1
|
Käyhkö J, Malmström Nee Jurgilevich A, Räsänen A, Pörsti S, Juhola S. Policy impact pathways of climate-related urban health vulnerability - A retrospective analysis. Health Place 2024; 88:103266. [PMID: 38761638 DOI: 10.1016/j.healthplace.2024.103266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/15/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
Climate change-related health risks are likely to become more prevalent in cities. Cities are also key actors in adaptation to these risks. Adaptation can take place through intentional measures to reduce vulnerability or exposure and unintentionally through other urban policy processes and outcomes. However, complex and dynamic relations between urban policy impacts and vulnerability development are an understudied phenomena. This limits the understanding of how urban climate-related health risks emerge and evolve. We examine urban policy pathways that influence vulnerability to climate-related health impacts with a most similar - most different case study. With a qualitative retrospective analysis of four urban areas in Finland we unveil the mechanism of how urban policy affects urban environment over time and how these impacts and changes shape vulnerability. Contrasting the most different cases, we show that urban policy impacts set differing preconditions to adaptation between local districts. We conclude by suggesting that to adapt to future challenges in cities with respect to social and ecological justice, it is necessary to mainstream adaptation into urban policies with continuous cross-sector and multi-level dialogue about the development of vulnerability.
Collapse
Affiliation(s)
- Janina Käyhkö
- Ecosystems and Environment Research Program, Faculty of Biological and Environmental Sciences, University of Helsinki, P.O. Box 65, Viikinkaari 1, 00014, Finland.
| | - Alexandra Malmström Nee Jurgilevich
- Ecosystems and Environment Research Program, Faculty of Biological and Environmental Sciences, University of Helsinki, P.O. Box 65, Viikinkaari 1, 00014, Finland.
| | - Aleksi Räsänen
- Bioeconomy and Environment Unit, Natural Resources Institute Finland (Luke), Paavo Havaksen tie 3, 90570, Oulu, Finland; Geography Research Unit, University of Oulu, Finland.
| | - Saara Pörsti
- Ecosystems and Environment Research Program, Faculty of Biological and Environmental Sciences, University of Helsinki, P.O. Box 65, Viikinkaari 1, 00014, Finland.
| | - Sirkku Juhola
- Ecosystems and Environment Research Program, Faculty of Biological and Environmental Sciences, University of Helsinki, P.O. Box 65, Viikinkaari 1, 00014, Finland.
| |
Collapse
|
2
|
Lin S, Qi Q, Liu H, Deng X, Trees I, Yuan X, Gallant MP. The Joint Effects of Thunderstorms and Power Outages on Respiratory-Related Emergency Visits and Modifying and Mediating Factors of This Relationship. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:67002. [PMID: 38829734 PMCID: PMC11166412 DOI: 10.1289/ehp13237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 04/27/2024] [Accepted: 05/10/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND While limited studies have evaluated the health impacts of thunderstorms and power outages (POs) separately, few have assessed their joint effects. We aimed to investigate the individual and joint effects of both thunderstorms and POs on respiratory diseases, to identify disparities by demographics, and to examine the modifications and mediations by meteorological factors and air pollution. METHODS Distributed lag nonlinear models were used to examine exposures during three periods (i.e., days with both thunderstorms and POs, thunderstorms only, and POs only) in relation to emergency department visits for respiratory diseases (2005-2018) compared to controls (no thunderstorm/no PO) in New York State (NYS) while controlling for confounders. Interactions between thunderstorms and weather factors or air pollutants on health were assessed. The disparities by demographics and seasons and the mediative effects by particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ) and relative humidity (RH) were also evaluated. RESULTS Thunderstorms and POs were independently associated with total and six subtypes of respiratory diseases in NYS [highest risk ratio (RR) = 1.12; 95% confidence interval (CI): 1.08, 1.17], but the impact was stronger when they co-occurred (highest RR = 1.44; 95% CI: 1.22, 1.70), especially during grass weed, ragweed, and tree pollen seasons. The stronger thunderstorm/PO joint effects were observed on chronic obstructive pulmonary diseases, bronchitis, and asthma (lasted 0-10 d) and were higher among residents who lived in rural areas, were uninsured, were of Hispanic ethnicity, were 6-17 or over 65 years old, and during spring and summer. The number of comorbidities was significantly higher by 0.299-0.782/case. Extreme cold/heat, high RH, PM 2.5 , and ozone concentrations significantly modified the thunderstorm-health effect on both multiplicative and additive scales. Over 35% of the thunderstorm effects were mediated by PM 2.5 and RH. CONCLUSION Thunderstorms accompanied by POs showed the strongest respiratory effects. There were large disparities in thunderstorm-health associations by demographics. Meteorological factors and air pollution levels modified and mediated the thunderstorm-health effects. https://doi.org/10.1289/EHP13237.
Collapse
Affiliation(s)
- Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Albany, New York, USA
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Albany, New York, USA
| | - Quan Qi
- Department of Economics, University at Albany, State University of New York, Albany, New York, USA
| | - Han Liu
- Population Studies and Training Center, Brown University, Providence, Rhode Island, USA
| | - Xinlei Deng
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina, USA
| | - Ian Trees
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland, USA
| | - Xiaojun Yuan
- Department of Information Sciences and Technology, College of Emergency Preparedness, Homeland Security and Cybersecurity, University at Albany, State University of New York, Albany, New York, USA
| | - Mary P. Gallant
- Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| |
Collapse
|
3
|
Yamasaki L, Kamada T, Ng CFS, Takane Y, Nakajima K, Yamaguchi K, Oka K, Honda Y, Kim Y, Hashizume M. Heat-related mortality and ambulance transport after a power outage in the Tokyo metropolitan area. Environ Epidemiol 2024; 8:e292. [PMID: 38617431 PMCID: PMC11008645 DOI: 10.1097/ee9.0000000000000292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 01/02/2024] [Indexed: 04/16/2024] Open
Abstract
Background Air conditioners can prevent heat-related illness and mortality, but the increased use of air conditioners may enhance susceptibility to heat-related illnesses during large-scale power failures. Here, we examined the risks of heat-related illness ambulance transport (HIAT) and mortality associated with typhoon-related electricity reduction (ER) in the summer months in the Tokyo metropolitan area. Methods We conducted event study analyses to compare temperature-HIAT and mortality associations before and after the power outage (July to September 2019). To better understand the role of temperature during the power outage, we then examined whether the temperature-HIAT and mortality associations were modified by different power outage levels (0%, 10%, and 20% ER). We computed the ratios of relative risks to compare the risks associated with various ER values to the risks associated without ER. Results We analyzed the data of 14,912 HIAT cases and 74,064 deaths. Overall, 93,200 power outage cases were observed when the typhoon hit. Event study results showed that the incidence rate ratio was 2.01 (95% confidence interval [CI] = 1.42, 2.84) with effects enduring up to 6 days, and 1.11 (95% CI = 1.02, 1.22) for mortality on the first 3 days after the typhoon hit. Comparing 20% to 0% ER, the ratios of relative risks of heat exposure were 2.32 (95% CI = 1.41, 3.82) for HIAT and 0.95 (95% CI = 0.75, 1.22) for mortality. Conclusions A 20% ER was associated with a two-fold greater risk of HIAT because of summer heat during the power outage, but there was little evidence for the association with all-cause mortality.
Collapse
Affiliation(s)
- Lisa Yamasaki
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Takuma Kamada
- Osaka School of International Public Policy, Osaka University, Osaka, Japan
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuya Takane
- Environmental Management Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Ko Nakajima
- Environmental Management Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Kazuki Yamaguchi
- TEPCO Research Institute, Tokyo Electric Power Company Holdings, Inc, Yokohama, Japan
| | - Kazutaka Oka
- National Institute for Environmental Studies, Ibaraki, Japan
| | - Yasushi Honda
- National Institute for Environmental Studies, Ibaraki, Japan
| | - Yoonhee Kim
- Department of Global Environmental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| |
Collapse
|
4
|
Abstract
Buildings, parks, and roads are all elements of the "built environment," which can be described as the human-made structures that comprise the neighborhoods and communities where people live, work, learn, and recreate (https://www.epa.gov/smm/basic-information-about-built-environment). The design of communities where children and adolescents live, learn, and play has a profound impact on their health. Moreover, the policies and practices that determine community design and the built environment are a root cause of disparities in the social determinants of health that contribute to health inequity. An understanding of the links between the built environment and pediatric health will help to inform pediatricians' and other pediatric health care professionals' care for patients and advocacy on their behalf. This policy statement outlines community design solutions that can improve pediatric physical and mental health, and improve health equity. It describes opportunities for pediatricians and the health care sector to incorporate this knowledge in patient care, as well as to play a role in advancing a health-promoting built environment for all children and families. The accompanying technical report reviews the range of pediatric physical and mental health conditions influenced by the built environment, as well as historical and persistent effects of the built environment on health disparities.
Collapse
Affiliation(s)
- Aparna Bole
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Aaron Bernstein
- Department 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
| | - Michelle J White
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| |
Collapse
|
5
|
Taubman C, Hart A, Hertelendy A, Tin D, Hata R, Ciottone GR. Reviewing the Health Care Impacts of Attacks on Critical Infrastructure. Prehosp Disaster Med 2023; 38:660-667. [PMID: 37548187 DOI: 10.1017/s1049023x23006167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
INTRODUCTION Health care provision depends on reliable critical infrastructure (CI) to power equipment and to provide water for medication and sanitation. Attacks on CI limiting such functions can have a profound and prolonged influence on delivery of care. METHODS A retrospective analysis of the Global Terrorism Database (GTD) was performed of all attacks occurring from 1970-2020. Data were filtered using the internal database search function for all events where the primary target was "Utilities," "Food or Water Supply," and "Telecommunications." For the purposes of this study, the subtype "Food Supply" was excluded. Events were collated based on year, country, region, and numbers killed and wounded. RESULTS The GTD listed 7,813 attacks on CI, with 6,280 of those attacks targeting utilities, leading to 1,917 persons directly killed and 1,377 persons wounded. In total, there were 1,265 attacks targeting telecommunications causing 205 direct deaths and 510 wounded. Lastly, 268 attacks targeted the water supply with 318 directly killed and 261 wounded. Regionally, South America had the most attacks with 2,236, followed by Central America and the Caribbean with 1,390. Based on infrastructure type, the most attacks on utilities occurred in El Salvador (1,061), and the most attacks on telecommunications were in India (140). Peru (46) had the most attacks on its water supply. CONCLUSION The regions with the highest number of total attacks targeting CI have historically been in South America, with more attacks against power and utilities than other infrastructure. Although the numbers of persons directly killed and wounded in these attacks were lower than with other target types, the true impacts on lack of health care delivery are not accounted for in these numbers. By understanding the pattern and scope of these attacks, Counter-Terrorism Medicine (CTM) initiatives can be created to target-harden health care-related infrastructure.
Collapse
Affiliation(s)
- Cara Taubman
- Fellow, BIDMC Disaster Medicine Fellowship; Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Alexander Hart
- Director of Research, BIDMC Disaster Medicine Fellowship; Department of Emergency Medicine, Hartford Hospital; University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Attila Hertelendy
- Director of Research/Director of Innovation and Technology, BIDMC Disaster Medicine Fellowship; Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Derrick Tin
- Director of Counter-Terrorism Medicine, BIDMC Disaster Medicine Fellowship; Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Ryan Hata
- Fellow, BIDMC Disaster Medicine Fellowship; Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Gregory R Ciottone
- Director, BIDMC Disaster Medicine Fellowship; Department of Emergency Medicine, Beth Israel Deaconess Medical Center; Associate Professor, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
6
|
Flores NM, McBrien H, Do V, Kiang MV, Schlegelmilch J, Casey JA. The 2021 Texas Power Crisis: distribution, duration, and disparities. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:21-31. [PMID: 35963946 PMCID: PMC9851928 DOI: 10.1038/s41370-022-00462-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 05/22/2023]
Abstract
BACKGROUND Precipitated by an unusual winter storm, the 2021 Texas Power Crisis lasted February 10 to 27 leaving millions of customers without power. Such large-scale outages can have severe health consequences, especially among vulnerable subpopulations such as those reliant on electricity to power medical equipment, but limited studies have evaluated sociodemographic disparities associated with outages. OBJECTIVE To characterize the 2021 Texas Power Crisis in relation to distribution, duration, preparedness, and issues of environmental justice. METHODS We used hourly Texas-wide county-level power outage data to estimate geographic clustering and association between outage exposure (distribution and duration) and six measures of racial, social, political, and/or medical vulnerability: Black and Hispanic populations, the Centers for Disease Control and Prevention (CDC) Social Vulnerability Index (SVI), Medicare electricity-dependent durable medical equipment (DME) usage, nursing homes, and hospitals. To examine individual-level experience and preparedness, we used a preexisting and non-representative internet survey. RESULTS At the peak of the Texas Power Crisis, nearly 1/3 of customers statewide (N = 4,011,776 households/businesses) lost power. We identified multiple counties that faced a dual burden of racial/social/medical vulnerability and power outage exposure, after accounting for multiple comparisons. County-level spatial analyses indicated that counties where more Hispanic residents resided tended to endure more severe outages (OR = 1.16, 95% CI: 1.02, 1.40). We did not observe socioeconomic or medical disparities. With individual-level survey data among 1038 respondents, we found that Black respondents were more likely to report outages lasting 24+ hours and that younger individuals and those with lower educational attainment were less likely to be prepared for outages. SIGNIFICANCE Power outages can be deadly, and medically vulnerable, socioeconomically vulnerable, and marginalized groups may be disproportionately impacted or less prepared. Climate and energy policy must equitably address power outages, future grid improvements, and disaster preparedness and management.
Collapse
Affiliation(s)
- Nina M Flores
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Heather McBrien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Vivian Do
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Mathew V Kiang
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Jeffrey Schlegelmilch
- National Center for Disaster Preparedness at the Columbia Climate School, Columbia University, New York, NY, USA
| | - Joan A Casey
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| |
Collapse
|
7
|
Tarabochia‐Gast AT, Michanowicz DR, Bernstein AS. Flood Risk to Hospitals on the United States Atlantic and Gulf Coasts From Hurricanes and Sea Level Rise. GEOHEALTH 2022; 6:e2022GH000651. [PMID: 36203949 PMCID: PMC9521195 DOI: 10.1029/2022gh000651] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 08/16/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
Hurricanes have caused major healthcare system disruptions. No systematic assessment of hurricane risk to United States hospital-based healthcare delivery has been performed. Here, we show that 25 of 78 metropolitan statistical areas (MSAs) on the United States Atlantic and Gulf Coasts have half or more of their hospitals at risk of flooding from relatively weak hurricanes. 0.82 m of sea level rise expected within this century from climate change increases the odds of hospital flooding 22%. Furthermore, in 18 MSAs at least half of the roads within 1.6 km of hospitals were at risk of flooding from a category 2 storm. These findings identify previously undescribed risks to hospital-based care delivery in Atlantic and Gulf Coast communities. They suggest that lower intensity hurricanes can have outsized impacts on healthcare access, particularly in places where per capita bed availability is low.
Collapse
Affiliation(s)
- A. T. Tarabochia‐Gast
- Center for Climate, Health and the Global EnvironmentHarvard T.H. Chan School of Public HealthBostonMAUSA
- Department of Family MedicineBoston University School of MedicineBostonMAUSA
| | - D. R. Michanowicz
- Center for Climate, Health and the Global EnvironmentHarvard T.H. Chan School of Public HealthBostonMAUSA
- Physicians, Scientists, and Engineers for Healthy EnergyOaklandCAUSA
| | - A. S. Bernstein
- Center for Climate, Health and the Global EnvironmentHarvard T.H. Chan School of Public HealthBostonMAUSA
- Boston Children's HospitalBostonMAUSA
| |
Collapse
|
8
|
Deng X, Friedman S, Ryan I, Zhang W, Dong G, Rodriguez H, Yu F, Huang W, Nair A, Luo G, Lin S. The independent and synergistic impacts of power outages and floods on hospital admissions for multiple diseases. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 828:154305. [PMID: 35257771 DOI: 10.1016/j.scitotenv.2022.154305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 05/16/2023]
Abstract
Highly destructive disasters such as floods and power outages (PO) are becoming more commonplace in the U.S. Few studies examine the effects of floods and PO on health, and no studies examine the synergistic effects of PO and floods, which are increasingly co-occurring events. We examined the independent and synergistic impacts of PO and floods on cardiovascular diseases, chronic respiratory diseases, respiratory infections, and food-/water-borne diseases (FWBD) in New York State (NYS) from 2002 to 2018. We obtained hospitalization data from the NYS discharge database, PO data from the NYS Department of Public Service, and floods events from NOAA. Distributed lag nonlinear models were used to evaluate the PO/floods-health association while controlling for time-varying confounders. We identified significant increased health risks associated with both the independent effects from PO and floods, and their synergistic effects. Generally, the Rate Ratios (RRs) for the co-occurrence of PO and floods were the highest, followed by PO alone, and then floods alone, especially when PO coverage is >75th percentile of its distribution (1.72% PO coverage). For PO and floods combined, immediate effects (lag 0) were observed for chronic respiratory diseases (RR:1.58, 95%CI: 1.24, 2.00) and FWBD (RR:3.02, 95%CI: 1.60, 5.69), but delayed effects were found for cardiovascular diseases (lag 3, RR:1.13, 95%CI: 1.03, 1.24) and respiratory infections (lag 6, RR:1.85, 95%CI: 1.35, 2.53). The risk association was slightly stronger among females, whites, older adults, and uninsured people but not statistically significant. Improving power system resiliency could be a very effective way to alleviate the burden on hospitals during co-occurring floods. We conclude that PO and floods have independently and jointly led to increased hospitalization for multiple diseases, and more research is needed to confirm our findings.
Collapse
Affiliation(s)
- Xinlei Deng
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, USA
| | - Samantha Friedman
- Department of Sociology, University at Albany, State University of New York, USA
| | - Ian Ryan
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, USA
| | - Wangjian Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Guanghui Dong
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | | | - Fangqun Yu
- School of Public Health and Preventive Medicine, Monash University, Australia
| | - Wenzhong Huang
- School of Public Health and Preventive Medicine, Monash University, Australia
| | - Arshad Nair
- Atmospheric Sciences Research Center, University at Albany, State University of New York, USA
| | - Gan Luo
- Atmospheric Sciences Research Center, University at Albany, State University of New York, USA
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, USA; Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, USA.
| |
Collapse
|
9
|
Sheridan SC, Zhang W, Deng X, Lin S. The individual and synergistic impacts of windstorms and power outages on injury ED visits in New York State. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 797:149199. [PMID: 34346383 DOI: 10.1016/j.scitotenv.2021.149199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/13/2021] [Accepted: 07/18/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND There is little work in assessing the impact of storm events combined with power outage (PO). In this study, we evaluated the individual and synergistic impacts of wind events and PO on overall and subtypes of injuries in New York State (NYS) and by demographics. METHODS The emergency department (ED) visit data were obtained from the NYS Department of Health from November-April 2005-2013 to identify injury cases, length of stay and care costs. Wind event was defined according to high wind, strong wind or thunderstorm wind defined by NOAA. PO occurrence was defined when PO coverage exceeded the 50th percentile of its distribution. By comparing non-event days, we used distributed lag nonlinear models to evaluate the impacts of wind events, PO, and their combined effect on injuries during the cold season over a 0-3-day lag period, while controlling for time-varying confounders. The differences in critical care indicators between event and non-event days were also evaluated. RESULTS Overall injuries ED visits (16,628,812) significantly increased during the wind events (highest Risk Ratio (RR): 1.05; 95% CI: 1.02-1.08), and were highest when wind events cooccurred with PO (highest RR: 1.14; 95% CI: 1.10-1.18), but not during PO alone (RR: 1.00; 95%CI: 0.96-1.04). The increase was also observed with all subgroups through Day 2 after the event. Greater risks exist for older adults (≥65 years) and those on Medicaid. After the joint occurrences of wind events and PO, average visits are 0.2 days longer, and cost 13% more, compared to no wind/no PO days. CONCLUSION There is a significant increase in ED visits, length of stay and cost of injuries during wind events, especially when they coupled with PO and especially among older cases and Medicaid holders. Our findings may be used for planning disaster preparedness and recovery efforts.
Collapse
Affiliation(s)
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xinlei Deng
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA.
| |
Collapse
|
10
|
Skarha J, Gordon L, Sakib N, June J, Jester DJ, Peterson LJ, Andel R, Dosa DM. Association of Power Outage With Mortality and Hospitalizations Among Florida Nursing Home Residents After Hurricane Irma. JAMA HEALTH FORUM 2021; 2:e213900. [PMID: 35977265 PMCID: PMC8796882 DOI: 10.1001/jamahealthforum.2021.3900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/06/2021] [Indexed: 11/14/2022] Open
Abstract
Importance Exposure to hurricanes is associated with increased mortality and morbidity in nursing home (NH) residents, but the factors contributing to these outcomes are less understood. One hypothesized pathway could be power outages from hurricanes that expose NH residents to excess ambient heat. Objective To determine the association of power loss from Hurricane Irma with hospitalization and mortality in NH residents in Florida. Design Setting and Participants This retrospective cohort study of NH residents residing in Florida when Hurricane Irma landed on September 10, 2017, assessed mortality at 7 and 30 days after the storm and hospitalization at 30 days after the storm. The analysis was conducted from May 2, 2021, to June 28, 2021. All NH residents residing in Florida at landfall were eligible (N = 67 273). We excluded those younger than 65 years, missing power status information, or who were evacuated (13 178 [19.6%]). Exposure We used state-administered surveys to determine NH power outage status. Exposed residents experienced a power outage poststorm, whereas unexposed residents did not experience a power outage poststorm. Main Outcomes and Measures We used Medicare claims to assess mortality and hospitalization after Hurricane Irma landfall using generalized linear models with robust standard errors. Results In the aftermath of Hurricane Irma, 27 892 residents (18 510 women [66.4%]; 3906 [14.0%] Black, 1651 [5.9%] Hispanic, and 21 756 [78.0%] White individuals) in 299 NHs were exposed to power loss and 26 203 residents (17 620 women [67.2%]; 4175 [15.9%] Black, 1030 [3.9%] Hispanic, and 20 477 [78.1%] White individuals) in 292 NHs were unexposed. Nursing homes that lost power were similar in size, quality star rating, and type of ownership compared with NHs that did not lose power. Power loss was associated with an increased adjusted odds of mortality among all residents within 7 days (odds ratio [OR],1.25; 95% CI,1.05-1.48) and 30 days (OR, 1.12; 95% CI,1.02-1.23) poststorm and hospitalization within 30 days, although only among residents aged 65 to 74 years (OR, 1.16; 95% CI, 1.03-1.33). Conclusions and Relevance In this cohort study, power loss was associated with higher odds of mortality in all affected NH residents and hospitalization in some residents. The benefits and costs of policies that require NHs to have emergency alternate power sources should be assessed.
Collapse
Affiliation(s)
- Julianne Skarha
- School of Public Health, Brown University, Providence, Rhode Island
| | - Lily Gordon
- School of Public Health, Brown University, Providence, Rhode Island
| | - Nazmus Sakib
- Department of Industrial and Management Systems Engineering, University of South Florida, Tampa
| | - Joseph June
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa
| | - Dylan J. Jester
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa
- Department of Psychiatry, University of California San Diego, La Jolla
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla
| | - Lindsay J. Peterson
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa
| | - Ross Andel
- Florida Policy Exchange Center on Aging, School of Aging Studies, University of South Florida, Tampa
| | - David M. Dosa
- School of Public Health, Brown University, Providence, Rhode Island
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Department of Primary Care, Providence VAMC, Providence, Rhode Island
| |
Collapse
|
11
|
Qu Y, Zhang W, Ye B, Penta S, Dong G, Liu X, Lin S. Power outage mediates the associations between major storms and hospital admission of chronic obstructive pulmonary disease. BMC Public Health 2021; 21:1961. [PMID: 34715823 PMCID: PMC8556928 DOI: 10.1186/s12889-021-12006-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death worldwide with continuous rise. Limited studies indicate that COPD was associated with major storms and related power outages (PO). However, significant gaps remain in understanding what PO's role is on the pathway of major storms-COPD. This study aimed to examine how PO mediates the major storms-COPD associations. METHODS In this time-series study, we extracted all hospital admissions with COPD as the principal diagnosis in New York, 2001-2013. Using distributed lag nonlinear models, the hospitalization rate during major storms and PO was compared to non-major storms and non-PO periods to determine the risk ratios (RRs) for COPD at each of 0-6 lag days respectively after controlling for time-varying confounders and concentration of fine particulate matter (PM2.5). We then used Granger mediation analysis for time series to assess the mediation effect of PO on the major storms-COPD associations. RESULTS The RRs of COPD hospitalization following major storms, which mainly included flooding, thunder, hurricane, snow, ice, and wind, were 1.23 to 1.49 across lag 0-6 days. The risk was strongest at lag3 and lasted significantly for 4 days. Compared with non-outage periods, the PO period was associated with 1.23 to 1.61 higher risk of COPD admissions across lag 0-6 days. The risk lasted significantly for 2 days and was strongest at lag2. Snow, hurricane and wind were the top three contributors of PO among the major storms. PO mediated as much as 49.6 to 65.0% of the major storms-COPD associations. CONCLUSIONS Both major storms and PO were associated with increased hospital admission of COPD. PO mediated almost half of the major storms-COPD hospitalization associations. Preparation of surrogate electric system before major storms is essential to reduce major storms-COPD hospitalization.
Collapse
Affiliation(s)
- Yanji Qu
- Guangdong Cardiovascular Institute, WHO Collaborating Center for Research and Training in Cardiovascular Diseases, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
- Department of Environmental Health Sciences, University at Albany, State University of New York, New York, NY, USA
| | - Wangjian Zhang
- Department of Environmental Health Sciences, University at Albany, State University of New York, New York, NY, USA
| | - Bo Ye
- Department of Epidemiology and Biostatistics, University at Albany, State University of New York, New York, NY, USA
| | - Samantha Penta
- College of Emergency Preparedness, Homeland Security and Cybersecurity, University at Albany, State University of New York, New York, NY, USA
| | - Guanghui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoqing Liu
- Guangdong Cardiovascular Institute, WHO Collaborating Center for Research and Training in Cardiovascular Diseases, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, New York, NY, USA.
- Department of Epidemiology and Biostatistics, University at Albany, State University of New York, New York, NY, USA.
| |
Collapse
|
12
|
McDermott-Levy R, Scolio M, Shakya KM, Moore CH. Factors That Influence Climate Change-Related Mortality in the United States: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158220. [PMID: 34360518 PMCID: PMC8345936 DOI: 10.3390/ijerph18158220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/23/2021] [Accepted: 07/29/2021] [Indexed: 12/02/2022]
Abstract
Global atmospheric warming leads to climate change that results in a cascade of events affecting human mortality directly and indirectly. The factors that influence climate change-related mortality within the peer-reviewed literature were examined using Whittemore and Knafl’s framework for an integrative review. Ninety-eight articles were included in the review from three databases—PubMed, Web of Science, and Scopus—with literature filtered by date, country, and keywords. Articles included in the review address human mortality related to climate change. The review yielded two broad themes in the literature that addressed the factors that influence climate change-related mortality. The broad themes are environmental changes, and social and demographic factors. The meteorological impacts of climate change yield a complex cascade of environmental and weather events that affect ambient temperatures, air quality, drought, wildfires, precipitation, and vector-, food-, and water-borne pathogens. The identified social and demographic factors were related to the social determinants of health. The environmental changes from climate change amplify the existing health determinants that influence mortality within the United States. Mortality data, national weather and natural disaster data, electronic medical records, and health care provider use of International Classification of Disease (ICD) 10 codes must be linked to identify climate change events to capture the full extent of climate change upon population health.
Collapse
Affiliation(s)
- Ruth McDermott-Levy
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA 19085, USA
- Correspondence:
| | - Madeline Scolio
- Department of Geography and the Environment, Villanova University, Villanova, PA 19085, USA; (M.S.); (K.M.S.)
| | - Kabindra M. Shakya
- Department of Geography and the Environment, Villanova University, Villanova, PA 19085, USA; (M.S.); (K.M.S.)
| | - Caroline H. Moore
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA 30341, USA;
| |
Collapse
|
13
|
Xiao J, Zhang W, Huang M, Lu Y, Lawrence WR, Lin Z, Primeau M, Dong G, Liu T, Tan W, Ma W, Meng X, Lin S. Increased risk of multiple pregnancy complications following large-scale power outages during Hurricane Sandy in New York State. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 770:145359. [PMID: 33736412 DOI: 10.1016/j.scitotenv.2021.145359] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/11/2021] [Accepted: 01/17/2021] [Indexed: 05/02/2023]
Abstract
BACKGROUND Large-scale power outages (PO) are increasing in the context of climate change. Although some research has been conducted into the adverse health impacts of POs, significant gaps remain regarding whether POs would affect the health of pregnant women. We investigated the association between ED visits due to pregnancy complications and the occurence, intensity, and duration of large-scale POs in eight Sandy-affected counties in New York State (NYS). METHODS In this cross-sectional study, daily ED visits for pregnancy complications and large-scale PO data in eight counties in NYS from October to December in 2005-2014 were collected. Using time-series analysis, we estimated the relative increase in ED visits for pregnancy complications during POs compared with non-PO periods at lag 0-7 days. Short-term health impacts of PO intensity and PO duration were investigated. Estimations were also stratified by sociodemographic characteristics and disease subtypes including threatened or spontaneous abortion, threatened or early labor, hypertension complications, infections of genitourinary tract, renal diseases, gestational diabetes mellitus, mental illnesses, and cardiovascular diseases during pregnancy. RESULTS From October to December in 2005-2014, there were 307,739 ED visits for pregnancy complications in the eight counties. We found significant increases in ED visits for overall pregnancy complications (16.6%, 95% confidence interval [CI]: 10.3%, 23.2%) during the Hurricane-PO period at lag 0-7 days. The ED visits increased by 8.8% per level increase in PO intensity and 1.4% per day increase in PO duration. Specifically, threatened/early delivery and gestational diabetes mellitus during the PO period increased by 26.7% (95% CI: 8.2%, 48.4%) and 111.8% (95% CI: 16.7%, 284.4%), respectively. Young adult, Black, Hispanic, and uninsured individuals were at higher risk of complications. CONCLUSIONS POs may adversely impact pregnancy, especially for certain pregnancy complications and among low sociodemographic women.
Collapse
Affiliation(s)
- Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China; Department of Occupational Health and Occupational Medicine, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Wangjian Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA
| | - Miaoling Huang
- Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Yi Lu
- Department of Health Law, Policy, Management, School of Public Health, Boston University, Boston, MA 02118, USA
| | - Wayne R Lawrence
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Albany, NY 12144, USA
| | - Ziqiang Lin
- Department of Psychiatry, New York University Langone Health School of Medicine, New York, NY 10016, USA
| | - Michael Primeau
- Office of Health Emergency Preparedness, New York State Department of Health, Albany, NY 12237, USA
| | - Guanghui Dong
- Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Weihong Tan
- The Reproductive Medicine and Genetic Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi 530021, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Xiaojing Meng
- Department of Occupational Health and Occupational Medicine, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China.
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA; Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Albany, NY 12144, USA.
| |
Collapse
|
14
|
Lin S, Zhang W, Sheridan S, Mongillo M, DiRienzo S, Stuart NA, Stern EK, Birkhead G, Dong G, Wu S, Chowdhury S, Primeau MJ, Hao Y, Romeiko XX. The immediate effects of winter storms and power outages on multiple health outcomes and the time windows of vulnerability. ENVIRONMENTAL RESEARCH 2021; 196:110924. [PMID: 33689823 DOI: 10.1016/j.envres.2021.110924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/09/2021] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND While most prior research has focused on extreme heat, few assessed the immediate health effects of winter storms and associated power outages (PO), although severe storms have become more frequent. This study evaluates the joint and independent health effects of winter storms and PO, snow versus ice-storm, effects by time window (peak timing, winter/transitional months) and the impacts on critical care indicators including numbers of comorbidity, procedure, length of stay and cost. METHODS We use distributed lag nonlinear models to assess the impacts of winter storm/PO on hospitalizations due to cardiovascular, lower respiratory diseases (LRD), respiratory infections, food/water-borne diseases (FWBD) and injuries in New York State on 0-6 lag days following storm/PO compared with non-storm/non-PO periods (references), while controlling for time-varying factors and PM2.5. The storm-related hospitalizations are described by time window. We also calculate changes in critical care indicators between the storm/PO and control periods. RESULTS We found the joint effects of storm/PO are the strongest (risk ratios (RR) range: 1.01-1.90), followed by that of storm alone (1.02-1.39), but not during PO alone. Ice storms have stronger impacts (RRs: 1.04-3.15) than snowstorms (RRs: 1.03-2.21). The storm/PO-health associations, which occur immediately, and some last a whole week, are stronger in FWBD, October/November, and peak between 3:00-8:00 p.m. Comorbidity and medical costs significantly increase after storm/PO. CONCLUSION Winter storms increase multiple diseases, comorbidity and medical costs, especially when accompanied by PO or ice storms. Early warnings and prevention may be critical in the transitional months and afternoon rush hours.
Collapse
Affiliation(s)
- Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA.
| | - Wangjian Zhang
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Scott Sheridan
- Department of Geography, Kent State University, Kent, OH, USA
| | - Melanie Mongillo
- Department of Health Policy, Management and Behavior, University at Albany, State University of New York, Rensselaer, NY, USA
| | | | | | - Eric K Stern
- College of Emergency Preparedness, Homeland Security, and Cyber-Security, University at Albany, State University of New York, Albany, NY, USA
| | - Guthrie Birkhead
- Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, USA
| | - Guanghui Dong
- Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | | | - Michael J Primeau
- Office of Health Emergency Preparedness, New York State Department of Health, Albany, NY, USA
| | - Yuantao Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaobo X Romeiko
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA
| |
Collapse
|
15
|
Zhang W, Sheridan SC, Birkhead GS, Croft DP, Brotzge JA, Justino JG, Stuart NA, Du Z, Romeiko XX, Ye B, Dong G, Hao Y, Lin S. Power Outage: An Ignored Risk Factor for COPD Exacerbations. Chest 2020; 158:2346-2357. [PMID: 32502591 PMCID: PMC7768937 DOI: 10.1016/j.chest.2020.05.555] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 04/06/2020] [Accepted: 05/03/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND COPD is the third leading cause of death in the United States, with 16 million Americans currently experiencing difficulty with breathing. Power outages could be life-threatening for those relying on electricity. However, significant gaps remain in understanding the potential impact of power outages on COPD exacerbations. RESEARCH QUESTION The goal of this study was to determine how power outages affect COPD exacerbations. STUDY DESIGN AND METHODS Using distributed lag nonlinear models controlling for time-varying confounders, the hospitalization rate during a power outage was compared vs non-outage periods to determine the rate ratio (RR) for COPD and its subtypes at each of 0 to 6 lag days in New York State from 2001 to 2013. Stratified analyses were conducted according to sociodemographic characteristics, season, and clinical severity; changes were investigated in numerous critical medical indicators, including length of stay, hospital cost, the number of comorbidities, and therapeutic procedures between the two periods. RESULTS The RR of COPD hospitalization following power outages ranged from 1.03 to 1.39 across lag days. The risk was strongest at lag0 and lag1 days and lasted significantly for 7 days. Associations were stronger for the subgroup with acute bronchitis (RR, 1.08-1.69) than for cases of acute exacerbation (RR, 1.03-1.40). Compared with non-outage periods, the outage period was observed to be $4.67 thousand greater in hospital cost and 1.38 greater in the number of comorbidities per case. The average cost (or number of comorbidities) was elevated in all groups stratified according to cost (or number of comorbidities). In contrast, changes in the average length of stay (-0.43 day) and the average number of therapeutic procedures (-0.09) were subtle. INTERPRETATION Power outages were associated with a significantly elevated rate of COPD hospitalization, as well as greater costs and number of comorbidities. The average cost and number of comorbidities were elevated in all clinical severity groups.
Collapse
Affiliation(s)
- Wangjian Zhang
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY
| | | | - Guthrie S Birkhead
- Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY
| | - Daniel P Croft
- Department of Medicine, University of Rochester Medical Center, Rochester, NY
| | - Jerald A Brotzge
- New York State Mesonet, College of Arts and Sciences, State University of New York, Albany, NY
| | - John G Justino
- Center for Global Health, University at Albany, State University of New York, Rensselaer, NY
| | | | - Zhicheng Du
- Department of Medical Statistics and Epidemiology, University at Albany, State University of New York, Rensselaer, NY
| | - Xiaobo X Romeiko
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY
| | - Bo Ye
- Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY
| | - Guanghui Dong
- Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuantao Hao
- Department of Medical Statistics and Epidemiology, University at Albany, State University of New York, Rensselaer, NY
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY.
| |
Collapse
|
16
|
Casey JA, Fukurai M, Hernández D, Balsari S, Kiang MV. Power Outages and Community Health: a Narrative Review. Curr Environ Health Rep 2020; 7:371-383. [PMID: 33179170 PMCID: PMC7749027 DOI: 10.1007/s40572-020-00295-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE OF REVIEW Power outages, a common and underappreciated consequence of natural disasters, are increasing in number and severity due to climate change and aging electricity grids. This narrative review synthesizes the literature on power outages and health in communities. RECENT FINDINGS We searched Google Scholar and PubMed for English language studies with titles or abstracts containing "power outage" or "blackout." We limited papers to those that explicitly mentioned power outages or blackouts as the exposure of interest for health outcomes among individuals living in the community. We also used the reference list of these studies to identify additional studies. The final sample included 50 articles published between 2004 and 2020, with 17 (34%) appearing between 2016 and 2020. Exposure assessment remains basic and inconsistent, with 43 (86%) of studies evaluating single, large-scale power outages. Few studies used spatial and temporal control groups to assess changes in health outcomes attributable to power outages. Recent research linked data from electricity providers on power outages in space and time and included factors such as number of customers affected and duration to estimate exposure. The existing literature suggests that power outages have important health consequences ranging from carbon monoxide poisoning, temperature-related illness, gastrointestinal illness, and mortality to all-cause, cardiovascular, respiratory, and renal disease hospitalizations, especially for individuals relying on electricity-dependent medical equipment. Nonetheless the studies are limited, and more work is needed to better define and capture the relevant exposures and outcomes. Studies should consider modifying factors such as socioeconomic and other vulnerabilities as well as how community resiliency can minimize the adverse impacts of widespread major power outages.
Collapse
Affiliation(s)
- Joan A Casey
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Mihoka Fukurai
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Diana Hernández
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Satchit Balsari
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
- FXB Center for Health and Human Rights, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Mathew V Kiang
- FXB Center for Health and Human Rights, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
17
|
Abstract
Purpose of Review Climate change has direct impacts on human health, but those impacts vary widely by location. Local health impacts depend on a large number of factors including specific regional climate impacts, demographics and human vulnerabilities, and existing local adaptation capacity. There is a need to incorporate local data and concerns into climate adaptation plans and evaluate different approaches. Recent Findings The Centers for Disease Control and Prevention (CDC) has provided funding, technical assistance, and an adaptation framework to assist localities with climate planning and activities. The differing processes with which states, cities, and tribes develop and implement adaptation plans have been observed. We outline examples of the implementation of CDC’s framework and activities for local adaptation, with a focus on case studies at differing jurisdictional levels (a state, a city, and a sovereign tribe). Summary The use of local considerations and data are important to inform climate adaptation. The adaptable implementation of CDC’s framework is helping communities protect health.
Collapse
|
18
|
Towards Self-Sustainable Island Grids through Optimal Utilization of Renewable Energy Potential and Community Engagement. ENERGIES 2020. [DOI: 10.3390/en13133386] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Solving the issue of energy security for geographical islands presents a one-of-a-kind problem that has to be tackled from multiple sides and requires an interdisciplinary approach that transcends just technical and social aspects. With many islands suffering in terms of limited and costly energy supply due to their remote location, providing a self-sustainable energy system is of utmost importance for these communities. In order to improve upon the status quo, novel solutions and projects aimed at increasing sustainability not only have to consider optimal utilization of renewable energy potentials in accordance with local conditions, but also must include active community participation. This paper analyzes both of these aspects for island communities and brings them together in an optimization scenario that is utilized to determine the relationship between supposed demand flexibility levels and achievable savings in a setting with variable renewable generation. The results, specifically discussed for a use case with real-world data for the La Graciosa island in Spain, show that boosting community participation and thus unlocking crucial demand flexibility, can be used as a powerful tool to augment novel generation technologies with savings from flexibility at around 7.5% of what is achieved purely by renewable sources.
Collapse
|
19
|
Jessel S, Sawyer S, Hernández D. Energy, Poverty, and Health in Climate Change: A Comprehensive Review of an Emerging Literature. Front Public Health 2019; 7:357. [PMID: 31921733 PMCID: PMC6920209 DOI: 10.3389/fpubh.2019.00357] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 11/11/2019] [Indexed: 11/25/2022] Open
Abstract
Household energy is increasingly vital for maintaining good health. Unaffordable and inadequate household energy presents adverse consequences that are amplified by poverty and a changing climate. To date, the connections between energy, socioeconomic disadvantage, and well-being are generally underappreciated, and household energy connection with climate change is under-researched. Building on the energy insecurity framework, this review explores literature related to household energy, poverty, and health in order to highlight the disproportionate burdens borne by vulnerable populations in adequately meeting household energy needs. This paper is based on a comprehensive review of books, peer-reviewed articles, and reports published between 1990 and 2019, identified via databases including JSTOR and PubMed. A total of 406 publications were selected as having potential for full review, 203 received full review, and 162 were included in this paper on the basis of set inclusion criteria. From the literature review, we created an original heuristic model that describes energy insecurity as either acute or chronic, and we further explore the mediators and pathways that link energy insecurity to health. In the discussion, we posit that the extant literature does not sufficiently consider that vulnerable communities often experience energy insecurity bundled with other hardships. We also discuss energy, poverty, and health through the lens of climate change, making the criticism that most research on household energy does not consider climate change. This evidence is important for enhancing research in this field and developing programmatic and policy interventions as they pertain to energy access, affordability, and health, with special emphasis on vulnerable populations, climate change, and social inequality.
Collapse
Affiliation(s)
- Sonal Jessel
- Helibrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, United States
| | - Samantha Sawyer
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, United States
| | - Diana Hernández
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, United States
| |
Collapse
|
20
|
Dominianni C, Ahmed M, Johnson S, Blum M, Ito K, Lane K. Power Outage Preparedness and Concern among Vulnerable New York City Residents. J Urban Health 2018; 95:716-726. [PMID: 30051238 PMCID: PMC6181821 DOI: 10.1007/s11524-018-0296-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Power outages can impact health, and certain populations may be more at risk. Personal preparedness may reduce impacts, but information on power outage preparedness and risk perception among vulnerable populations is limited. We examined power outage preparedness and concern among New York City residents, including vulnerable populations defined as older adults (≥ 65 years), and respondents with household members who require assistance with daily activities or depend on electric medical devices. A random sample telephone survey was conducted during November-December 2016. Preparedness was defined as having a three-day supply of drinking water, non-perishable food, and a working flashlight. Among all respondents (n = 887), 58% were prepared and 46% expressed concern about health. Respondents with electric-dependent household members (9% of all respondents) tended to have higher preparedness (70 vs. 56% of respondents without electric-dependent household members). Among this group, only 40% reported being registered with a utility company to receive early notification of outages. While the subgroup sample was small, respondents with registered electric-dependent household members had lower preparedness than those with non-registered users (59 vs. 76%). Respondents with household members who needed assistance had comparable levels of preparedness to respondents without someone who needed assistance (59 vs. 57%). Older adults had greater preparedness than younger adults (65 vs. 56%). Health concerns were greater among all vulnerable groups than the general population. Levels of preparedness varied among vulnerable respondents, and awareness of power outage notification programs was low. Our findings highlight the need to increase awareness and preparedness among at-risk people.
Collapse
Affiliation(s)
- Christine Dominianni
- Division of Environmental Health, New York City Department of Health and Mental Hygiene, New York, NY, USA.
| | - Munerah Ahmed
- Division of Environmental Health, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Sarah Johnson
- Division of Environmental Health, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Micheline Blum
- Baruch College Survey Research, Marxe School of Public and International Affairs, Baruch College, City University of New York, New York, NY, USA
| | - Kazuhiko Ito
- Division of Environmental Health, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Kathryn Lane
- Division of Environmental Health, New York City Department of Health and Mental Hygiene, New York, NY, USA
| |
Collapse
|