Effects of Hurricane Sandy on Functional Limitation Trajectories of Older Adults

飓风桑迪对老年人功能限制轨迹的影响

• 批准号: 9205920
• 负责人: RACHEL A PRUCHNO
• 金额: $ 13万
• 依托单位: ROWAN UNIVERSITY SCHOOL/OSTEOPATHIC MED
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-01 至 2017-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9205920
• 关键词: Address; Affect; Aging-Related Process; Biological Preservation; Characteristics; Climate; Communities; Complement; Data; Data Collection; Development; Disasters; Droughts; Elderly; Employee Strikes; Event; Expenditure; Exposure to; Face; Fostering; Goals; Health; Healthcare; Heating; Hurricane; Individual; Intervention; Knowledge; Lead; Life; Link; Medicare/Medicaid; Mental Health; Minority; Mission; Natural Disasters; New Jersey; Outcome; Pain; Pathway interactions; Patient Self-Report; Pattern; Physical Function; Process; Psychopathology; Public Health; Quality of life; Research; Resources; Risk Factors; Sampling; Testing; Walking; Wildfire; Work; aged; base; design; disability; experience; functional decline; functional disability; grasp; health care service utilization; improved; innovation; mortality; physical conditioning; resilience; stressor; therapy development; urban area

DESCRIPTION (provided by applicant): Although natural disasters present serious challenges for residents of affected communities, many questions about their effects on the physical health of older adults remain. The long-term goal is to inform intervention and resource planning efforts designed to mitigate the effects of disasters on older people, reduce health care utilization and expenditures and improve the quality of life of older people. The objective of this application is o identify how trajectories of functional limitations are affected by disaster. Our central hypothesi is that the majority of older adults exposed to disaster are resilient, healthcare utilization and expenditures associated with some functional limitation trajectories in the wake of disaster are significant, and pre-disaster characteristics of individuals and communities can distinguish trajectories of resilience and vulnerability. Our hypothesis was formulated based on our previous empirical and conceptual work and on work by others. The rationale for the proposed research is that, once it is known how disasters affect functional limitation trajectories, interventions ca be developed that will reduce the vulnerability of older adults and increase their resilience in th face of disaster, resulting in new and innovative approaches to improving the quality of life for older people. The hypothesis will be tested by pursing three specific aims: (1) To ascertain the effects of a natural disaster on the functional limitation trajectories of older adults; (2) To contrast the healthcare utilization and expenditures associated with functional limitation trajectories for older people experiencing disaster with those of older people not exposed to disaster; and (3) To identify the pathways by which risk factors and resilience resources influence trajectories of functional limitation. The aims will be addressed by building on a longitudinal panel of 1,977 people aged 65 to 80 when Hurricane Sandy hit New Jersey. Three post-hurricane self-reported assessments would complement data from two prior data collection efforts. These data would be linked with Medicare/Medicaid claims data. This work is significant because it is the first step in a continuum of research expected to lead to the development of interventions that will bolster the capabilities of older people to face natural disasters without increasing functional limitations. The proposed research is innovative, because it: (1) focuses on functional limitations, a linchpin in the disability cycle, (2) examines the effects of disaster ona large representative sample of people living in one of the states hardest hit by a recent hurricane, and (3) builds on data collected before the storm struck, includes people with and without direct exposure to the storm, and has 3 post- disaster assessments, yielding one of the few studies able to disentangle causal relationships attributable to disaster. Knowledge from this project will advance understanding of disaster's effects on older people, and inform interventions likely to improve their quality of life, both before and after disasters strike.

描述（由申请人提供）：尽管自然灾害给受影响社区的居民带来了严峻的挑战，但有关其对老年人身体健康影响的许多问题仍然存在。长期目标是为旨在减轻灾害对老年人的影响、减少医疗保健利用率和支出并提高老年人生活质量的干预措施和资源规划工作提供信息。该应用程序的目的是确定灾难如何影响功能限制的轨迹。我们的中心假设是，大多数遭受灾害的老年人都有复原力，灾难发生后与某些功能限制轨迹相关的医疗保健利用和支出是显着的，个人和社区的灾前特征可以区分复原力和脆弱性的轨迹。我们的假设是根据我们之前的经验和概念工作以及其他人的工作制定的。拟议研究的基本原理是，一旦了解灾害如何影响功能限制轨迹，就可以制定干预措施，减少老年人的脆弱性并提高他们面对灾害的复原力，从而产生新的创新方法来改善老年人的功能障碍。老年人的生活质量。该假设将通过追求三个具体目标来检验：（1）确定自然灾害对老年人功能限制轨迹的影响； (2) 将遭受灾害的老年人与未遭受灾害的老年人的与功能限制轨迹相关的医疗保健利用和支出进行对比； (3) 确定风险因素和复原力资源影响功能限制轨迹的途径。当桑迪飓风袭击新泽西州时，这些目标将通过建立一个由 1,977 名年龄在 65 岁至 80 岁之间的人组成的纵向小组来实现。三项飓风后自我报告评估将补充之前两项数据收集工作的数据。这些数据将与医疗保险/医疗补助索赔数据相关联。这项工作意义重大，因为它是一系列研究的第一步，预计将导致开发干预措施，从而增强老年人应对自然灾害的能力，而不增加功能限制。拟议的研究具有创新性，因为它：（1）关注功能限制，这是残疾循环的关键，（2）研究了灾难对居住在最近飓风袭击最严重的州之一的具有代表性的大量人群的影响，(3) 以风暴袭击前收集的数据为基础，包括直接接触和未接触风暴的人员，并进行了 3 项灾后评估，这是为数不多的能够理清灾害因果关系的研究之一。该项目的知识将增进对灾害对老年人影响的了解，并为可能在灾害发生之前和之后改善他们的生活质量的干预措施提供信息。