Climate & Health Actionable Research and Translation Center

气候

• 批准号: 10835462
• 负责人: Howard H Chang
• 金额: $ 115.83万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-26 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10835462
• 关键词: Accident and Emergency department; Address; Adopted; Age; Air; Air Pollution; Area; Attitude; Awareness; Back; Behavior; Behavior assessment; Behavioral; Biometry; Cities; Climate; Communities; Computerized Medical Record; Data; Data Science; Databases; Disparity; Economics; Emergency Care; Emergency department visit; Environment; Environmental Epidemiology; Environmental Hazards; Ethnic Origin; Exposure disparity; Exposure to; Goals; Green space; Health; Health Knowledge Attitudes Practice; Health Status; Healthcare; Healthcare Systems; Heat Stress Disorders; Heterogeneity; Home; Homelessness; Hospitals; Hour; Housing; Human; Human Activities; Humidity; Individual; Infrastructure; Insurance Coverage; Intervention; Interview; Joints; Knowledge; Link; Location; Maps; Matched Case-Control Study; Medical Records; Methods; Molds; Monitor; Morbidity - disease rate; Multi-Hospital Systems; Neighborhoods; Outcome; Participant; Patient Recruitments; Patients; Pattern; Perception; Pharmaceutical Preparations; Physical environment; Physiological; Pollen; Population; Predisposition; Public Hospitals; Qualitative Methods; Race; Rain; Reporting; Research; Research Design; Research Project Grants; Research Project Summaries; Resources; Risk; Risk Assessment; Risk Estimate; Risk Factors; Structure; Surveys; Temperature; Time; Translations; Trees; Urban Community; Urban Health; Variant; Visit; Work; absorption; built environment; climate change; climate-related health; community engaged research; community engagement; comorbidity; density; diaries; epidemiology study; experience; exposure pathway; health disparity; heat island; novel; population based; recruit; residence; sex; social; social health determinants; socioeconomics; tool; urban setting

CHART: RESEARCH PROJECT – SUMMARY High ambient temperature is a well-recognized environmental hazard to human health. The overarching goal of this project is to examine factors related to physiologic susceptibility and factors along exposure pathways that may lead to disparities in heat-related illnesses. The project also aims to map features within multiple social determinants of health (SODH) domains that can alter an individual’s ability to mitigate heat exposure to help identify actionable intervention strategies. Aim 1 will quantify disparities in associations between heat and emergency department (ED) visits in Atlanta, GA during the period 2013 to 2021. ED visit is an important and understudied heat-related morbidity outcome. We will compile a database of geocoded electronic medical records from the Grady Memorial Hospital and four hospitals within Emory Healthcare. We will assess patient- level effect modifiers (e.g., age, sex, homelessness, insurance status, co-morbid conditions, and home medication), and modifiers that are related to the residential built environment (e.g., building type, building year and green space). Aim 2 will conduct a matched case-control study of 400 participants from Grady and Emory hospitals to examine risk factors for heat-related ED visits that are not captured through medical records, such as how and why exposure occurred. We will develop a survey tool and structured interview to assess demographic, physiological/health status, neighborhood and individual SDOH, and knowledge, attitudes, and practices around factors hypothesized to impact susceptibility and exposure to heat. Qualitative analysis will be used to contextualize and understand the exposure pathways and challenges experienced among the cases leading to their presentation at the ED. To address knowledge gaps in the understanding of heat exposures, Aim 3 will characterize temperature exposure for 120 individuals living in under-resourced communities by conducting 48-hour continuous monitoring of personal, indoor and outdoor exposure to temperature, humidity and air quality. We will characterize absolute differences between personal, indoor, and outdoor temperatures, as well as identify demographic, behavioral, socioeconomic, time-activity-location, and built environment factors contributing to these differences in exposures. We will disseminate findings and monitoring results back to participants. In all Aims, we will engage with community partners to determine additional salient risk factors, develop surveys and interviews, and identify participants for recruitment. Overall, the project will provide timely knowledge on the adverse health effects of heat in an urban setting with a focus on under-resourced communities. The proposed research project is highly aligned with the Center’s theme of assessing how climate change threatens the health of urban communities. Moreover, the project’s findings, data, and infrastructure will provide opportunities for capacity building and translation in climate and health research.

图表：研究项目 - 摘要 高环境温度是对人类健康的公认环境危害。总体目标 这个项目的是检查与生理敏感性和沿暴露途径的因素有关的因素 这可能导致与热有关的疾病的差异。该项目还旨在绘制多个功能 健康的社会决定者（SODH）领域，可以改变个人减轻热量暴露的能力 帮助确定可行的干预策略。 AIM 1将量化热量与热量之间的关联差异 在2013年至2021年期间，紧急部门（ED）访问乔治亚州亚特兰大。 正在研究的与热相关的发病率结果。我们将编译一个地理编码电子医疗数据库 Grady纪念医院的记录和Emory Healthcare内的四家医院。我们将评估患者 - 水平效应修饰符（例如，年龄，性别，无家可归，保险状态，合并状况和家庭 用药）和与居民建造环境相关的修饰符（例如，建筑类型，建筑年度 和绿色空间）。 AIM 2将对来自Grady和Emory的400名参与者进行匹配的病例对照研究 医院检查未通过医疗记录捕获的与热有关的ED访问的危险因素， 作为如何以及为什么发生暴露。我们将开发一个调查工具和结构化访谈以评估 人口，身体/健康状况，社区和个人SDOH以及知识，参加者以及 围绕因素的练习，假设会影响易感性和暴露于热量。定性分析将是 用于将案件中经历的暴露途径和挑战进行环境化和了解 导致他们在急诊室的演讲。在理解热暴露时，要解决知识差距， AIM 3将表征居住在资源不足社区中的120个人的温度暴露 进行48小时的个人，室内和室外暴露于温度，湿度 和空气质量。我们将表征个人，室内和室外温度之间的绝对差异， 以及确定人口统计学，行为，社会经济，时间效率和建筑环境 导致这些暴露差异的因素。我们将传播发现并重新监视结果 给参与者。总体而言，我们将与社区合作伙伴互动，以确定其他显着风险因素， 开发调查和访谈，并确定参与者进行招聘。总体而言，该项目将及时提供 在城市环境中对热量不利影响的知识，重点是资源不足 社区。拟议的研究项目与该中心的评估主题高度一致 气候变化威胁着城市社区的健康。此外，项目的发现，数据和 基础设施将为气候和健康研究中的能力建设和翻译提供机会。