Association Between Hurricane Sandy and Emergency Department Visits in New York City by Age and Cause.

The magnitude, timing, and etiology of morbidity associated with tropical cyclones remains incompletely quantified. We examined the relative change in cause-specific emergency department (ED) visits among residents of New York City during and after Hurricane Sandy, a tropical cyclone that affected the northeastern United States in October 2012. We used quasi-Poisson constrained distributed lag models to compare the number of ED visits on and after Hurricane Sandy with all other days, 2005-2014, adjusting for temporal trends. Among residents aged ≥65 years, Hurricane Sandy was associated with a higher rate of ED visits due to injuries and poisoning (relative risk (RR) = 1.19, 95% confidence interval (CI): 1.10, 1.28), respiratory disease (RR = 1.35, 95% CI: 1.21, 1.49), cardiovascular disease (RR = 1.10, 95% CI: 1.02, 1.19), renal disease (RR = 1.44, 95% CI: 1.22, 1.72), and skin and soft tissue infections (RR = 1.20, 95% CI: 1.03, 1.39) in the first week following the storm. Among adults aged 18-64 years, Hurricane Sandy was associated with a higher rate of ED visits for renal disease (RR = 2.15, 95% CI: 1.79, 2.59). Among those aged 0-17 years, the storm was associated with lower rates of ED visits for up to 3 weeks. These results suggest that tropical cyclones might result in increased health-care utilization due to a wide range of causes, particularly among older adults.

A tree-ring δ18O based reconstruction of East Asia summer monsoon over the past two centuries.

The East Asian summer monsoon (EASM) exhibits considerable decadal variations since the late 20th century. Efforts to examine long-term behaviors and dynamics of the EASM are impeded largely due to the shortness of instrumental meteorological records. So far, reconstructions of the EASM with annual resolution from its core regions remain limited. We conduct the first 200-year robust EASM reconstruction based on tree-ring cellulose δ18O records derived from Pinus massoniana trees growing in the middle Yangtze River basin, one of the core EASM areas. The δ18O chronology accounts for 46.2% of the actual variation in an index of the EASM from 1948 to 2014. The reconstructed EASM indicates that the monsoon intensity was below average before the 1950s, peaked in the 1950s-1970s, and then began to decline. The reconstructed EASM is negatively correlated with the El Niño-Southern Oscillation (ENSO), but this teleconnection is dynamic through time, i.e. enhanced (reduced) ENSO variability coheres with strong (weak) EASM-ENSO connections. In addition, despite high ENSO variability since the 1980s, the EASM-ENSO relationship weakened possibly due to anthropogenic impact, particularly aerosol emissions.

Human-centric infrastructure resilience: Uncovering well-being risk disparity due to infrastructure disruptions in disasters.

The objective of this paper is to empirically examine the impacts of infrastructure service disruptions on the well-being of vulnerable populations during disasters. There are limited studies that empirically evaluate the extent to which disruptions in infrastructure system services impact subpopulation groups differently and how these impacts relate to the wellbeing of households. Being able to systematically capture the differential experiences of sub-populations in a community due to infrastructure disruptions is necessary to highlight the differential needs and inequities that households have. In order to address this knowledge gap, this study derives an empirical relationship between sociodemographic factors of households and their subjective well-being impacts due to disruptions in various infrastructure services during and immediately after Hurricane Harvey. Statistical analysis driven by spearman-rank order correlations and fisher-z tests indicated significant disparities in well-being due to service disruptions among vulnerable population groups. The characterization of subjective well-being is used to explain to what extent infrastructure service disruptions influence different subpopulations. The results show that: (1) disruptions in transportation, solid waste, food, and water infrastructure services resulted in more significant well-being impact disparities as compared to electricity and communication services; (2) households identifying as Black and African American experienced well-being impact due to disruptions in food, transportation, and solid waste services; and (3) households were more likely to feel helpless, difficulty doing daily tasks and feeling distance from their community as a result of service disruptions. The findings present novel insights into understanding the role of infrastructure resilience in household well-being and highlights why it is so important to use approaches that consider various factors. Infrastructure resilience models tend to be monolithic. The results provide empirical and quantitative evidence of the inequalities in well-being impacts across various sub-populations. The research approach and findings enable a paradigm shift towards a more human-centric approach to infrastructure resilience.

Growth estimates of Caribbean reef sponges on a shipwreck using 3D photogrammetry.

The growth rates and ages of many benthic marine organisms are poorly understood, complicating our understanding of ecosystem change. This is particularly true for sponges, which are morphologically diverse and lack indicators of annual growth. In this study, we used emerging technologies to measure volume, surface area, and approximate age of 16 sponge species on the Tibbetts shipwreck off Cayman Brac, Caribbean Sea. Photogrammetry was used to determine the volume of individual sponges on the wreck surface, and a time series of YouTube videos was amassed in order to approximate the greatest possible age of the sponges as 8.74 y. Applying the volume measurements to an existing growth equation for the Caribbean sponge Aiolochroia crassa yielded age estimates of 5.2-10.4 y for the largest individuals of the 16 species. Specific growth rates were then calculated for 7 species from the Tibbetts and 8 species from a second shipwreck (Spiegel Grove, Key Largo, FL). Subsequent growth forecasts from these 15 species corroborate a resource trade-off between growth and the production of chemical defenses. Shipwrecks and other anthropogenic structures can be an important source of demographic information for benthic organisms, provided that certain assumptions about their provenance and history can be met.

Long-term Effects of Disasters on Seniors With Diabetes: Evidence From Hurricanes Katrina and Rita.

OBJECTIVE: To estimate the long-run mortality effects of Hurricanes Katrina and Rita on seniors with diabetes. RESEARCH DESIGN AND METHODS: We performed a retrospective cohort analysis of Medicare enrollment and claims data covering four states and ∼10 years. Affected individuals were identified by whether they lived in a county that suffered a high impact and were stratified by whether they moved to a different county following the storms. Propensity scores matched affected and comparison subjects based on demographic and socioeconomic characteristics and the presence of chronic conditions. Our sample consisted of 170,328 matched affected subjects. RESULTS: The affected subjects had a nearly 40% higher all-cause mortality risk in the 1st month after the storms, but the difference fell to <6% by the end of the full observation period. The mortality risks of heart disease and nephritis also exhibited the largest differences immediately following the storms. Among the affected subjects, the all-cause mortality risk was higher for those who moved to a different county, with an especially large difference among those who moved to an affected county. CONCLUSIONS: The propensity matching procedure resulted in the comparison and affected groups having similar observable characteristics. However, we only examined the extreme outcome of mortality, our definition of affected was somewhat crude, and our sample did not include individuals enrolled in Medicare Advantage. Our findings highlight the importance of the immediate response to disasters, yet also demonstrate the long-lasting impact disasters can have.

Forecast: Increasing Mental Health Consequences From Atlantic Hurricanes Throughout the 21st Century.

Global environmental climate change is altering the behavior of hurricanes. Hurricane seasons are becoming more active, generating storms that are ever more damaging to coastal and island communities. Exposure to hurricane hazards and experiencing resultant losses and life changes can lead to new-onset mental disorders among previously healthy survivors and jeopardize the health of persons with preexisting mental illness. High rates of common mental disorders have been documented after recent hurricanes. As hurricanes become increasingly severe, health care systems may expect to see more mental illness related to these extreme storms. Psychiatrists and allied health professionals can play vital roles in several areas: educating and preparing current caseloads of patients for possible storm impacts; intervening with persons who develop new-onset disorders after storm exposure; providing consultation to public health and community preparedness leadership about the mental health consequences of hurricanes; participating actively in community emergency response; and championing the integration of psychiatry with climate science and advocacy.

The children of Superstorm Sandy: Maternal prenatal depression blunts offspring electrodermal activity.

We set out to examine the relations between prenatal exposure to the natural disaster Superstorm Sandy, maternal depression, and offspring electrodermal activity (EDA). EDA was measured via skin conductance response (SCR) magnitude in 198 children (M = 42.54 months, SD = 12.76) during a startle paradigm. In keeping with prior research, we expected prenatal depression to be associated with hyporeactive EDA and prenatal stress to be associated with hyperreactive EDA. SCR magnitude was lower in children prenatally exposed to depression alone, when compared to Superstorm Sandy, and controls. SCR magnitude of children prenatally exposed to both maternal depression and the storm was lower than that of all other groups. Our results emphasize the influence of maternal prenatal mental health, support targeted risk assessment for children who experienced an adverse prenatal environment, and highlight the need for a deeper understanding of the interactions between maternal mood and stress on the developing child.

Tropical storms influence the movement behavior of a demersal oceanic fish species.

Extreme weather events strongly influence marine, freshwater, and estuarine ecosystems in myriad ways. We quantified movements of a demersal oceanic fish species (gray triggerfish Balistes capriscus; N = 30) before, during, and after two hurricanes in 2017 using fine-scale acoustic telemetry at a 37-m deep study site in North Carolina, USA. During storms, gray triggerfish movement and emigration rates were 100% and 2550% higher, respectively, than on days with no storms. We found that increased movement rates were much more strongly correlated with wave orbital velocity (i.e., wave-generated oscillatory flow at the seabed) than either barometric pressure or bottom water temperature, two covariates that have been demonstrated to be important for organisms in shallower water. Higher movement rates during storms were due to increased mobility at night, and emigrations typically occurred at night in the direction of deeper water. Overall, we found significant storm effects on the movement behavior of a demersal fish species in the open ocean, despite our study occurring in deeper water than previous studies that have examined storm effects on animal movement. We conclude that tropical storms are a driving force behind the structure of marine ecosystems, in part by influencing movements of mobile animals.

Hurricane Harvey: The Way Back.

Lessons learned as practices emerge from Harvey's wrath.

Public Health Emergency Response Lessons Learned by Rapid Deployment Force 3, 2006-2016.

Following Hurricane Katrina, the uniformed US Public Health Service created an updated system through which its officers participated in emergency responses. The Rapid Deployment Force (RDF) concept, begun in 2006, involved five teams of officers with diverse clinical and public health skill sets organized into an incident command system led by a team commander. Each team can deploy within 12 hours, according to a defined but flexible schedule. The core RDF mission is to set up and provide care for up to 250 patients, primarily persons with chronic diseases or disabilities, in a temporary federal medical station. Between 2006 and 2016, the RDF 3 team deployed multiple times in response to natural disasters and public health emergencies. Notable responses included Hurricane Sandy in 2012, the unaccompanied children mission in 2014, and the Louisiana floods in 2016. Lessons learned from the RDF 3 experience include the need for both clinical and public health capacity, the value of having special mental health resources, the benefits of collaboration with other federal medical responders, and recognition of the large burden of chronic disease management issues following natural disasters.

San Juan Bautista School of Medicine's Experience in the Aftermath of Hurricane Maria.

The San Juan Bautista School of Medicine (SJBSM) is located in Caguas, Puerto Rico. On September 20, 2017, Hurricane Maria hit the island, making landfall as a Category 4 storm. The extreme wind force and rainfall caused extensive power outages and other damage. In this Invited Commentary, the authors discuss SJBSM's actions and lessons learned in the aftermath of Hurricane Maria.By September 25, SJBSM had contacted students to ensure their safety and identify their immediate needs. The medical school's primary goal was to restore services as expeditiously as possible. By October 9, SJBSM had reopened and adjusted its offerings and practices to accommodate students' needs. The medical school worked to support students' emotional and physical well-being as well as meet their academic needs. First- and second-year students who could not be present received recorded lectures, study guides, assessments, and other materials electronically or via hard copy. Third- and fourth-year students were authorized to complete a single clerkship rotation at another medical school in the United States. During this time, SJBSM consulted with the Association of American Medical Colleges, the Liaison Committee on Medical Education, and other academic agencies. These groups offered advice on how to proceed given the hardships the medical school faced.Since then, SJBSM has applied lessons learned from Hurricane Maria and taken measures to ensure that it can meet the needs of faculty, staff, and students in the immediate aftermath of future disasters.

The effect of social support, gratitude, resilience and satisfaction with life on depressive symptoms among police officers following Hurricane Katrina.

BACKGROUND: Police officers in the New Orleans geographic area faced a number of challenges following Hurricane Katrina. AIM: This cross-sectional study examined the effect of social support, gratitude, resilience and satisfaction with life on symptoms of depression. METHOD: A total of 86 male and 30 female police officers from Louisiana participated in this study. Ordinary least-square (OLS) regression mediation analysis was used to estimate direct and indirect effects between social support, gratitude, resilience, satisfaction with life and symptoms of depression. All models were adjusted for age, alcohol intake, military experience and an increase in the number of sick days since Hurricane Katrina. RESULTS: Mean depressive symptom scores were 9.6 ± 9.1 for females and 10.9 ± 9.6 for males. Mediation analyses indicates that social support and gratitude are directly associated with fewer symptoms of depression. Social support also mediated the relationships between gratitude and depression, gratitude and satisfaction with life, and satisfaction with life and depression. Similarly, resilience mediated the relationship between social support and fewer symptoms of depression. CONCLUSION: Social support, gratitude and resilience are associated with higher satisfaction with life and fewer symptoms of depression. Targeting and building these factors may improve an officer's ability to address symptoms of depression.