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——总结 高环境温度是公认的对人类健康的环境危害。 该项目的目的是检查与生理易感性相关的因素以及暴露途径中的因素 这可能会导致与高温相关的疾病的差异。该项目还旨在绘制多种疾病的特征图。 健康的社会决定因素 (SODH) 领域可以改变个人减轻热暴露的能力 帮助确定可行的干预策略，目标 1 将量化热量与热量之间关联的差异。 2013 年至 2021 年期间，乔治亚州亚特兰大市急诊科 (ED) 就诊。急诊科就诊是一项重要且重要的工作 我们将编制一个地理编码电子医疗数据库。 我们将评估来自格雷迪纪念医院和埃默里医疗保健中心四家医院的记录。 水平效应修正因素（例如年龄、性别、无家可归、保险状况、共病状况和家庭状况） 药物）以及与住宅建筑环境相关的修饰因素（例如建筑类型、建筑年份 Aim 2 将对来自 Grady 和 Emory 的 400 名参与者进行匹配病例对照研究 医院应检查医疗记录中未记录的与高温相关的急诊就诊的风险因素，例如 我们将开发调查工具和结构化访谈来评估暴露的方式和原因。 人口统计、生理/健康状况、社区和个人 SDOH 以及知识、态度和 围绕影响敏感性和热暴露的因素进行实践。 用于了解和了解案例中的暴露途径和挑战 导致他们在教育部发表演讲，以解决对热暴露的理解方面的知识差距， 目标 3 将描述生活在资源贫乏社区的 120 个人的温度暴露情况： 对个人、室内外的温度、湿度进行48小时连续监测 我们将描述个人、室内和室外温度之间的绝对差异， 以及确定人口统计、行为、社会经济、时间-活动-地点和建筑环境 我们将传播调查结果并反馈监测结果。 在所有目标中，我们将与社区合作伙伴合作，以确定其他显着的风险因素， 开展调查和访谈，并确定招募参与者 总体而言，该项目将提供及时的帮助。 关于城市环境中高温对健康不利影响的知识，重点关注资源贫乏地区 拟议的研究项目与该中心评估如何进行的主题高度一致。 此外，气候变化威胁着城市社区的健康。 基础设施将为气候和健康研究的能力建设和转化提供机会。