Laverdière Émélie, Généreux Mélissa, Gaudreau Pierrette, Morais José A, Shatenstein Bryna, Payette Hélène
Eastern Townships Public Health Department, Sherbrooke, Quebec (Canada). Department of Community Health Sciences, Université de Sherbrooke, Sherbrooke, Québec (Canada). Research Centre on Aging, Health and Social Services Centre-University Institute of Geriatrics of Sherbrooke, Sherbrooke, Quebec (Canada)..
Can J Public Health. 2015 Jun 18;106(5):e315-21. doi: 10.17269/cjph.106.5029.
Heat vulnerability is increasing owing to climate change, aging and urbanization. This vulnerability may vary geographically. Our study examined the prevalence and distribution of risk and protective factors of heat-related outcomes among older adults across three health regions of Southern Quebec (Canada).
This secondary cross-sectional study used data from the 1st follow-up of the NuAge longitudinal study, a cohort of community-dwelling older adults, aged 68-82 years at baseline, of three health regions: Eastern Townships, Montreal and Laval. Prevalence of factors, identified in Health Canada guidelines, was measured. An Older Adult Heat Vulnerability Index (OAHVI) simultaneously considering medical, social and environmental factors was constructed. The distribution of each factor and OAHVI was examined across the three regions. Results were weighted for age, sex (overall and region-specific analyses) and region (overall analyses).
Ninety percent of participants had ≥1 risk factor, the most prevalent being: cardiovascular medication (50.8%), hypertension (46.7%), living alone (39.2%), cardiovascular disease (36.9%), living in an urban heat island (34.7%) and needing help in activities of daily living (26.5%). Two thirds of participants had ≥1 protective factor, the most prevalent being talking on the phone daily (70.9%). Heat vulnerability varied greatly by region and this variation was mainly attributable to social and environmental rather than medical factors. According to the OAHVI, 87.2% of participants cumulated ≥2 factors (median = 3.0 factors/participant).
Our results support the need for small-scale assessment of heat vulnerability. This study could help stakeholders tackle heat-related illness and develop regionally tailored prevention programs.
由于气候变化、老龄化和城市化,热脆弱性正在增加。这种脆弱性可能因地理位置而异。我们的研究调查了加拿大魁北克省南部三个健康区域的老年人中与热相关结局的风险和保护因素的患病率及分布情况。
这项二次横断面研究使用了NuAge纵向研究第一次随访的数据,该队列研究对象为社区居住的老年人,基线年龄在68 - 82岁,来自三个健康区域:东镇、蒙特利尔和拉瓦尔。测量了加拿大卫生部指南中确定的因素的患病率。构建了一个同时考虑医学、社会和环境因素的老年人热脆弱性指数(OAHVI)。检查了三个区域中每个因素和OAHVI的分布情况。对年龄、性别(总体和区域特定分析)和区域(总体分析)进行了结果加权。
90%的参与者有≥1个风险因素,最常见的是:心血管药物治疗(50.8%)、高血压(46.7%)、独居(39.2%)、心血管疾病(36.9%)、生活在城市热岛(34.7%)以及在日常生活活动中需要帮助(26.5%)。三分之二的参与者有≥1个保护因素,最常见的是每天打电话(70.9%)。热脆弱性在不同区域差异很大,这种差异主要归因于社会和环境因素而非医学因素。根据OAHVI,87.2%的参与者累积有≥2个因素(中位数 = 3.0个因素/参与者)。
我们的结果支持对热脆弱性进行小规模评估的必要性。这项研究可以帮助利益相关者应对与热相关的疾病,并制定针对区域的预防计划。