The Long-Run Impacts of Natural Disasters on Mortality and Disease Burden Among US Elderly and Disabled Adults

自然灾害对美国老年人和残疾人死亡率和疾病负担的长期影响

• 批准号: 10448360
• 负责人: Tatyana Deryugina
• 金额: $ 32.67万
• 依托单位: NATIONAL BUREAU OF ECONOMIC RESEARCH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-15 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10448360
• 关键词: Adult; Affect; Age; Alzheimer' s Disease; Area; Behavior; Cessation of life; Characteristics; Chronic; Chronic Disease; Code; Communities; Community Participation; Continuity of Patient Care; Control Groups; Data; Data Sources; Databases; Dementia; Diagnosis; Digit structure; Dimensions; Disabled Persons; Disasters; Disease; Disease Progression; Economics; Elderly; Event; Excess Mortality; Exhibits; Expenditure; Floods; Frequencies; Government; Health; Health care facility; Healthcare; Hurricane; Income; Individual; Insurance; Local Government; Location; Low income; Machine Learning; Mediating; Medicaid eligibility; Medical; Medicare; Medicare claim; Morbidity - disease rate; Natural Disasters; Obesity; Outcome; Personal Satisfaction; Persons; Physicians; Policies; Population; Preparation; Prevalence; Proxy; Public Health; Public Policy; Race; Readiness; Recording of previous events; Records; Research; Research Personnel; Risk; Role; Running; Sampling; Sampling Errors; Severities; Source; Surveys; System; Time; Tornadoes; Vulnerable Populations; age related; base; beneficiary; burden of illness; climate change; cost; design; disability; hazard; health care availability; health plan; improved; mortality; programs; residence; resilience; response; sex; trait; treatment group; trend

OTHER PROJECT INFORMATION – Project Summary/Abstract The Long-run Impacts of Natural Disasters on Mortality and Disease Burden among US Elderly and Disabled Adults Natural disasters have increased in frequency and severity in recent decades, a trend projected to intensify under climate change. The risks these disasters pose to individual health and well-being are heightened among older adults with age-related disabilities or chronic illness, such as those living with Alzheimer’s disease or dementia. Public policies regarding disaster preparedness and response serve an important role in avoiding or reducing the health impacts of disasters and improving individual health resiliency. The optimal design of these policies depends crucially on quantifying the short- and long-run health risks imposed by disasters, precisely identifying the most vulnerable populations, and understanding the underlying mechanisms that drive and mediate outcomes. However, much remains unknown about these important dimensions. This project will use individual-level administrative Medicare data on all elderly (65+) and long-term disabled beneficiaries from 1992– 2017 to estimate the short- and long-run effects of a broad range of natural disasters – such as hurricanes, tornadoes, and floods – on health, health care use, and health-related expenditures among the elderly. The study will compile a comprehensive and spatially detailed database of US natural disasters from a variety of data sources. The Medicare data provide the 9-digit ZIP code of residence, allowing researchers to pinpoint the location of victims more precisely than prior research. The project will track individuals living in disaster-affected areas before the disaster regardless of where they move, and a control group of unaffected elderly will be used to establish how outcomes would have evolved in the absence of the event. The project will also use a new machine learning approach to identify vulnerable subpopulations based on individual health characteristics (e.g., pre-existing chronic conditions), demographic traits (e.g., age, race, sex), and local economic and public health circumstances (e.g., per capita income, prevalence of obesity, community participation in the National Flood Insurance Program's Community Rating System). The project will also assess several continuity-of-care mechanisms that could moderate or exacerbate post-disaster mortality and disease impacts, including damage to health care facilities, loss of access to one’s physician, and health plan network restrictions. This analysis will be performed for the whole population of beneficiaries and for subpopulations thought to be particularly vulnerable to continuity-of-care disruptions, like adults with multiple pre-existing chronic conditions. Finally, the project will estimate the extent to which certain characteristics (e.g., health care availability, local government expenditure, and healthy behaviors) in areas where victims relocate to following a disaster can explain their health outcomes.

其他项目信息 - 项目摘要/摘要 自然灾害对美国老年人和老年人死亡率和疾病负担的长期影响 残疾人成人 近几十年来，自然灾害的频率和严重程度有所增加，预计这一趋势还会加剧 这些灾害对个人健康和福祉构成的风险就是其中之一。 患有与年龄相关的残疾或慢性疾病的老年人，例如患有阿尔茨海默病的人或 有关备灾和应对痴呆症的公共政策在避免或应对痴呆症方面发挥着重要作用。 减少灾害对健康的影响并提高个人健康复原力这些的优化设计。 政策关键取决于对灾害造成的短期和长期健康风险的量化，准确地说 确定最脆弱的人群，并了解驱动和影响的根本机制 然而，关于该项目将使用的这些重要维度仍有很多未知之处。 1992 年以来所有老年人（65 岁以上）和长期残疾受益人的个人医疗保险管理数据 2017 年评估一系列自然灾害（例如飓风、 龙卷风和洪水——对老年人健康、医疗保健使用和健康相关支出的影响。 研究将根据各种数据编制一个全面且详细的美国自然灾害数据库 医疗保险数据提供了 9 位数的居住邮政编码，使研究人员能够查明居住地。 该项目将比之前的研究更准确地追踪受灾地区的个人。 灾难前的地区，无论他们搬到哪里，并将使用未受影响的老年人作为对照组 以确定在没有该事件的情况下结果将如何演变，该项目还将使用一种新的方法。 机器学习方法根据个人健康特征（例如， 已有的慢性病）、人口特征（例如年龄、种族、性别）以及当地经济和公共卫生 情况（例如，人均收入、肥胖患病率、社区参与全国洪水 保险计划的社区评级系统）该项目还将评估多项护理连续性。 可能减轻或加剧灾后死亡率和疾病影响（包括损害）的机制 该分析将影响医疗保健机构、无法看医生以及健康计划网络限制。 对整个受益人群体以及被认为特别受惠的亚群体进行 容易受到护理连续性中断的影响，例如患有多种慢性病的成年人。 项目将估计某些特征（例如医疗保健的可用性、地方政府 灾后搬迁到的地区的支出和健康行为）可以解释他们的情况 健康结果。