Dataset Information

Determinants of Hurricane Evacuation from a Large Representative Sample of the U.S. Gulf Coast.

ABSTRACT: Exposure to natural disasters like hurricanes negatively impacts the mental and physical health of populations, and evacuation is an important step taken to prevent these adverse health events. This study uses data from a large representative sample of U.S. Gulf Coast residents to explore the determinants of hurricane evacuation. In December 2017, data were collected from 3030 residents of the U.S. Gulf Coast, including Texas, Louisiana, Mississippi, Alabama, and Florida-2557 of whom reported being impacted during the 2017 hurricane season. Bivariate analyses were conducted using prevalence differences and tested for statistical significance with chi-square tests. Multivariable logistic regression models were fitted to identify factors associated with hurricane evacuation. One-third of the respondents (919 of 2557; 35.9%) evacuated from a hurricane that impacted the U.S. Gulf Coast in 2017. The determinants of hurricane evacuation in this population were: residing in a mobile home, higher perception of storm surge risk, higher perception of wind risk, self-sufficiency, carrying flood insurance, and reliance on media and family for evacuation decisions. These findings may be relevant for reducing the adverse health effects of hurricanes by improving emergency planning and evacuation in this highly vulnerable region.

SUBMITTER: Karaye IM

PROVIDER: S-EPMC6861906 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Determinants of Hurricane Evacuation from a Large Representative Sample of the U.S. Gulf Coast.

Karaye Ibraheem M IM Horney Jennifer A JA Retchless David P DP Ross Ashley D AD

International journal of environmental research and public health 20191103 21

Exposure to natural disasters like hurricanes negatively impacts the mental and physical health of populations, and evacuation is an important step taken to prevent these adverse health events. This study uses data from a large representative sample of U.S. Gulf Coast residents to explore the determinants of hurricane evacuation. In December 2017, data were collected from 3030 residents of the U.S. Gulf Coast, including Texas, Louisiana, Mississippi, Alabama, and Florida-2557 of whom reported be ...[more]

PMID: 31684143

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Project description:BACKGROUND:Styrene is an established neurotoxicant at occupational levels, but effects at levels relevant to the general population have not been studied. We examined the neurologic effects of environmental styrene exposure among U.S. Gulf coast residents. METHODS:We used National Air Toxics Assessment (NATA) 2011 estimates of ambient styrene concentrations to assign exposure levels for 21,962 non-diabetic Gulf state residents, and additionally measured blood styrene concentration in a subset of participants (n?=?874). Neurologic symptoms, as well as detailed covariate information, were ascertained via telephone interview. We used log-binomial regression to estimate prevalence ratios (PR) and 95% confidence intervals (95% CI) for cross-sectional associations between both ambient and blood styrene levels and self-reported neurologic symptoms. We estimated associations independently for ten unique symptoms, as well as for the presence of any neurologic, central nervous system (CNS), or peripheral nervous system (PNS) symptoms. We also examined heterogeneity of associations with estimated ambient styrene levels by race and sex. RESULTS:One-third of participants reported at least one neurologic symptom. The highest quartile of estimated ambient styrene was associated with one or more neurologic (PR, 1.12; 95% CI: 1.07,1.18), CNS (PR, 1.17; 95% CI: 1.11,1.25), and PNS (PR, 1.16; 95% CI: 1.09,1.25) symptom. Results were less consistent for biomarker analyses, but blood styrene level was suggestively associated with nausea (PR, 1.78; 95% CI: 1.04, 3.03). In stratified analyses, we observed the strongest effects among non-White participants. CONCLUSIONS:Increasing estimated ambient styrene concentration was consistently associated with increased prevalence of neurologic symptoms. Associations between blood styrene levels and some neurologic symptoms were suggestive. Environmental styrene exposure levels may be sufficient to elicit symptomatic neurotoxic effects.

Project description:Medicare utilization and costs for residents of the U.S. Gulf Coast, who are highly vulnerable to natural disasters, may be impacted by their disaster exposure.To estimate differences in healthcare utilization by disaster exposure, we calculated Medicare expenditures among residents of U.S. Gulf States and compared them with expenditures among residents of other regions of the U.S.Panel models were used to calculate changes in overall Medicare expenditures, inpatient expenditures, and home health expenditures for 32,819 Medicare beneficiaries. Individual demographic characteristics were included as predictors of change in expenditures.Medicare beneficiaries with National Health Interview Survey participation were identified and Part A claims were linked. Federal Emergency Management Agency (FEMA) data was used to determine counties that experienced no, some, high, and extreme hazard exposure. FEMA data was merged with Medicare claims data to create a panel dataset from 2001 to 2007.Medicare Part A claims for the years 2001 to 2007 were merged with FEMA data related to disasters in each U.S. County. Overall Medicare costs, as well as costs for inpatient and home health care for residents of states located along the U.S. Gulf Coast (Texas, Louisiana, Mississippi, Alabama, and Florida) were compared to costs for residents of the rest of the U.S.Expenditures among residents of U.S. Gulf States decreased with increased hazard exposure. Decreases in inpatient expenditures persisted in the years following a disaster.The use of beneficiary-level data highlights the potential for natural hazards to impact health care costs. This study demonstrates the possibility that exposure to more severe disasters may limit access to health care and therefore reduce expenditures. Additional research is needed to determine if there is a substitution of services (e.g., inpatient rehabilitation for home health) in disaster-affected areas during the post-disaster period.

Project description:Palliative care aims to improve quality of life for people with serious illness and their families. One potential barrier to palliative care uptake is inaccurate knowledge and/or negative beliefs among the general population, which may inhibit early interest in, communication about, and integration of palliative care following subsequent illness diagnosis. We explored knowledge and beliefs about palliative care among the general public using nationally-representative data collected in 2018 as part of the cross-sectional Health Information National Trends Survey. Only individuals who had heard of palliative care (n = 1,162, Mage = 51.8, 64% female) were queried on knowledge and beliefs. We examined whether self-assessed level of awareness of palliative care (i.e., knowing a little vs. enough to explain it) was associated with the relative likelihood of having accurate/positive beliefs, inaccurate/negative beliefs, or responding "don't know" to questions about palliative care. Respondents who indicated knowing a lot about palliative care had more accurate versus inaccurate knowledge than those who knew a little on only two of six items and more positive attitudes on only one of three items. In particular, respondents with greater awareness were equally likely to report that palliative care is the same as hospice and requires stopping other treatments, and equally likely to believe that palliative care means giving up and to associate palliative care with death. Those with higher awareness were less likely than those with lower awareness to respond "don't know," but greater awareness was not necessarily associated with having accurate or positive beliefs about palliative care as opposed to inaccurate or negative beliefs. Thus, even members of the general public who perceived themselves to know a lot about palliative care were often no less likely to report inaccurate knowledge or negative beliefs (versus accurate and positive, respectively). Findings suggest a need to improve awareness and attitudes about palliative care.

Dataset Information

Determinants of Hurricane Evacuation from a Large Representative Sample of the U.S. Gulf Coast.

Publications

Determinants of Hurricane Evacuation from a Large Representative Sample of the U.S. Gulf Coast.

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