Puzhko
- Postdoral Researcher, Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | | | - Patrick Archambault
- Associate Professor, Department of Family and Emergency Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Cyrille Launay
- Geriatrician, Clinical Researcher, Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
| | - Paul Holyoke
- Executive Director, SE Research Centre, SE Health, Markham, Ontario, Canada
| | - Caroline Sauriol
- Director, Little Brothers Organization, Montreal, Quebec, Canada
| | - Kevin Galery
- Assistant Director, Research Centre, Research Center of the Institut Universitaire en Gériatrie de Montréal, Montreal, Quebec, Canada
| | - Nadia Sourial
- Assistant Professor, Department of Health Management, Evaluation and Policy, School of Public Health, Université de Montreal, Université de Montréal, and Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
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18
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Bell SA, Donnelly JP, Li W, Davis MA. Hospitalizations for chronic conditions following hurricanes among older adults: A self-controlled case series analysis. J Am Geriatr Soc 2022; 70:1695-1703. [PMID: 35171505 PMCID: PMC9177560 DOI: 10.1111/jgs.17702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND/PURPOSE Extreme events such as hurricanes adversely impact healthcare systems and the communities they serve. The degree to which hurricanes affect healthcare use among high need groups such as older adults with chronic conditions has not been well examined, nor has the impact of hurricane severity on health outcomes. We characterized hospitalizations among older adults by chronic condition after eight large-scale hurricanes in the United States. METHODS Using a combination of administrative healthcare data and the Federal Emergency Management Agency's Disaster Declaration database we conducted a self-controlled case series analysis. We identified Medicare beneficiaries who were exposed to one of eight hurricanes and compared hospitalizations in the 30-days after a hurricane to hospitalizations in the rest of the calendar year of the hurricane. We examined hospitalizations (1) in total, (2) separately for diabetes, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) admissions, and (3) by hurricane damage category. RESULTS Among all older adults exposed, hospitalizations in the 30-day period after each disaster increased for all three chronic conditions; diabetes (incidence rate ratio [IRR] = 1.06, 95% confidence interval [CI] 1.03, 1.10), COPD (IRR = 1.06, 95% CI 1.04, 1.08), and CHF (IRR = 1.19, 95% CI 1.17, 1.21. In the 30-to-60-day period hospitalizations also increased for each chronic condition; diabetes (IRR = 1.06, 95% CI 1.03, 1.10), COPD (IRR = 1.12, 95% CI 1.10, 1.15), and CHF (IRR = 1.32, 95% CI 1.30, 1.34). Substantial differences in hospitalizations were observed according to individual hurricane and by the chronic disease examined. CONCLUSION Exposure to hurricanes is associated with an increase in hospitalizations for chronic conditions across all hurricane damage categories. As disasters are expected to increase in strength and frequency, our results underscore the need for response strategies and health policy planning for healthcare systems designed to address the health needs of older Americans with chronic conditions.
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Affiliation(s)
- Sue Anne Bell
- University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - John P Donnelly
- University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Wang Li
- University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Matthew A Davis
- University of Michigan School of Nursing, Ann Arbor, Michigan, USA
- University of Michigan School of Medicine, Ann Arbor, Michigan, USA
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Tomita A, Ncama BP, Moodley Y, Davids R, Burns JK, Mabhaudhi T, Modi AT, Slotow R. Community disaster exposure and first onset of depression: A panel analysis of nationally representative South African data, 2008-2017. PLOS CLIMATE 2022; 1:0000024. [PMID: 37720892 PMCID: PMC7615093 DOI: 10.1371/journal.pclm.0000024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Sub-Saharan Africa faces unprecedented disasters, with climate change expected to exacerbate the frequency and severity of unpredictable and stressful catastrophic events. Unlike developed nations, reconstruction in developing nations is hindered by resource constraints, with certain communities potentially experiencing multiple and enduring effects of disasters. Despite the potential danger of such cumulative community disaster exposure on mental health (e.g. depression), large-scale population-level evidence for the region is limited. We investigated the association between exposure to cumulative disaster and the first onset of depression in a nationally representative survey in South Africa. We used panel data from the South African National Income Dynamics Study (SA-NIDS) from 2008-2017, consisting of 17,255 adult study participants who were depression free at baseline. Risk of first depression onset between individuals exposed and unexposed to community disaster was measured, accounting for multiple disaster exposure over time by fitting generalized estimating equation (GEE) regression models. Data on the geographic location of disasters were obtained from the South African government gazette, and mapped with the government delineated SA-NIDS households' locations. Of the sampled individuals, 2,986 were exposed to disaster during the study duration (17.3%). Increased cumulative community disaster was significantly associated with the likelihood of depression onset (adjusted relative risk [aRR] = 1.20, p<0.01, 95% CI: 1.09-1.33), even after controlling for socio-demographic factors. In sub-group analyses, greater likelihood of depression onset was found among females [but not in men] (aRR = 1.23, p<0.01, 95% CI: 1.09-1.38), Black African [but not in other population group] (aRR = 1.21, p<0.01, 95% CI: 1.09-1.36), lower education attainment group [but not in tertiary and above educational attainment group] (aRR = 1.20, p<0.01, 95% CI: 1.08-1.33), and lower income attainment group [but not in the top income quartile group] (aRR = 1.24, p<0.01, 95% CI: 1.11-1.38), due to cumulative community disaster. Although cumulative community disaster exposure was significantly associated with the first onset of depression, its negative impact may be more pronounced among individuals considered chronically socially vulnerable (i.e. the groups above) in South Africa. Given that many individuals in South Africa rely on social, food parcel relief, and health services from government/public sector, timely access to community-based supportive intervention is needed for disaster survivors, prioritizing socially vulnerable groups to help mitigate problems associated with mental health challenges.
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Affiliation(s)
- Andrew Tomita
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Busisiwe P. Ncama
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Yoshan Moodley
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa
- Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rashieda Davids
- School of Agricultural, Earth and Environmental Sciences, College of Agriculture, Engineering and Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Jonathan K. Burns
- Institute of Health Research, University of Exeter, Exeter, United Kingdom
- Department of Psychiatry, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Tafadzwanashe Mabhaudhi
- Centre for Transformative Agricultural and Food Systems, School of Agriculture, Earth and Environmental Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
- International Water Management Institute (IWMI-GH)—West Africa Regional Office, Accra, Ghana
| | - Albert T. Modi
- Centre for Transformative Agricultural and Food Systems, School of Agriculture, Earth and Environmental Science, University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Rob Slotow
- School of Life Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Genetics, Evolution and Environment, University College, London, United Kingdom
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Barriers and facilitators to providing home-based care in a pandemic: policy and practice implications. BMC Geriatr 2022; 22:234. [PMID: 35313830 PMCID: PMC8936035 DOI: 10.1186/s12877-022-02907-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/02/2022] [Indexed: 01/07/2023] Open
Abstract
Objective The purpose of this study is to describe the experiences of home-based care providers (HBCP) in providing care to older adults during the pandemic in order to inform future disaster planning, including during pandemics. Design Qualitative inquiry using an abductive analytic approach. Setting and participants Home-based care providers in COVID-19 hotspots. Methods Telephone interviews were conducted with 27 participants (administrators, registered nurses and other members of the allied healthcare team), who provided in-home care during the pandemic in Medicare-certified home health agencies. Interviews focused on eliciting experiences from HBCP on challenges and successes in providing home-based care to older adults, including barriers to care and strategies employed to keep patients, and providers, safe in their homes during the pandemic. Results Data was distilled into four major themes that have potential policy and practice impact. These included disrupted aging-in-place resources, preparedness actions contributing to readiness for the pandemic, limited adaptability in administrative needs during the pandemic and challenges with unclear messaging from public health officials. Conclusions Home-based care plays an essential role in maintaining the health of older adults in disaster contexts, including pandemics. Innovative solutions, informed by policy that generate evidence-based best practices to support HBCP are needed to reduce barriers and increase protective factors, in order to maintain continuity of care for this vulnerable population during disruptive events.
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Sands LP, Do Q, Du P, Pruchno R. Peritraumatic Stress From a Disaster Increases Risk for Onset of Chronic Diseases Among Older Adults. Innov Aging 2022; 6:igab052. [PMID: 34993355 PMCID: PMC8720044 DOI: 10.1093/geroni/igab052] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Indexed: 11/12/2022] Open
Abstract
Background and Objectives Our understanding of the impact of disaster exposure on the physical health of older adults is largely based on hospital admissions for acute illnesses in the weeks following a disaster. Studies of longer-term outcomes have centered primarily on mental health. Missing have been studies examining whether exposure to disaster increases the risk for the onset of chronic diseases. We examined the extent to which 2 indicators of disaster exposure (geographic exposure and peritraumatic stress) were associated with new onset of cardiovascular disease, diabetes, arthritis, and lung disease to improve our understanding of the long-term physical health consequences of disaster exposure. Research Design and Methods We linked self-reported data collected prior to and following Hurricane Sandy from a longitudinal panel study with Medicare data to assess time to new onset of chronic diseases in the 4 years after the hurricane. Results We found that older adults who reported high levels of peritraumatic stress from Hurricane Sandy had more than twice the risk of experiencing a new diagnosis of lung disease, diabetes, and arthritis in the 4 years after the hurricane compared to older adults who did not experience high levels of peritraumatic stress. Geographic proximity to the hurricane was not associated with these outcomes. Analyses controlled for known risk factors for the onset of chronic diseases, including demographic, psychosocial, and health risks. Discussion and Implications Findings reveal that physical health effects of disaster-related peritraumatic stress extend beyond the weeks and months after a disaster and include new onset of chronic diseases that are associated with loss of functioning and early mortality.
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Affiliation(s)
- Laura P Sands
- Center for Gerontology, Virginia Tech, Blacksburg, Virginia, USA
| | - Quyen Do
- Department of Statistics, Virginia Tech, Blacksburg, Virginia,USA
| | - Pang Du
- Department of Statistics, Virginia Tech, Blacksburg, Virginia,USA
| | - Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
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22
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Miller A. What's new in critical illness and injury science? The effect of concomitant natural and manmade disasters on chronic disease exacerbations: COVID-19, armed conflicts, refugee crises and research needs. Int J Crit Illn Inj Sci 2022; 12:1-3. [PMID: 35433393 PMCID: PMC9008291 DOI: 10.4103/ijciis.ijciis_19_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 03/10/2022] [Indexed: 11/29/2022] Open
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23
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The Impact of Natural Hazards on Older Adult Health: Lessons Learned From Hurricane Maria in Puerto Rico. Disaster Med Public Health Prep 2021; 17:e52. [PMID: 34725020 DOI: 10.1017/dmp.2021.305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE With natural hazards increasing in frequency and severity and global population aging, preparedness efforts must evolve to address older adults' risks in disasters. This study elucidates potential contributors to the elevated older adult mortality risk following Hurricane Maria in Puerto Rico through an examination of community stakeholder preparedness, response, and recovery experiences. METHODS In April 2018, qualitative interviews (n = 22) were conducted with stakeholders in 7 Puerto Rican municipalities. Interview transcripts were deductively and inductively coded and analyzed to identify salient topics and themes representing participant response patterns. RESULTS The hurricane's detrimental impact on older adult health emerged as a prominent finding. Through 6 months post-hurricane, many older adults experienced unmet needs that contributed to declining physical and emotional health, inadequate non-communicable disease management, social isolation, financial strain, and excess morbidity and mortality. These needs were predominantly consequences of lengthy public service gaps, unsafe living conditions, interrupted health care, and the incongruence between preparedness and event severity. CONCLUSIONS In a landscape of increasing natural hazard frequency and magnitude, a pattern of older adult risk has become increasingly clear. Study findings compel practitioners to engage in natural hazard preparedness planning, research, and policy-making that considers the multiple facets of older adult well-being.
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Bell SA, Dickey S, Rosemberg MA. "You get three different hats on and try to figure it out:" home based care provision during a disaster. BMC Nurs 2021; 20:155. [PMID: 34461891 PMCID: PMC8406738 DOI: 10.1186/s12912-021-00676-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 08/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Home based care is a vital, and growing, part of the health care system that allows individuals to remain in their homes while still receiving health care. During a disaster, when normal health care systems are disrupted, home based care remains a vital source of support for older adults. The purpose of this paper is to qualitatively understand the barriers and facilitators of both patients and providers that influence the provision of home based care activities in two hurricane affected communities. METHODS Using qualitative inquiry informed by the social ecological model, five focus groups were conducted with home based care providers (n = 25) in two settings affected by Hurricane Irma and Hurricane Harvey. An open-source database of home health agencies participating in Centers for Medicare and Medicaid Services programs was used to identify participants. Data were manually coded and larger themes were generated from recurring ideas and concepts using an abductive analysis approach. RESULTS Twenty five participants were included in one of five focus groups. Of the 22 who responded to the demographic survey, 65 % were registered nurses, 20 % were Licensed Vocational Nurses (LVN), and 15 % were other types of health care providers. 12 % of the sample was male and 88 % was female. Five themes were identified in the analysis: barriers to implementing preparedness plans, adaptability of home based care providers, disasters exacerbate inequalities, perceived unreliability of government and corporations, and the balance between caring for self and family and caring for patients. CONCLUSIONS This study provides qualitative evidence on the factors that influence home based care provision in disaster-affected communities, including the barriers and facilitators faced by both patients and providers in preparing for, responding to and recovering from a disaster. While home based care providers faced multiple challenges to providing care during and after a disaster, the importance of community supports and holistic models of care in the immediate period after the disaster were emphasized. We recommend greater inclusion of home health agencies in the community planning process. This study informs the growing body of evidence on the value of home based care in promoting safety and well-being for older adults during a disaster.
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Affiliation(s)
- Sue Anne Bell
- University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA.
| | - Sarah Dickey
- University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA
| | - Marie-Anne Rosemberg
- University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA
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Quantifying Disaster Impacts on Local Public Health Agency's Leadership, Staffing, and Provision of Essential Public Health Services. Disaster Med Public Health Prep 2021; 16:1552-1557. [PMID: 34396948 DOI: 10.1017/dmp.2021.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The objective of this study is to assess the impact that natural disaster response has on local health departments' (LHD) ability to continue to provide essential public health services. METHODS A web-based survey was sent to all North Carolina Local Health Directors. The survey asked respondents to report on LHD functioning following Hurricanes Florence (2018) and Dorian (2019). RESULTS After Hurricane Florence, the positions who most frequently had regular duties postponed or interrupted were leadership (15 of 48; 31.3%), and professional staff (e.g., nursing and epidemiology: 11 of 48; 22.9%). Staffing shelters for all phases - from disaster response through long-term recovery - was identified as a burden by LHDs, particularly for nursing staff. Approximately 66.6% of LHD jurisdictions opened an Emergency Operations Center (EOC) or activated Incident Command System in response to both hurricanes. If an EOC was activated, the LHD was statistically, significantly more likely to report that normal duties had been interrupted across every domain assessed. CONCLUSIONS The ability of LHDs to perform regular activities and provide essential public health services is impacted by their obligations to support disaster response. Better metrics are needed to measure the impacts to estimate indirect public health impacts of disasters.
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Amberson T, Heagele T, Castner J, Wyte-Lake T, Couig MP, Bell SA, Mammen MJ, Wells V. Social support, educational, and behavioral modification interventions for improving household disaster preparedness in the general community-dwelling population. Hippokratia 2021. [DOI: 10.1002/14651858.cd014934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - Tara Heagele
- Hunter-Bellevue School of Nursing, Hunter College; The City University of New York; New York New York USA
| | - Jessica Castner
- Castner Incorporated; Grand Island New York USA
- Journal of Emergency Nursing; Grand Island New York USA
| | - Tamar Wyte-Lake
- Veterans Emergency Management Evaluation Center; Los Angeles California USA
- Department of Family Medicine; Oregon Health & Science University; Portland Oregon USA
| | - Mary Pat Couig
- College of Nursing; University of New Mexico; Albuquerque New Mexico USA
| | | | - Manoj J Mammen
- State University of New York at Buffalo; Buffalo New York USA
| | - Valerie Wells
- MRC/CSO Social and Public Health Sciences Unit; University of Glasgow; Glasgow UK
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De Rubeis V, Lee J, Anwer MS, Yoshida-Montezuma Y, Andreacchi AT, Stone E, Iftikhar S, Morgenstern JD, Rebinsky R, Neil-Sztramko SE, Alvarez E, Apatu E, Anderson LN. Impact of disasters, including pandemics, on cardiometabolic outcomes across the life-course: a systematic review. BMJ Open 2021; 11:e047152. [PMID: 33941635 PMCID: PMC8098961 DOI: 10.1136/bmjopen-2020-047152] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/27/2021] [Accepted: 03/29/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Disasters are events that disrupt the daily functioning of a community or society, and may increase long-term risk of adverse cardiometabolic outcomes, including cardiovascular disease, obesity and diabetes. The objective of this study was to conduct a systematic review to determine the impact of disasters, including pandemics, on cardiometabolic outcomes across the life-course. DESIGN A systematic search was conducted in May 2020 using two electronic databases, EMBASE and Medline. All studies were screened in duplicate at title and abstract, and full-text level. Studies were eligible for inclusion if they assessed the association between a population-level or community disaster and cardiometabolic outcomes ≥1 month following the disaster. There were no restrictions on age, year of publication, country or population. Data were extracted on study characteristics, exposure (eg, type of disaster, region, year), cardiometabolic outcomes and measures of effect. Study quality was evaluated using the Joanna Briggs Institute critical appraisal tools. RESULTS A total of 58 studies were included, with 24 studies reporting the effects of exposure to disaster during pregnancy/childhood and 34 studies reporting the effects of exposure during adulthood. Studies included exposure to natural (n=35; 60%) and human-made (n=23; 40%) disasters, with only three (5%) of these studies evaluating previous pandemics. Most studies reported increased cardiometabolic risk, including increased cardiovascular disease incidence or mortality, diabetes and obesity, but not all. Few studies evaluated the biological mechanisms or high-risk subgroups that may be at a greater risk of negative health outcomes following disasters. CONCLUSIONS The findings from this study suggest that the burden of disasters extend beyond the known direct harm, and attention is needed on the detrimental indirect long-term effects on cardiometabolic health. Given the current COVID-19 pandemic, these findings may inform public health prevention strategies to mitigate the impact of future cardiometabolic risk. PROSPERO REGISTRATION NUMBER CRD42020186074.
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Affiliation(s)
- Vanessa De Rubeis
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jinhee Lee
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Muhammad Saqib Anwer
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Yulika Yoshida-Montezuma
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Alessandra T Andreacchi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Erica Stone
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Saman Iftikhar
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jason D Morgenstern
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Reid Rebinsky
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sarah E Neil-Sztramko
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- National Collaborating Centre for Methods and Tools, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth Alvarez
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Emma Apatu
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Laura N Anderson
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
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Casey JA, Mango M, Mullendore S, Kiang MV, Hernández D, Li BH, Li K, Im TM, Tartof SY. Trends from 2008 to 2018 in Electricity-dependent Durable Medical Equipment Rentals and Sociodemographic Disparities. Epidemiology 2021; 32:327-335. [PMID: 33591051 PMCID: PMC8140591 DOI: 10.1097/ede.0000000000001333] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Duration and number of power outages have increased over time, partly fueled by climate change, putting users of electricity-dependent durable medical equipment (hereafter, "durable medical equipment") at particular risk of adverse health outcomes. Given health disparities in the United States, we assessed trends in durable medical equipment rental prevalence and individual- and area-level sociodemographic inequalities. METHODS Using Kaiser Permanente South California electronic health record data, we identified durable medical equipment renters. We calculated annual prevalence of equipment rental and fit hierarchical generalized linear models with ZIP code random intercepts, stratified by rental of breast pumps or other equipment. RESULTS 243,559 KPSC members rented durable medical equipment between 2008 and 2018. Rental prevalence increased over time across age, sex, racial-ethnic, and Medicaid categories, most by >100%. In adjusted analyses, Medicaid use was associated with increased prevalence and 108 (95% confidence interval [CI] = 99, 117) additional days of equipment rental during the study period. ZIP code-level sociodemographics were associated with increased prevalence of equipment rentals, for example, a 1 SD increase in percent unemployed and CONCLUSIONS We observed some socioeconomic disparities among a growing electricity-dependent population. Our findings are consistent with the hypothesis that reliable electricity access is increasingly required to meet the health needs of medically disadvantaged groups. See video abstract at http://links.lww.com/EDE/B793.
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Affiliation(s)
- Joan A. Casey
- Columbia University Mailman School of Public Health, New York, NY
| | | | | | - Mathew V. Kiang
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA
| | - Diana Hernández
- Columbia University Mailman School of Public Health, New York, NY
| | - Bonnie H. Li
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Kris Li
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Theresa M. Im
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Sara Y. Tartof
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
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Bell SA, Krienke LK, Dickey S, De Vries RG. "Helping fill that gap:" a qualitative study of aging in place after disaster through the lens of home-based care providers. BMC Geriatr 2021; 21:235. [PMID: 33832424 PMCID: PMC8033697 DOI: 10.1186/s12877-021-02159-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/16/2021] [Indexed: 11/18/2022] Open
Abstract
Background During a disaster, home-based care fills the critical need for continuation of health care. Home-based care is intended to function using existing care delivery models, continuing to provide care for patients wherever they are located, including in shelters and hotels. Home-based care providers are often the closest in contact with their patients —seeing them in place, even throughout a disaster— through which they develop a unique insight into aging in place during a disaster. The purpose of this study was to identify individual and community-level support needs of older adults after a disaster through the lens of home-based care providers. Methods Using qualitative inquiry, five focus groups were conducted with home-based care providers (n = 25) who provided in-home care during Hurricane Irma and Hurricane Harvey. Participants were identified by contacting home health agencies listed in an open-source database of agencies participating in Centers for Medicare and Medicaid Services programs. Data were coded using an abductive analytic approach, and larger themes were generated in light of existing theory. Results The results were distilled into eight themes that related to the importance of community and family, informal and formal supports throughout the disaster management cycle, maintaining autonomy during a disaster, and institutional and systemic barriers to obtaining assistance. Conclusions In this study, home-based care providers described the challenges aging adults face in the response and recovery period after a large-scale disaster including maintaining continuity of care, encouraging individual preparedness, and accessing complex governmental support. Listening to home-based care providers offers new and important insights for developing interventions to address social and health needs for older adults aging in place after a large-scale disaster. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02159-0.
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Affiliation(s)
- Sue Anne Bell
- University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA.
| | | | - Sarah Dickey
- University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA
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Gayle AV, Quint JK, Fuertes EI. Understanding the relationships between environmental factors and exacerbations of COPD. Expert Rev Respir Med 2021; 15:39-50. [PMID: 32713218 DOI: 10.1080/17476348.2020.1801426] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/22/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with a significant health burden both for patients and healthcare systems. Exposure to various environmental factors increases the risk of exacerbations. AREAS COVERED We searched PubMed and assessed literature published within the last 10 years to include epidemiological evidence on the relationships between air pollution, temperature and COPD exacerbation risk as well as the implications of extreme weather events on exacerbations. EXPERT OPINION Ongoing climate change is expected to increase air pollution levels, global temperature and the frequency and severity of extreme weather events, all of which are associated with COPD exacerbations. Further research is needed using patient-focused methodological approaches to better understand and quantify these relationships, so that effective mitigation strategies that decrease the risk of exacerbations can be developed.
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Affiliation(s)
- Alicia V Gayle
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London , London, UK
- Global Real World Evidence, AstraZeneca Plc , Cambridge, UK
| | - Jennifer K Quint
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London , London, UK
| | - Elaine I Fuertes
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London , London, UK
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Bell SA. Practice Informs Research and Research Informs Practice: The Making of a Disaster Nurse Scientist. J Emerg Nurs 2020; 46:553-556. [PMID: 32828474 PMCID: PMC7435282 DOI: 10.1016/j.jen.2020.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Sue Anne Bell
- For correspondence, write: Sue Anne Bell, PhD, FNP-BC, NHDP-BC, University of Michigan School of Nursing, 400 North Ingalls, Rm 4346, Ann Arbor, MI 48109
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