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佛罗里达州热带气旋暴露后老年人的健康差距。

Health disparities among older adults following tropical cyclone exposure in Florida.

机构信息

Institute at Brown for Environment and Society, Brown University, Providence, RI, USA.

Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.

出版信息

Nat Commun. 2023 Apr 19;14(1):2221. doi: 10.1038/s41467-023-37675-7.

Abstract

Tropical cyclones (TCs) pose a significant threat to human health, and research is needed to identify high-risk subpopulations. We investigated whether hospitalization risks from TCs in Florida (FL), United States, varied across individuals and communities. We modeled the associations between all storms in FL from 1999 to 2016 and over 3.5 million Medicare hospitalizations for respiratory (RD) and cardiovascular disease (CVD). We estimated the relative risk (RR), comparing hospitalizations during TC-periods (2 days before to 7 days after) to matched non-TC-periods. We then separately modeled the associations in relation to individual and community characteristics. TCs were associated with elevated risk of RD hospitalizations (RR: 4.37, 95% CI: 3.08, 6.19), but not CVD (RR: 1.04, 95% CI: 0.87, 1.24). There was limited evidence of modification by individual characteristics (age, sex, or Medicaid eligibility); however, risks were elevated in communities with higher poverty or lower homeownership (for CVD hospitalizations) and in denser or more urban communities (for RD hospitalizations). More research is needed to understand the potential mechanisms and causal pathways that might account for the observed differences in the association between tropical cyclones and hospitalizations across communities.

摘要

热带气旋(TC)对人类健康构成重大威胁,需要研究确定高危亚人群。我们调查了美国佛罗里达州(FL)的 TC 是否会导致个体和社区之间的住院风险存在差异。我们分析了 1999 年至 2016 年期间 FL 所有风暴与超过 350 万例医疗保险住院治疗呼吸系统疾病(RD)和心血管疾病(CVD)之间的关联。我们通过比较 TC 期间(前 2 天至后 7 天)和匹配的非 TC 期间的住院情况,估算了相对风险(RR)。然后,我们分别根据个体和社区特征建模关联。TC 与 RD 住院风险升高有关(RR:4.37,95%CI:3.08,6.19),但与 CVD 无关(RR:1.04,95%CI:0.87,1.24)。个体特征(年龄、性别或医疗补助资格)的调整作用有限;然而,在贫困程度较高或住房自有率较低(CVD 住院)或人口密度较高或城市化程度较高的社区(RD 住院),风险较高。需要进一步研究,以了解可能解释热带气旋与社区之间住院关联差异的潜在机制和因果途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d06/10115860/6a42a045f1e1/41467_2023_37675_Fig1_HTML.jpg

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