Association of Tropical Cyclones With County-Level Mortality in the US.
JAMA
; 327(10): 946-955, 2022 03 08.
Article
en En
| MEDLINE
| ID: mdl-35258534
ABSTRACT
Importance Tropical cyclones have a devastating effect on society, but a comprehensive assessment of their association with cause-specific mortality over multiple years of study is lacking. Objective:
To comprehensively evaluate the association of county-level tropical cyclone exposure and death rates from various causes in the US. Design, Setting, andParticipants:
A retrospective observational study using a Bayesian conditional quasi-Poisson model to examine how tropical cyclones were associated with monthly death rates. Data from 33.6 million deaths in the US were collected from the National Center for Health Statistics over 31 years (1988-2018), including residents of the 1206 counties in the US that experienced at least 1 tropical cyclone during the study period. Exposures Tropical cyclone days per county-month, defined as number of days in a month with a sustained maximal wind speed 34 knots or greater. Main Outcomes andMeasures:
Monthly cause-specific county-level death rates by 6 underlying causes of death cancers, cardiovascular diseases, infectious and parasitic diseases, injuries, neuropsychiatric conditions, and respiratory diseases. The model yielded information about the association between each additional cyclone day per month and monthly county-level mortality compared with the same county-month in different years, up to 6 months after tropical cyclones, and how these estimated associations varied by age, sex, and social vulnerability. The unit of analysis was county-month.Results:
There were 33â¯619â¯393 deaths in total (16â¯691â¯681 females and 16â¯927â¯712 males; 8â¯587â¯033 aged 0-64 years and 25â¯032â¯360 aged 65 years or older) from the 6 causes recorded in 1206 US counties. There was a median of 2 tropical cyclone days experienced in total in included US counties. Each additional cyclone day was associated with increased death rates in the month following the cyclone for injuries (3.7% [95% credible interval {CrI}, 2.5%-4.9%]; 2.0 [95% CrI, 1.3-2.7] additional deaths per 1â¯000â¯000 for 2018 monthly age-standardized median rate [DPM]; 54.3 to 56.3 DPM), infectious and parasitic diseases (1.8% [95% CrI, 0.1%-3.6%]; 0.2 [95% CrI, 0.0-0.4] additional DPM; 11.7 to 11.9 DPM), respiratory diseases (1.3% [95% CrI, 0.2%-2.4%]; 0.6 [95% CrI, 0.1-1.1] additional DPM; 44.9 to 45.5 DPM), cardiovascular diseases (1.2% [95% CrI, 0.6%-1.7%]; 1.5 [95% CrI, 0.8-2.2] additional DPM; 129.6 to 131.1 DPM), neuropsychiatric conditions (1.2% [95% CrI, 0.1%-2.4%]; 0.6 [95% CrI, 0.1-1.2] additional DPM; 52.1 to 52.7 DPM), with no change for cancers (-0.3% [95% CrI, -0.9% to 0.3%]; -0.3 [95% CrI, -0.9 to 0.3] additional DPM; 100.4 to 100.1 DPM). Conclusions and Relevance Among US counties that experienced at least 1 tropical cyclone from 1988-2018, each additional cyclone day per month was associated with modestly higher death rates in the months following the cyclone for several causes of death, including injuries, infectious and parasitic diseases, cardiovascular diseases, neuropsychiatric conditions, and respiratory diseases.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Causas de Muerte
/
Tormentas Ciclónicas
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
País como asunto:
America do norte
Idioma:
En
Año:
2022
Tipo del documento:
Article