Bass Danielle Hildegard, Ghamasaee Pardis, Bigford Gregory E, Wakefield Mandeville, Duthely Lunthita M, Samano Daniel
Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Int J Environ Res Public Health. 2024 Mar 22;21(4):382. doi: 10.3390/ijerph21040382.
(1) Background: Climate change is increasing the already frequent diverse extreme weather events (EWE) across geographic locations, directly and indirectly impacting human health. However, current ongoing research fails to address the magnitude of these indirect impacts, including healthcare access. Vulnerable populations such as persons with spinal cord injury (pSCI) face added physiologic burden such as thermoregulation or mobility challenges like closure of public transportation. Our exploratory research assessed commute and transport to healthcare facilities as well as the knowledge, attitudes and behaviors (KAB) of pSCI regarding EWE and climate change when compared to pSCI caregivers (CG) and the general public (GP). (2) Methods: A KAB survey was employed to conduct a cross-sectional assessment of pSCI, CG, and GP in Miami from October through November 2019 using snowball sampling. Descriptive and logistic regression statistical analyses were used. (3) Results: Of 65 eligible survey respondents, 27 (41.5%) were pSCI, 11 (17%) CG, and 27 (41.5%) GP. Overall, pSCI reported EWE, particularly flooding and heavy rain, affecting their daily activities including healthcare appointments, more frequently than CG or GP. The overall models for logistic regression looking at commute to and attendance of healthcare appointments were statistically significant. pSCI self-report being less vulnerable than others, and a large proportion of each group was not fully convinced climate change is happening. (4) Conclusions: This study provided insight to the KAB of 3 population subgroups in Miami, Florida. pSCI are significantly more vulnerable to the effects of regional weather events yet exhibit disproportionate self-perception of their vulnerability. Continued and more comprehensive research is needed to characterize the barriers that vulnerable populations face during weather events.
(1) 背景：气候变化正在加剧全球各地本就频发的各种极端天气事件（EWE），直接或间接地影响人类健康。然而，当前正在进行的研究未能解决这些间接影响的程度问题，包括医疗保健可及性。脊髓损伤患者（pSCI）等弱势群体面临额外的生理负担，如体温调节问题或行动挑战，例如公共交通停运。我们的探索性研究评估了前往医疗保健机构的通勤和交通情况，以及与脊髓损伤患者护理人员（CG）和普通公众（GP）相比，脊髓损伤患者对极端天气事件和气候变化的知识、态度和行为（KAB）。(2) 方法：2019年10月至11月，采用雪球抽样法，通过KAB调查对迈阿密的脊髓损伤患者、护理人员和普通公众进行横断面评估。使用描述性和逻辑回归统计分析。(3) 结果：在65名符合条件的调查受访者中，27名（41.5%）为脊髓损伤患者，11名（17%）为护理人员，27名（41.5%）为普通公众。总体而言，脊髓损伤患者报告极端天气事件，特别是洪水和暴雨，比护理人员或普通公众更频繁地影响他们的日常活动，包括医疗预约。逻辑回归分析中关于前往医疗预约地点的通勤和就诊情况的总体模型具有统计学意义。脊髓损伤患者自我报告比其他人更不易受影响，而且每组中很大一部分人并不完全相信气候变化正在发生。(4) 结论：本研究深入了解了佛罗里达州迈阿密三个群体亚组的知识、态度和行为。脊髓损伤患者明显更容易受到区域天气事件的影响，但对自身脆弱性的认知却不成比例。需要持续开展更全面的研究，以明确弱势群体在天气事件期间面临的障碍。
