Health Disparities Among Older Adults Following Tropical Cyclone Exposure in Florida, USA, 1999-2016

Abstract

BACKGROUND AND AIM: As tropical cyclones (TCs) become more frequent and severe in much of the world, research is needed to identify subpopulations who are particularly vulnerable to their adverse health impacts. This study investigated whether hospitalization risks from TCs in Florida (FL), USA varied across age and sex. METHODS: We obtained county-level TC data for all storms in FL during the study period in which windspeed exceeded strong gale force winds (a 9 on the Beaufort scale or ~21m/s). We included hospitalization data among pay-per-service Medicare beneficiaries in FL for respiratory illnesses and cardiovascular disease (CVD), as well as 5 other broad causes, from 1999-2016. We used distributed lag non-linear mixed-effects models to estimate the relative risk (RR) for TC exposure by comparing hospitalizations occurring in TC-periods (from 2 days before to 7 days after) to matched non-TC-periods. We first quantified overall associations between TC exposure and cause-specific hospitalization risk. We then separately modeled associations between TC exposure and hospitalizations in subgroups defined by individual-level characteristics. RESULTS:Preliminary results show that TC exposure was associated with overall increased risk of respiratory hospitalizations (RR: 4.01, 95% CI: 2.91, 5.53) comparing TC to non-TC periods, but not CVD (RR: 0.79, 95% CI: 0.93, 1.09) hospitalizations, confirming that risk patterns in FL are similar to national patterns identified in previous studies. However, stratified models showed limited evidence of modification by individual-level characteristics for either respiratory or cardiovascular disease hospitalizations: we did not find differences in risk of hospitalization between men and women nor across age groups (65-74, 75-84, and ≥ 85 years). CONCLUSIONS:These findings contrast with those from other environmental exposures, including air pollution, whose effects have been shown to vary across different subgroups. To better understand the impact of TCs on population and subgroup health, future research should focus on understanding specific mechanisms and causal pathways. KEYWORDS: Natural disasters, environmental disparities, tropical cyclones, climate change, hospitalizations