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Williamson T, Sugg MM, Singh D, Green S, Runkle JD. Crisis response in Texas youth impacted by Hurricane Harvey: A difference-in-differences analysis. J Affect Disord 2024; 359:215-223. [PMID: 38768821 PMCID: PMC11284573 DOI: 10.1016/j.jad.2024.05.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/10/2024] [Accepted: 05/17/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Hurricane Harvey was the second costliest storm to impact the U.S. More research is needed to understand the mental health consequences of these extreme events in children and adolescents extending beyond the acute recovery period. METHODS Daily anonymized Crisis Text Line (CTL) conversations were used to understand patterns in crisis responses for youth one year before and after Harvey's landfall. A quasi-experimental difference-in-differences analysis compared changes in texts for stress/anxiety, depression, thoughts of suicide, and self-harm following Harvey between exposed and unexposed youth in Texas. RESULTS CTL users with Texas-based area codes (N = 23,016) were compriesd largely of youth who self-identified as female (78.1 %), 14-17 year old (50.4 %), white (38.9 %), and LGBTQ+ (51.2 %). We observed parallel increases in crisis texts for depression and thoughts of suicide in most months following Harvey among exposed and unexposed youth. However, non-impacted youth had significantly larger increases in texts for depression up to three months post-Harvey and thoughts of suicide one year after Harvey compared to directly impacted communities. LIMITATIONS Sample size was restricted to texters who completed the post-conversation demographics survey, who may fundamentally differ from those who declined to respond. Harvey exposure was determined using texter area code and county-level disaster declarations, limiting our ability to guarantee individual-level exposure. CONCLUSIONS Texas youth traditionally considered unexposed experienced nearly identical increases in concerns of depression and thoughts of suicide to those directly exposed. Findings suggest spillover effects (e.g., economic concerns, media exposure) may contribute to statewide impacts on youth mental health after natural disasters.
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Affiliation(s)
- Trey Williamson
- North Carolina Institute for Climate Studies, North Carolina State University, 151 Patton Avenue, Asheville, NC 28801, USA
| | - Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, Boone, NC 28607, USA
| | - Devyani Singh
- Research & Impact Team, Crisis Text Line, New York, NY, USA
| | | | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, 151 Patton Avenue, Asheville, NC 28801, USA.
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2
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Flores AB, Sullivan JA, Yu Y, Friedrich HK. Health Disparities in the Aftermath of Flood Events: A Review of Physical and Mental Health Outcomes with Methodological Considerations in the USA. Curr Environ Health Rep 2024; 11:238-254. [PMID: 38605256 DOI: 10.1007/s40572-024-00446-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE OF REVIEW This review applies an environmental justice perspective to synthesize knowledge of flood-related health disparities across demographic groups in the USA. The primary aim is to examine differential impacts on physical and mental health outcomes while also assessing methodological considerations such as flood exposure metrics, baseline health metrics, and community engagement. RECENT FINDINGS In our review (n = 27), 65% and 72% of studies identified racial, ethnic, or socio-economic disparities in physical and mental health outcomes post-flooding, respectively. The majority of racial/ethnic disparities were based on Black race, while most socio-economic disparities were based on lower household income. Forty-two percent of studies lacked flood exposure metrics, but often identified disparities. Common flood exposure metrics included self-reported flooding, flood risk models, and satellite-based observations. Seventy percent of studies lacked baseline health measurements or suitable alternatives, and only 19% incorporated community engagement into their research design. The literature consistently finds that both physical and mental health burdens following flooding are unequally shared across racial, ethnic, and socio-economic groups. These findings emphasize the need for disaster risk reduction policies that address underlying vulnerabilities to flooding, unequal exposure to flooding, and progressive funding for recovery efforts. Findings also underscore the importance of methodological enhancements to facilitate precise assessments of flood exposure and health outcomes.
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Affiliation(s)
- Aaron B Flores
- School of Geographical Sciences & Urban Planning, Arizona State University, Lattie F. Coor Hall, 975 S Myrtle Ave, Tempe, AZ, 85281, USA.
- Urban Climate Research Center, Arizona State University, Tempe, AZ, USA.
| | - Jonathan A Sullivan
- School of Geography, Development & Environment, University of Arizona, Tucson, AZ, 85721, USA
| | - Yilei Yu
- School of Geographical Sciences & Urban Planning, Arizona State University, Lattie F. Coor Hall, 975 S Myrtle Ave, Tempe, AZ, 85281, USA
| | - Hannah K Friedrich
- School of Geography, Development & Environment, University of Arizona, Tucson, AZ, 85721, USA
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3
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Anton B, Cuevas S, Hanson M, Bhutta ZA, Langlois EV, Iaia DG, Gasparri G, Borghi J. Opportunities and challenges for financing women's, children's and adolescents' health in the context of climate change. BMJ Glob Health 2024; 9:e014596. [PMID: 38677778 PMCID: PMC11057322 DOI: 10.1136/bmjgh-2023-014596] [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: 11/19/2023] [Accepted: 03/14/2024] [Indexed: 04/29/2024] Open
Abstract
Women, children and adolescents (WCA), especially in low-income and middle-income countries (LMICs), will bear the worst consequences of climate change during their lifetimes, despite contributing the least to global greenhouse gas emissions. Investing in WCA can address these inequities in climate risk, as well as generating large health, economic, social and environmental gains. However, women's, children's and adolescents' health (WCAH) is currently not mainstreamed in climate policies and financing. There is also a need to consider new and innovative financing arrangements that support WCAH alongside climate goals.We provide an overview of the threats climate change represents for WCA, including the most vulnerable communities, and where health and climate investments should focus. We draw on evidence to explore the opportunities and challenges for health financing, climate finance and co-financing schemes to enhance equity and protect WCAH while supporting climate goals.WCA face threats from the rising burden of ill-health and healthcare demand, coupled with constraints to healthcare provision, impacting access to essential WCAH services and rising out-of-pocket payments for healthcare. Climate change also impacts on the economic context and livelihoods of WCA, increasing the risk of displacement and migration. These impacts require additional resources to support WCAH service delivery, to ensure continuity of care and protect households from the costs of care and enhance resilience. We identify a range of financing solutions, including leveraging climate finance for WCAH, adaptive social protection for health and adaptations to purchasing to promote climate action and support WCAH care needs.
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Affiliation(s)
- Blanca Anton
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Soledad Cuevas
- Instituto de Economía, Geografía y Demografía, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Mark Hanson
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
| | - Zulfiqar Ahmed Bhutta
- Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Etienne V Langlois
- Partnership for Maternal, Newborn and Child Health, World Health Organization, Geneve, Switzerland
| | - Domenico Gerardo Iaia
- Partnership for Maternal, Newborn and Child Health, World Health Organization, Geneve, Switzerland
| | - Giulia Gasparri
- Partnership for Maternal, Newborn and Child Health, World Health Organization, Geneve, Switzerland
| | - Josephine Borghi
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
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4
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Stein PJS, Stein MA, Groce N, Kett M, Akyeampong EK, Alford WP, Chakraborty J, Daniels-Mayes S, Eriksen SH, Fracht A, Gallegos L, Grech S, Gurung P, Hans A, Harpur P, Jodoin S, Lord JE, Macanawai SS, McClain-Nhlapo CV, Mezmur BD, Moore RJ, Muñoz Y, Patel V, Pham PN, Quinn G, Sadlier SA, Shachar C, Smith MS, Van Susteren L. Advancing disability-inclusive climate research and action, climate justice, and climate-resilient development. Lancet Planet Health 2024; 8:e242-e255. [PMID: 38580426 DOI: 10.1016/s2542-5196(24)00024-x] [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: 07/12/2023] [Revised: 11/30/2023] [Accepted: 02/14/2024] [Indexed: 04/07/2024]
Abstract
Globally, more than 1 billion people with disabilities are disproportionately and differentially at risk from the climate crisis. Yet there is a notable absence of climate policy, programming, and research at the intersection of disability and climate change. Advancing climate justice urgently requires accelerated disability-inclusive climate action. We present pivotal research recommendations and guidance to advance disability-inclusive climate research and responses identified by a global interdisciplinary group of experts in disability, climate change, sustainable development, public health, environmental justice, humanitarianism, gender, Indigeneity, mental health, law, and planetary health. Climate-resilient development is a framework for enabling universal sustainable development. Advancing inclusive climate-resilient development requires a disability human rights approach that deepens understanding of how societal choices and actions-characterised by meaningful participation, inclusion, knowledge diversity in decision making, and co-design by and with people with disabilities and their representative organisations-build collective climate resilience benefiting disability communities and society at large while advancing planetary health.
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Affiliation(s)
- Penelope J S Stein
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Michael Ashley Stein
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA.
| | - Nora Groce
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; International Disability Research Centre, University College London, London, UK
| | - Maria Kett
- International Disability Research Centre, University College London, London, UK
| | - Emmanuel K Akyeampong
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Department of African and African American Studies, Harvard University, Cambridge, MA, USA
| | - Willliam P Alford
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Jayajit Chakraborty
- Bren School of Environmental Science and Management, University of California-Santa Barbara, Santa Barbara, CA, USA
| | | | - Siri H Eriksen
- Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - Anne Fracht
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Luis Gallegos
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; The United Nations Institute for Training and Research, Quito, Ecuador
| | - Shaun Grech
- Community Based Inclusive Development Initiative, CBM, Bensheim, Germany
| | - Pratima Gurung
- National Indigenous Disabled Women Association Nepal, Kusunti, Nepal
| | - Asha Hans
- School of Women's Studies, Utkal University, Bhubaneswar, India
| | - Paul Harpur
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; TC Beirne School of Law, University of Queensland, Brisbane, QLD, Australia
| | | | - Janet E Lord
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Center for International and Comparative Law, University of Baltimore, Baltimore, MD, USA
| | | | | | | | - Rhonda J Moore
- All of US Research Program, National Institutes of Health, Washington, DC, USA
| | | | - Vikram Patel
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Department of Global Health and Social Medicine, Harvard Medical School, Cambridge, MA, USA
| | - Phuong N Pham
- Harvard Humanitarian Initiative, Cambridge, MA, USA; Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Gerard Quinn
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Faculty of Law, University of Galway, Galway, Ireland
| | | | - Carmel Shachar
- Health Law and Policy Clinic at the Center for Health Law and Policy Innovation, Harvard Law School, Cambridge, MA, USA
| | - Matthew S Smith
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Lise Van Susteren
- Department of Psychiatry and Behavorial Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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5
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Ahdoot S, Baum CR, Cataletto MB, Hogan P, Wu CB, Bernstein A. Climate Change and Children's Health: Building a Healthy Future for Every Child. Pediatrics 2024; 153:e2023065504. [PMID: 38374809 DOI: 10.1542/peds.2023-065504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/21/2024] Open
Abstract
The warming of our planet matters to every child. Driven by fossil fuel-generated greenhouse gas emissions, climate conditions stable since the founding of modern pediatrics in the mid-nineteenth century have shifted, and old certainties are falling away. Children's physical and mental health are threatened by climate change through its effects on temperature, precipitation, and extreme weather; ecological disruption; and community disruption. These impacts expose and amplify existing inequities and create unprecedented intergenerational injustice. Fossil fuel extraction and combustion cause harm today and reach centuries into the future, jeopardizing the health, safety, and prosperity of today's children and future generations. Appreciating the unique vulnerability of their patients, pediatricians have become leading health advocates for climate actions necessary to protect all living and future children. Policies that reduce reliance on fossil fuels and promote cleaner air, facilitate walking and bicycling, encourage more sustainable diets, increase access to nature, and develop more connected communities lead to immediate gains in child health and equity, and build a foundation for generations of children to thrive.
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Affiliation(s)
- Samantha Ahdoot
- University of Virginia School of Medicine, Charlottesville, Virginia
| | - Carl R Baum
- Section of Pediatric Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Mary Bono Cataletto
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, New York University Long Island School of Medicine, Mineola, New York
| | - Patrick Hogan
- Pediatric Residency Program, Oregon Health & Science University, Portland, Oregon
| | - Christina B Wu
- O'Neill Center for Global and National Health Law, Georgetown University Law Center, Washington, District of Columbia
| | - Aaron Bernstein
- Division of General Pediatrics, Boston Children's Hospital, and Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Ahdoot S, Baum CR, Cataletto MB, Hogan P, Wu CB, Bernstein A. Climate Change and Children's Health: Building a Healthy Future for Every Child. Pediatrics 2024; 153:e2023065505. [PMID: 38374808 DOI: 10.1542/peds.2023-065505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/21/2024] Open
Abstract
Observed changes in temperature, precipitation patterns, sea level, and extreme weather are destabilizing major determinants of human health. Children are at higher risk of climate-related health burdens than adults because of their unique behavior patterns; developing organ systems and physiology; greater exposure to air, food, and water contaminants per unit of body weight; and dependence on caregivers. Climate change harms children through numerous pathways, including air pollution, heat exposure, floods and hurricanes, food insecurity and nutrition, changing epidemiology of infections, and mental health harms. As the planet continues to warm, climate change's impacts will worsen, threatening to define the health and welfare of children at every stage of their lives. Children who already bear higher burden of disease because of living in low-wealth households and communities, lack of access to high quality education, and experiencing racism and other forms of unjust discrimination bear greater risk of suffering from climate change hazards. Climate change solutions, advanced through collaborative work of pediatricians, health systems, communities, corporations, and governments lead to immediate gains in child health and equity and build a foundation for generations of children to thrive. This technical report reviews the nature of climate change and its associated child health effects and supports the recommendations in the accompanying policy statement on climate change and children's health.
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Affiliation(s)
- Samantha Ahdoot
- University of Virginia School of Medicine, Charlottesville, Virginia
| | - Carl R Baum
- Section of Pediatric Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Mary Bono Cataletto
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, New York University Long Island School of Medicine, Mineola, New York
| | - Patrick Hogan
- Pediatric Residency Program, Oregon Health & Science University, Portland, Oregon
| | - Christina B Wu
- O'Neill Center for Global and National Health Law, Georgetown University Law Center, Washington, District of Columbia
| | - Aaron Bernstein
- Division of General Pediatrics, Boston Children's Hospital, and Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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7
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Ortiz R, Kershaw KN, Zhao S, Kline D, Brock G, Jaffee S, Golden SH, Ogedegbe G, Carroll J, Seeman TE, Joseph JJ. Evidence for the Association Between Adverse Childhood Family Environment, Child Abuse, and Caregiver Warmth and Cardiovascular Health Across the Lifespan: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Circ Cardiovasc Qual Outcomes 2024; 17:e009794. [PMID: 38258561 DOI: 10.1161/circoutcomes.122.009794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 09/19/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND This study aimed to quantify the association between childhood family environment and longitudinal cardiovascular health (CVH) in adult CARDIA (Coronary Artery Risk Development in Young Adults) Study participants. We further investigated whether the association differs by adult income. METHODS We applied the CVH framework from the American Heart Association including metrics for smoking, cholesterol, blood pressure, glucose, body mass index, physical activity, and diet. CVH scores (range, 0-14) were calculated at years 0, 7, and 20 of the study. Risky Family environment (range, 7-28) was assessed at year 15 retrospectively, for childhood experiences of abuse, caregiver warmth, and family or household challenges. Complete case ordinal logistic regression and mixed models associated risky family (exposure) with CVH (outcome), adjusting for age, sex, race, and alcohol use. RESULTS The sample (n=2074) had a mean age of 25.3 (±3.5) years and 56% females at baseline. The median risky family was 10 with ideal CVH (≥12) met by 288 individuals at baseline (28.4%) and 165 (16.3%) at year 20. Longitudinally, for every 1-unit greater risky family, the odds of attaining high CVH (≥10) decreased by 3.6% (OR, 0.9645 [95% CI, 0.94-0.98]). Each unit greater child abuse and caregiver warmth score corresponded to 12.8% lower and 11.7% higher odds of ideal CVH (≥10), respectively (OR, 0.872 [95% CI, 0.77-0.99]; OR, 1.1165 [95% CI, 1.01-1.24]), across all 20 years of follow-up. Stratified analyses by income in adulthood demonstrated associations between risky family environment and CVH remained significant for those of the highest adult income (>$74k), but not the lowest (<$35k). CONCLUSIONS Although risky family environmental factors in childhood increase the odds of poor longitudinal adult CVH, caregiver warmth may increase the odds of CVH, and socioeconomic attainment in adulthood may contextualize the level of risk. Toward a paradigm of primordial prevention of cardiovascular disease, childhood exposures and economic opportunity may play a crucial role in CVH across the life course.
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Affiliation(s)
- Robin Ortiz
- Departments of Pediatrics and Population Health, New York University, Grossman School of Medicine (R.O.)
- Institute for Excellence in Health Equity, New York University Langone Health (R.O., G.O.)
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL (K.N.K.)
| | - Songzhu Zhao
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus (S.Z., G.B.)
| | - David Kline
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (D.K.)
| | - Guy Brock
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus (S.Z., G.B.)
| | - Sara Jaffee
- Department of Psychology, The University of Pennsylvania, Philadelphia (S.J.)
| | - Sherita H Golden
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (S.H.G.)
| | - Gbenga Ogedegbe
- Institute for Excellence in Health Equity, New York University Langone Health (R.O., G.O.)
- Department of Medicine, New York University, Grossman School of Medicine (G.O.)
| | - Judith Carroll
- The University of California, Los Angeles, David Geffen School of Medicine, Jane and Terri Semel Institute for Neuroscience and Human Behavior, Cousins Center for Psychoneuroimmunology, Department of Psychiatry and Biobehavioral Sciences (J.C.)
| | - Teresa E Seeman
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (T.E.S.)
| | - Joshua J Joseph
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus (J.J.J.)
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Lindsay S, Hsu S, Ragunathan S, Lindsay J. The impact of climate change related extreme weather events on people with pre-existing disabilities and chronic conditions: a scoping review. Disabil Rehabil 2023; 45:4338-4358. [PMID: 36426560 DOI: 10.1080/09638288.2022.2150328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/16/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE People with disabilities experience a disproportionate impact of extreme weather events and there is a critical need to better understand the impact that climate change has for them. Most previous reviews focus on the risk of acquiring a new disability or injury after a climate-related event and not the impact on people with pre-existing disabilities or chronic conditions, which is the purpose of this study. METHODS We conducted a scoping review while searching seven international databases that identified 45 studies meeting our inclusion criteria. RESULTS The studies included in our review involved 2 337 199 participants with pre-existing disabilities and chronic conditions across 13 countries over a 20-year period. The findings demonstrated the following trends: (1) the impact on physical and mental health; (2) the impact on education and work; (3) barriers to accessing health and community services (i.e., lack of access to services, lack of knowledge about people with disabilities, communication challenges, lack of adequate housing); and (4) coping strategies (i.e., social supports and connecting to resources) and resilience. CONCLUSIONS Our findings highlight the critical need for rehabilitation clinicians and other service providers to explore opportunities to support their clients in preparing for climate-related emergencies.
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Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Shaelynn Hsu
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Sharmigaa Ragunathan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - John Lindsay
- Department of Geography, Environment & Geomatics, University of Guelph, Guelph, Canada
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Li Y, Buendia J, Sears S, Ibrahimovic M, Bertero H, Wiseman R, Bhakta N. Impact of Hurricane Harvey on Inpatient Asthma Hospitalization Visits Within Southeast Texas, 2016-2019. J Occup Environ Med 2023; 65:924-930. [PMID: 37488772 DOI: 10.1097/jom.0000000000002928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
OBJECTIVE The aim of the study is to estimate inpatient asthma hospital visit rates among impacted Texans in Public Health Region 6/5S during the year of and after Hurricane Harvey. METHODS Asthma inpatient hospitalization discharges were collected from the Texas Health Care Information Collection database (2016-2019). RESULTS Females (age-adjusted rates [AARs] = 4.8-5.0) and Black Texans (AARs = 5.0-8.1) experienced significantly higher AARs compared with males and White Texans during the year of and after Harvey. During the year of Hurricane Harvey, females were 1.49 times as likely to have an inpatient asthma visit compared with males, while Black Texans were 2.78 times as likely to have an inpatient asthma hospitalization compared with White Texans. CONCLUSIONS Findings from this study may assist public health professionals and local officials to allocate future resources to the most impacted subgroups as well as establish effective processes to mitigate consequences.
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Affiliation(s)
- Yiyao Li
- From the Health Promotion and Chronic Disease Prevention Section, Department of State Health Services, Austin, Texas
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10
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Pham NK, Do M, Diep J. Factors Associated With Poor Health Outcomes Among Vietnamese Americans After Hurricane Harvey, Houston, Texas, 2018-2019. Public Health Rep 2023; 138:944-954. [PMID: 36703565 PMCID: PMC10576473 DOI: 10.1177/00333549221148169] [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] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Immigrants typically experience poor health outcomes after disasters but are often excluded in disaster studies. We assessed physical and mental health outcomes among Houston-area Vietnamese American residents after Hurricane Harvey and hurricane-related characteristics associated with poor health outcomes. METHODS We conducted in-person structured surveys among 120 Vietnamese Americans from November 2018 through February 2019. We used the physical and mental component scores of the 12-Item Short-Form Health Survey to assess health outcomes. We used descriptive statistics for health outcomes and hurricane-related effects and examined the associations between hurricane-related characteristics and health outcomes. RESULTS Overall mean (95% CI) physical and mental component scores were 39.8 (29.7-49.9) and 32.6 (27.6-37.6), respectively. The odds of poor physical health poststorm were significantly higher among participants reporting ≥5 versus <5 depressive symptoms (odds ratio [OR] = 3.04; 95% CI, 1.11-8.29; P = .03) and significantly lower among participants with versus without health insurance (OR = 0.25; 95% CI, 0.09-0.71; P = .01). The odds of experiencing poor mental health more than a year after the hurricane were significantly higher among those sustaining versus not sustaining a serious injury/illness because of the hurricane (OR = 3.34; 95% CI, 1.12-9.94; P = .03) and among those who were married/partnered versus not married/partnered (OR = 4.16; 95% CI, 1.32-13.07; P = .02). Receiving versus not receiving free health care services after the hurricane and having high versus low levels of acculturation protected against poor mental health (P < .05 for both). CONCLUSIONS Our findings highlight the inequalities of postdisaster health outcomes in this immigrant population and emphasize the need for improved disaster recovery programs that account for these factors.
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Affiliation(s)
- NhuNgoc K. Pham
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Mai Do
- Department of International Health and Sustainable Development, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
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Schiller JH, Bernicker E, Thomas A. Climate Change and Cancer Care-Feeling the Heat. JAMA Oncol 2023; 9:1495-1496. [PMID: 37768656 DOI: 10.1001/jamaoncol.2023.3511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
This Viewpoint describes how climate change and air pollution markedly affect cancer incidence, care delivery, and patient outcomes.
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Affiliation(s)
- Joan H Schiller
- Department of Medicine, University of Virginia, Charlottesville
| | | | - Alexandra Thomas
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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12
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Pham NK, Do M, Diep J. Social support and community embeddedness protect against post-disaster depression among immigrants: a Vietnamese American case study. Front Psychiatry 2023; 14:1075678. [PMID: 37720904 PMCID: PMC10501809 DOI: 10.3389/fpsyt.2023.1075678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 08/09/2023] [Indexed: 09/19/2023] Open
Abstract
Immigrants often face increased vulnerabilities to disaster-related poor health and recovery, compared to mainstream populations. Little is known about Hurricane Harvey's impacts among the storm affected area's large Vietnamese American population. Our study documented diverse psychological experiences and recovery challenges 1 year post-storm among a sample of 120 Vietnamese Americans residing in the Houston, Texas area. Using linear regression modeling, we examined the association between social support and depressive symptom development among these storm-affected Vietnamese Americans. Social support encapsulating both social embeddedness and perceived support was measured by the Louisville Social Support Scale and depressive symptom development was measured by 18 items that assessed emotional distress. These items included loss of appetite, loss of concentration, exposure to persistent pain, and the exhibition of hopelessness, tiredness, sadness, frustration, discouragement, desperation, exhaustion, disgraced, anger, and craziness. We found adverse post-disaster health outcomes, as well as potential avenues to mitigate them, that should be taken into consideration in the design and implementation of inclusive disaster programs. A high level of social support lowered depressive symptomology among Vietnamese Americans post-Hurricane Harvey, even when accounting for Hurricane Harvey-related home damages and injuries/illness. The negative association between social support and depressive symptom development remained after accounting for both post-storm self-rated mental and physical health. Our results suggested that public health practitioners and emergency management entities should prioritize social support resources to foster mental well-being after hurricanes among Vietnamese Americans as future hurricanes are expected to be stronger and more prevalent along the United States Gulf Coast.
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Affiliation(s)
- NhuNgoc K. Pham
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Mai Do
- Department of International Health and Sustainable Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
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13
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Cohen GH, Wang R, Sampson L, Lowe SR, Ettman CK, Abdalla SM, Wellenius GA, Cabral H, Ruggiero K, Galea S. Depression and PTSD among Houston Residents who Experienced Hurricane Harvey and COVID-19: Implications for Urban Areas Affected by Multiple Disasters. J Urban Health 2023; 100:860-869. [PMID: 37550501 PMCID: PMC10447846 DOI: 10.1007/s11524-023-00767-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 08/09/2023]
Abstract
Little is known about the combined impact of the COVID-19 pandemic and other major disasters on mental health. Hurricane Harvey hit the Gulf Coast in 2017, resulting in substantial costs, significant levels of displacement, and approximately 100 deaths, and was followed in 2020 by the COVID-19 pandemic. We randomly sampled 1167 Houstonians from 88 designated super-neighborhoods and surveyed them about their demographics, event-specific traumas and stressors, and symptoms of current depression and post-traumatic stress disorder (PTSD). We estimated the prevalence of depression (5.8%) and PTSD (12.6%) more than three years after Hurricane Harvey, and assessed the relative influence of event-specific stressors and traumas on current mental health. Overall, we observed evidence for two key findings that are salient for residents of urban environments in the context of multiple disasters. First, stressors were primary influences on depression, whereas both stressors and traumas influenced PTSD. Second, the influences of stressors and traumas on depression and PTSD symptoms faded with time.
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Affiliation(s)
- Gregory H Cohen
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Ruochen Wang
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Laura Sampson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sarah R Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Catherine K Ettman
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Salma M Abdalla
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Gregory A Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Howard Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Kenneth Ruggiero
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Sandro Galea
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Dean's Office, Boston University School of Public Health, Boston, MA, USA
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14
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Stimpson JP, Lopez Mercado D, Rivera-González AC, Ortega AN. Trends in Routine Checkup Within the Past Year Following a Hurricane. Disaster Med Public Health Prep 2023; 17:e430. [PMID: 37475480 PMCID: PMC10372726 DOI: 10.1017/dmp.2023.93] [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] [Indexed: 07/22/2023]
Abstract
The goal of this nationally representative, cross-sectional study is to evaluate the trends in routine checkup within the last year associated with exposure to a hurricane. We compared Puerto Rico (2017 Hurricane Irma, Hurricane Maria), Texas (2017 Hurricane Harvey), and Florida (2017 Hurricane Irma, Hurricane 2018 Michael) with states that had a category 1-2 hurricane make landfall from 2014 to 2019: Georgia, Louisiana, Mississippi, North Carolina, and South Carolina. We found that states impacted by a major hurricane in 2017 had a drop in routine checkup while the states that experienced a category 1-2 landfall did have a change in that year. By the following year, all states reported an increase in routine checkup suggesting that the disruption in routine care was temporary.
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Affiliation(s)
- Jim P. Stimpson
- Drexel University Dornsife School of Public Health, Philadelphia, PA
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15
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Deivanayagam TA, English S, Hickel J, Bonifacio J, Guinto RR, Hill KX, Huq M, Issa R, Mulindwa H, Nagginda HP, de Morais Sato P, Selvarajah S, Sharma C, Devakumar D. Envisioning environmental equity: climate change, health, and racial justice. Lancet 2023; 402:64-78. [PMID: 37263280 PMCID: PMC10415673 DOI: 10.1016/s0140-6736(23)00919-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 06/03/2023]
Abstract
Climate change has a broad range of health impacts and tackling climate change could be the greatest opportunity for improving global health this century. Yet conversations on climate change and health are often incomplete, giving little attention to structural discrimination and the need for racial justice. Racism kills, and climate change kills. Together, racism and climate change interact and have disproportionate effects on the lives of minoritised people both within countries and between the Global North and the Global South. This paper has three main aims. First, to survey the literature on the unequal health impacts of climate change due to racism, xenophobia, and discrimination through a scoping review. We found that racially minoritised groups, migrants, and Indigenous communities face a disproportionate burden of illness and mortality due to climate change in different contexts. Second, this paper aims to highlight inequalities in responsibility for climate change and the effects thereof. A geographical visualisation of responsibility for climate change and projected mortality and disease risk attributable to climate change per 100 000 people in 2050 was conducted. These maps visualise the disproportionate burden of illness and mortality due to climate change faced by the Global South. Our third aim is to highlight the pathways through which climate change, discrimination, and health interact in most affected areas. Case studies, testimony, and policy analysis drawn from multidisciplinary perspectives are presented throughout the paper to elucidate these pathways. The health community must urgently examine and repair the structural discrimination that drives the unequal impacts of climate change to achieve rapid and equitable action.
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Affiliation(s)
- Thilagawathi Abi Deivanayagam
- Institute for Global Health, University College London, London, UK; Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
| | - Sonora English
- Institute for Global Health, University College London, London, UK
| | - Jason Hickel
- Institute for Environmental Science and Technology, Autonomous University of Barcelona, Barcelona, Spain; International Inequalities Institute, London School of Economics and Political Science, London, UK
| | - Jon Bonifacio
- Youth Advocates for Climate Action Philippines, Quezon City, Philippines
| | - Renzo R Guinto
- Planetary and Global Health Program, St Luke's Medical Center College of Medicine-William H Quasha Memorial, Quezon City, Philippines
| | - Kyle X Hill
- Department of Indigenous Health, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, USA
| | - Mita Huq
- Institute for Global Health, University College London, London, UK
| | - Rita Issa
- Institute for Global Health, University College London, London, UK; School of International Development, University of East Anglia, Norwich, UK
| | | | | | | | | | - Chetna Sharma
- Institute for Global Health, University College London, London, UK
| | - Delan Devakumar
- Institute for Global Health, University College London, London, UK
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16
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Burrows K, Fong KC, Lowe SR, Fussell E, Bell ML. The impact of residential greenness on psychological distress among Hurricane Katrina survivors. PLoS One 2023; 18:e0285510. [PMID: 37167267 PMCID: PMC10174552 DOI: 10.1371/journal.pone.0285510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/24/2023] [Indexed: 05/13/2023] Open
Abstract
Residential greenness may support mental health among disaster-affected populations; however, changes in residential greenness may disrupt survivors' sense of place. We obtained one pre- and three post-disaster psychological distress scores (Kessler [K]-6) from a cohort (n = 229) of low-income mothers who survived Hurricane Katrina in New Orleans, Louisiana, USA. Greenness was assessed using average growing season Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) in the 300 m around participants' homes at each time point. We used multivariable logistic regressions to evaluate two hypotheses: 1) that cross-sectional greenness (above vs. below median) was associated with reduced psychological distress (K6≥5); and 2) that changes in residential greenness were associated with adverse mental health. When using EVI, we found that a change in level of greenness (i.e., from high to low [high-low], or from low to high [low-high] greenness, comparing pre- and post-Katrina neighborhoods) was associated with increased odds of distress at the first post-storm survey, compared to moving between or staying within low greenness neighborhoods (low-high odds ratio [OR] = 3.48; 95% confidence interval [CI] = 1.40, 8.62 and high-low OR = 2.60; 95% CI: 1.05, 6.42). Results for NDVI were not statistically significant. More research is needed to characterize how residential greenness may impact the health of disaster survivors, and how these associations may change over time.
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Affiliation(s)
- Kate Burrows
- Institute at Brown for Environment and Society, Brown University, Providence, RI, United States of America
| | - Kelvin C Fong
- Department of Earth and Environmental Sciences, Dalhousie University, Halifax, NS, Canada
| | - Sarah R Lowe
- Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, CT, United States of America
| | - Elizabeth Fussell
- Institute at Brown for Environment and Society, Brown University, Providence, RI, United States of America
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, United States of America
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17
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Grineski SE, Collins TW, Chakraborty J. Cascading disasters and mental health inequities: Winter Storm Uri, COVID-19 and post-traumatic stress in Texas. Soc Sci Med 2022; 315:115523. [PMID: 36379161 PMCID: PMC9645098 DOI: 10.1016/j.socscimed.2022.115523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/06/2022] [Accepted: 11/08/2022] [Indexed: 11/11/2022]
Abstract
Previous research on health effects of extreme weather has emphasized heat events even though cold-attributable mortality exceeds heat-attributable mortality worldwide. Little is known about the mental health effects of cold weather events, which often cascade to produce secondary impacts like power outages, leaving a knowledge gap in context of a changing climate. We address that gap by taking a novel "cascading disaster health inequities" approach to examine winter storm-associated post-traumatic stress (PTS) using survey data (n = 790) collected in eight Texas metro areas following Winter Storm Uri in 2021, which occurred against the backdrop of COVID-19. The incidence of storm-related PTS was 18%. Being Black (odds ratio [OR]: 6.6), Hispanic (OR: 3.5), or of another non-White race (OR: 4.2) was associated with greater odds of PTS compared to being White, which indicates substantial racial/ethnic inequities in mental health impacts (all p < 0.05). Having a disability also increased odds of PTS (OR: 4.4) (p < 0.05). Having piped water outages (OR: 1.9) and being highly impacted by COVID-19 (OR: 3.3) increased odds of PTS (both p < 0.05). When modelling how COVID-19 and outages cascaded, we compared householders to those with no outages and low COVID-19 impacts. PTS was more likely (p < 0.05) if householders had a water or power outage and high COVID-19 impacts (OR: 4.4) and if they had water and power outages and high COVID-19 impacts (OR: 7.7). Findings provide novel evidence of racial/ethnic inequities and cascading effects with regard to extreme cold events amid the COVID-19 pandemic.
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Affiliation(s)
- Sara E. Grineski
- University of Utah, 390 1530 E #301,Salt Lake City, UT 84112, USA,Corresponding author
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18
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Ghosh AK, Demetres MR, Geisler BP, Ssebyala SN, Yang T, Shapiro MF, Setoguchi S, Abramson D. Impact of Hurricanes and Associated Extreme Weather Events on Cardiovascular Health: A Scoping Review. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:116003. [PMID: 36448792 PMCID: PMC9710380 DOI: 10.1289/ehp11252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The frequency and destructiveness of hurricanes and related extreme weather events (e.g., cyclones, severe storms) have been increasing due to climate change. A growing body of evidence suggests that victims of hurricanes have increased incidence of cardiovascular disease (CVD), likely due to increased stressors around time of the hurricane and in their aftermath. OBJECTIVES The objective was to systematically examine the evidence of the association between hurricanes (and related extreme weather events) and adverse CVD outcomes with the goal of understanding the gaps in the literature. METHODS A comprehensive literature search of population-level and cohort studies focused on CVD outcomes (i.e., myocardial infarction, stroke, and heart failure) related to hurricanes, cyclones, and severe storms was performed in the following databases from inception to December 2021: Ovid MEDLINE, Ovid EMBASE, Web of Science, and The Cochrane Library. Studies retrieved were then screened for eligibility against predefined inclusion/exclusion criteria. Studies were then qualitatively synthesized based on the time frame of the CVD outcomes studied and special populations that were studied. Gaps in the literature were identified based on this synthesis. RESULTS Of the 1,103 citations identified, 48 met our overall inclusion criteria. We identified articles describing the relationship between CVD and extreme weather, primarily hurricanes, based on data from the United States (42), Taiwan (3), Japan (2), and France (1). Outcomes included CVD and myocardial infarction-related hospitalizations (30 studies) and CVVD-related mortality (7 studies). Most studies used a retrospective study design, including one case-control study, 39 cohort studies, and 4 time-series studies. DISCUSSION Although we identified a number of papers that reported evaluations of extreme weather events and short-term adverse CVD outcomes, there were important gaps in the literature. These gaps included a) a lack of rigorous long-term evaluation of hurricane exposure, b) lack of investigation of hurricane exposure on vulnerable populations regarding issues related to environmental justice, c) absence of research on the exposure of multiple hurricanes on populations, and d) absence of an exploration of mechanisms leading to worsened CVD outcomes. Future research should attempt to fill these gaps, thus providing an important evidence base for future disaster-related policy. https://doi.org/10.1289/EHP11252.
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Affiliation(s)
- Arnab K. Ghosh
- Department of Medicine, Weill Cornell Medical College, Cornell University, New York, New York, USA
| | - Michelle R. Demetres
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, New York, USA
| | - Benjamin P. Geisler
- Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Shakirah N. Ssebyala
- Department of Medicine, Weill Cornell Medical College, Cornell University, New York, New York, USA
| | - Tianyi Yang
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Martin F. Shapiro
- Department of Medicine, Weill Cornell Medical College, Cornell University, New York, New York, USA
| | - Soko Setoguchi
- Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA
| | - David Abramson
- Center of Public Health Disaster Science, School of Global Public Health, New York University, New York, New York, USA
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19
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Friedman RSC, Carpenter DM, Shaver JM, McDermott SC, Voelkel J. Telemedicine Familiarity and Post-Disaster Utilization of Emergency and Hospital Services for Ambulatory Care Sensitive Conditions. Am J Prev Med 2022; 63:e1-e9. [PMID: 35300889 DOI: 10.1016/j.amepre.2021.12.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/15/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION In this study, we examined the association between telemedicine use before a disaster and utilization of emergency or hospital services for ambulatory care sensitive conditions post-disaster. METHODS Difference-in-differences analyses were conducted in 2020‒2021 to assess pre- to post-fire changes in emergency or hospital utilization for 5 ambulatory care sensitive conditions: asthma, diabetes, hypertension, coronary artery disease, and heart failure across all Kaiser Permanente Santa Rosa patients (N=108,113) based on telemedicine utilization before the 2017 Tubbs wildfire. Inverse probability of treatment weighting was employed for cohort balancing across telemedicine familiar status. RESULTS Utilization for any ambulatory care sensitive condition increased from 9.03% pre-fire to 9.45% post-fire across the full cohort. Telemedicine familiarity (ref: not familiar) was associated with decreased absolute risk in pre- to post-fire inpatient and emergency department utilization for 4 conditions: asthma (absolute risk= -1.59%, 95% CI= -2.02%, -1.16%), diabetes (absolute risk= -0.68%, 95% CI= -0.89%, -0.47%), hypertension (absolute risk= -2.07%, 95% CI= -2.44%, -1.71%), and coronary artery disease (absolute risk= -0.43%, 95% CI= -0.61%, -0.24%). Telemedicine familiarity was associated with decreased relative change in pre- to post-fire utilization for 5 conditions: asthma (RRR=0.70, 95% CI=0.64, 0.75), diabetes (RRR=0.54, 95% CI=0.47, 0.63), hypertension (RRR=0.57, 95% CI=0.52, 0.62), heart failure (RRR=0.64, 95% CI=0.50, 0.82), and coronary artery disease (RRR=0.56, 95% CI=0.47, 0.67). Similar results were seen among patients residing in evacuation zones. CONCLUSIONS Telemedicine familiarity pre-fire was associated with decreased inpatient and emergency department utilization for certain ambulatory care sensitive conditions for 1-year post-fire. These results suggest a role for telemedicine in preventing unnecessary emergency and hospital utilization following disasters.
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Affiliation(s)
- Rachel S C Friedman
- Kaiser Permanente Santa Rosa Family Medicine Residency, Santa Rosa, California.
| | - Diane M Carpenter
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Julia M Shaver
- Kaiser Permanente Santa Rosa Family Medicine Residency, Santa Rosa, California
| | - Shannon C McDermott
- Kaiser Permanente Santa Rosa Family Medicine Residency, Santa Rosa, California
| | - Jackson Voelkel
- Kaiser Foundation Health Plan, Utility for Care Data Analysis, Portland, Oregon
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Berberian AG, Gonzalez DJX, Cushing LJ. Racial Disparities in Climate Change-Related Health Effects in the United States. Curr Environ Health Rep 2022; 9:451-464. [PMID: 35633370 PMCID: PMC9363288 DOI: 10.1007/s40572-022-00360-w] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Climate change is causing warming over most parts of the USA and more extreme weather events. The health impacts of these changes are not experienced equally. We synthesize the recent evidence that climatic changes linked to global warming are having a disparate impact on the health of people of color, including children. RECENT FINDINGS Multiple studies of heat, extreme cold, hurricanes, flooding, and wildfires find evidence that people of color, including Black, Latinx, Native American, Pacific Islander, and Asian communities are at higher risk of climate-related health impacts than Whites, although this is not always the case. Studies of adults have found evidence of racial disparities related to climatic changes with respect to mortality, respiratory and cardiovascular disease, mental health, and heat-related illness. Children are particularly vulnerable to the health impacts of climate change, and infants and children of color have experienced adverse perinatal outcomes, occupational heat stress, and increases in emergency department visits associated with extreme weather. The evidence strongly suggests climate change is an environmental injustice that is likely to exacerbate existing racial disparities across a broad range of health outcomes.
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Affiliation(s)
- Alique G Berberian
- Department of Environmental Health Sciences, University of California, 650 Charles E. Young Drive South, 71-259 CHS, Los Angeles, CA, 90095, USA
| | - David J X Gonzalez
- School of Public Health and Department of Environmental Science, Policy, and Management, University of California, Berkeley, CA, USA
| | - Lara J Cushing
- Department of Environmental Health Sciences, University of California, 650 Charles E. Young Drive South, 71-259 CHS, Los Angeles, CA, 90095, USA.
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21
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Aylward B, Cunsolo A, Vriezen R, Harper SL. Climate change is impacting mental health in North America: A systematic scoping review of the hazards, exposures, vulnerabilities, risks and responses. Int Rev Psychiatry 2022; 34:34-50. [PMID: 35584021 DOI: 10.1080/09540261.2022.2029368] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
As climate change progresses, it is crucial that researchers and policymakers understand the ways in which climate-mental health risks arise through interactions between climate hazards, human exposure and social vulnerabilities across time and location. This scoping review systematically examined the nature, range and extent of published research in North America that investigates climate-mental health interactions. Five electronic databases were searched and two independent reviewers applied pre-determined criteria to assess the eligibility of articles identified in the search. Eighty-nine articles were determined to be relevant and underwent data extraction and analysis. The published literature reported on numerous exposure pathways through which acute and chronic climate hazards interacted with social vulnerabilities to increase mental health risks, including wellbeing, trauma, anxiety, depression, suicide and substance use. This review also highlights important gaps within the North American climate-mental health evidence base, including minimal research conducted in Mexico, as well as a lack of studies investigating climate-mental health adaptation strategies and projected future mental health risks. Further research should support effective preparation for and adaptation to the current and future mental health impacts of climate change. Such strategies could reduce health risks and the long-term mental health impacts that individuals and communities experience in a changing climate.
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Affiliation(s)
- Breanne Aylward
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Ashlee Cunsolo
- School of Arctic & Subarctic Studies, Labrador Campus of Memorial University, Happy Valley-Goose Bay, Canada
| | - Rachael Vriezen
- School of Public Health, University of Alberta, Edmonton, Canada
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22
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Carrel M, Clore GS, Kim S, Vaughan Sarrazin M, Tate E, Perencevich EN, Goto M. Health Care Utilization Among Texas Veterans Health Administration Enrollees Before and After Hurricane Harvey, 2016-2018. JAMA Netw Open 2021; 4:e2138535. [PMID: 34889944 PMCID: PMC8665372 DOI: 10.1001/jamanetworkopen.2021.38535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
IMPORTANCE Hurricanes and flooding can interrupt health care utilization. Understanding the magnitude and duration of interruptions, as well as how they vary according to hazard exposure, race, and income, are important for identifying populations in need of greater retention in care. OBJECTIVE To determine how the differential exposure to Hurricane Harvey in August 2017 is associated with changes in utilization of Veterans Health Administration health care. DESIGN, SETTING, AND PARTICIPANTS This is a retrospective cohort analysis of primary care practitioner (PCP) visits, emergency department visits, and inpatient admissions in the Veterans Health Administration among Texas veterans residing in counties impacted by Hurricane Harvey from 2016 to 2018. Data analysis was performed from September 2020 to May 2021. EXPOSURES Residential flooding after Hurricane Harvey. MAIN OUTCOMES AND MEASURES Interrupted time series analysis measured changes in health care utilization over time, stratified by residential flood exposure, race, and income. RESULTS Of the 99 858 patients in the cohort, 89 931 (90.06%) were male, and their median (range) age was 58 (21 to 102) years. Compared with veterans in nonflooded areas, veterans living in flooded areas were more likely to be Black (24 715 veterans [33.80%] vs 4237 veterans [15.85%]) and low-income (14 895 veterans [20.37%] vs 4853 veterans [18.15%]). Rates of PCP visits decreased by 49.78% (95% CI, -64.52% to -35.15%) for veterans in flooded areas and by 45.89% (95% CI, -61.93% to -29.91%) for veterans in nonflooded areas and did not rebound until more than 8 weeks after the hurricane. Rates of PCP visits in flooded areas remained lower than expected for 11 weeks among White veterans (-6.99%; 95% CI, -14.36% to 0.81%) and for 13 weeks among racial minority veterans (-7.22%; 95% CI, -14.11% to 0.30%). Low-income veterans, regardless of flood status, experienced greater suppression of PCP visits in the 8 weeks following the hurricane (-13.72%; 95% CI, -20.51% to -6.68%) compared with their wealthier counterparts (-9.63%; 95% CI, -16.74% to -2.26%). CONCLUSIONS AND RELEVANCE These findings suggest that flood disasters such as Hurricane Harvey may be associated with declines in health care utilization that differ according to flood status, race, and income strata. Patients most exposed to the disaster also had the greatest delay or nonreceipt of care.
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Affiliation(s)
- Margaret Carrel
- Department of Geographical and Sustainability Sciences, University of Iowa, Iowa City
| | - Gosia S. Clore
- Department of Internal Medicine, University of Iowa, Iowa City
- Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, Iowa
| | - Seungwon Kim
- Department of Geographical and Sustainability Sciences, University of Iowa, Iowa City
| | - Mary Vaughan Sarrazin
- Department of Internal Medicine, University of Iowa, Iowa City
- Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, Iowa
| | - Eric Tate
- Department of Geographical and Sustainability Sciences, University of Iowa, Iowa City
| | - Eli N. Perencevich
- Department of Internal Medicine, University of Iowa, Iowa City
- Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, Iowa
| | - Michihiko Goto
- Department of Internal Medicine, University of Iowa, Iowa City
- Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, Iowa
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23
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Bozick R. The effects of Hurricane Harvey on the physical and mental health of adults in Houston. Health Place 2021; 72:102697. [PMID: 34700063 DOI: 10.1016/j.healthplace.2021.102697] [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: 04/29/2021] [Revised: 09/06/2021] [Accepted: 10/08/2021] [Indexed: 10/20/2022]
Abstract
Using data from the 2017-18 Health of Houston Survey, this study estimates the effect of Hurricane Harvey, the second costliest storm in the history of the United States, on the physical and mental health of adults living in Houston, Texas. The survey was fielded to a population-based probability sample whose data collection activities were interrupted and delayed by Hurricane Harvey. This interruption in data collection created a natural experiment that allowed for a comparison of community health before and after the storm. Following the storm, adults in Houston on average experienced an increase of 1.12 days a month of poor physical health and an increase of 1.31 days a month of poor mental health. These effects were most pronounced in parts of the city where structural damage from the storm was most severe.
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Affiliation(s)
- Robert Bozick
- Kinder Institute for Urban Research, Rice University, Kraft Hall, 6100 Main Street, Suite 305, Houston, TX, 77005-1892, USA.
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Ramesh B, Jagger MA, Zaitchik B, Kolivras KN, Swarup S, Deanes L, Gohlke JM. Emergency department visits associated with satellite observed flooding during and following Hurricane Harvey. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:832-841. [PMID: 34267308 PMCID: PMC8448911 DOI: 10.1038/s41370-021-00361-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND Flooding following heavy rains precipitated by hurricanes has been shown to impact the health of people. Earth observations can be used to identify inundation extents for subsequent analysis of health risks associated with flooding at a fine spatio-temporal scale. OBJECTIVE To evaluate emergency department (ED) visits before, during, and following flooding caused by Hurricane Harvey in 2017 in Texas. METHODS A controlled before and after design was employed using 2016-2018 ED visits from flooded and non-flooded census tracts. ED visits between landfall of the hurricane and receding of flood waters were considered within the flood period and post-flood periods extending up to 4 months were also evaluated. Modified Poisson regression models were used to estimate adjusted rate ratios for total and cause specific ED visits. RESULTS Flooding was associated with increased ED visits for carbon monoxide poisoning, insect bite, dehydration, hypothermia, intestinal infectious diseases, and pregnancy complications. During the month following the flood period, the risk for pregnancy complications and insect bite was still elevated in the flooded tracts. SIGNIFICANCE Earth observations coupled with ED visits increase our understanding of the short-term health risks during and following flooding, which can be used to inform preparedness measures to mitigate adverse health outcomes and identify localities with increased health risks during and following flooding events.
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Affiliation(s)
- Balaji Ramesh
- Department of Geography, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | | | - Benjamin Zaitchik
- Morton K. Blaustein Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Korine N Kolivras
- Department of Geography, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Samarth Swarup
- Biocomplexity Institute and Initiative, University of Virginia, Charlottesville, VA, USA
| | - Lauren Deanes
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Julia M Gohlke
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
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Gill S, Sutherland M, Raslan S, McKenney M, Elkbuli A. Natural Disasters Related Traumatic Injuries/Fatalities in the United States and Their Impact on Emergency Preparedness Operations. J Trauma Nurs 2021; 28:186-193. [PMID: 33949355 DOI: 10.1097/jtn.0000000000000581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION From 2015 to 2019, the United States experienced a 17% increase in weather-related disasters. OBJECTIVES We aimed to study the patterns of natural disaster-related traumatic injuries and fatalities across the United States from 2014 to 2019 and to provide recommendations that can serve to mitigate the impact these natural disasters have on trauma patient morbidity and mortality. METHODS A retrospective analysis of the National Safety Council (2014-2019) of natural disaster-related injuries and fatalities was conducted. Descriptive statistics and independent-samples t tests were performed, with significance defined as p < .05. RESULTS Floods produced significantly more mean fatalities per year than tornadoes (118 vs. 33; 95% CI [32.0, 139.0]), wildfires (118 vs. 43, 95% CI [24.8, 155.6]), hurricanes (118 vs. 13, 95% CI [51.5, 159.2]), and tropical storms (118 vs. 15, 95% CI [48.8, 158.2]). Tornadoes produced significantly more mean injuries per year than floods (528 vs. 43, 95% CI [255.9, 715.8]), wildfires (528 vs. 69, 95% CI [227.1, 691.2]), hurricanes (528 vs. 26, 95% CI [270.1, 734.2]), and tropical storms (528 vs. 4, 95% CI [295.9, 753.5]). Southern states experienced greater disaster-related morbidity and mortality over the 6-year study period than other regions with 2,752 injuries and 771 fatalities. CONCLUSIONS The incidence of traumatic injuries and fatalities related to certain natural disasters in the United States has significantly increased from 2014 to 2019. Hospital leaders, public health, emergency preparedness personnel, and policy makers must collaborate to implement protocols and guidelines that ensure adequate training, supplies, and personnel to maintain trauma surge capacity, improve emergency preparedness response, and reduce associated morbidity and mortality.
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Affiliation(s)
- Sabrina Gill
- Division of Trauma and Surgical Critical Care, Department of Surgery, Kendall Regional Medical Center, Miami, Florida (Ms Gill, Messrs Sutherland and Raslan, and Drs McKenney and Elkbuli); and Department of Surgery, University of South Florida, Tampa (Dr McKenney)
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Sheehan MC. Climate Change and Human Well-Being in the 2020s: Lessons From 2020. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2021; 51:281-286. [PMID: 33909535 DOI: 10.1177/00207314211012155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Behind the coronavirus headlines the year 2020 set multiple extreme weather records, including unprecedented wildfires in Australia and California, massive flooding in China, and back-to-back hurricanes in Central America. The impacts on the well-being of local populations have been devastating. We reviewed these extreme weather events, together with the year's newly published climate and health science reports, and identified three important themes for building health resilience in the decade ahead: (1) preparing for greater magnitude and intensity of climate hazards, extreme events, and population health impacts; (2) better anticipating cascading and compound impacts on population well-being, particularly for the most vulnerable; and (3) identifying appropriate, effective preparedness tools and strategies. While decarbonizing the economy is the urgent goal to protect both human and planetary health from a changing climate, 2020 demonstrates that recognizing the likely magnitude and complexity of future extreme weather events, and preparing local public health agencies and communities with the knowledge and tools to respond to them, will be essential in this critical decade.
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Affiliation(s)
- Mary C Sheehan
- 310948Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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Ebi KL, Vanos J, Baldwin JW, Bell JE, Hondula DM, Errett NA, Hayes K, Reid CE, Saha S, Spector J, Berry P. Extreme Weather and Climate Change: Population Health and Health System Implications. Annu Rev Public Health 2021; 42:293-315. [PMID: 33406378 PMCID: PMC9013542 DOI: 10.1146/annurev-publhealth-012420-105026] [Citation(s) in RCA: 156] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Extreme weather and climate events, such as heat waves, cyclones, and floods, are an expression of climate variability. These events and events influenced by climate change, such as wildfires, continue to cause significant human morbidity and mortality and adversely affect mental health and well-being. Although adverse health impacts from extreme events declined over the past few decades, climate change and more people moving into harm's way could alter this trend. Long-term changes to Earth's energy balance are increasing the frequency and intensity of many extreme events and the probability of compound events, with trends projected to accelerate under certain greenhouse gas emissions scenarios. While most of these events cannot be completely avoided, many of the health risks could be prevented through building climate-resilient health systems with improved risk reduction, preparation, response, and recovery. Conducting vulnerability and adaptation assessments and developing health system adaptation plans can identify priority actions to effectively reduce risks, such as disaster risk management and more resilient infrastructure. The risks are urgent, so action is needed now.
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Affiliation(s)
- Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, Washington 98195, USA;
| | - Jennifer Vanos
- School of Sustainability, Arizona State University, Tempe, Arizona 85287, USA
| | - Jane W Baldwin
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, New York 10964, USA
| | - Jesse E Bell
- Department of Environmental, Agricultural, and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska 68198, USA
| | - David M Hondula
- School of Geographical Sciences, Arizona State University, Tempe, Arizona 85287, USA
| | - Nicole A Errett
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington 98195, USA
| | - Katie Hayes
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5S 2S2, Canada
| | - Colleen E Reid
- Geography Department, University of Colorado, Boulder, Colorado 80309, USA
| | - Shubhayu Saha
- Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA
| | - June Spector
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington 98195, USA
- Department of Medicine, School of Medicine, University of Washington, Seattle, Washington 98195, USA
| | - Peter Berry
- Faculty of Environment, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
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Chen S, Bagrodia R, Pfeffer CC, Meli L, Bonanno GA. Anxiety and resilience in the face of natural disasters associated with climate change: A review and methodological critique. J Anxiety Disord 2020; 76:102297. [PMID: 32957002 DOI: 10.1016/j.janxdis.2020.102297] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 12/17/2022]
Abstract
In the past two decades, climate change-related natural disasters, such as hurricanes, floods, and droughts have become increasingly frequent and severe, impacting the emotional and psychological well-being of those who are directly or indirectly exposed to them. Despite great interest in understanding differences in anxiety and resilience in response to natural disasters, enthusiasm appears to outstrip empirical clarity, as there remains considerable ambiguity as to determinants of resilient or pathological outcomes following exposure to natural disasters. In addition, there are several major methodological limitations in climate change and related natural disaster research, including the use of univariate analyses, cross-sectional design, and retrospective measures. Keeping these limitations in mind, we first review literature examining the mental health outcomes of natural disasters. Findings suggest that, overall, resilience is more common than pathological outcomes. Second, we use a multi-dimensional framework of resilience to selectively review factors at the event, individual, as well as family and community levels that could help inform resilient or pathological outcomes. Finally, we consider key limitations and future directions for research and practice in the field of anxiety and resilience in response to climate disasters.
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Affiliation(s)
- Shuquan Chen
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States.
| | - Rohini Bagrodia
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States
| | - Charlotte C Pfeffer
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States
| | - Laura Meli
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States
| | - George A Bonanno
- Department of Clinical and Counseling Psychology, Teachers College, Columbia University, United States.
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