Impacts of compounding drought and heatwave events on child mental health: insights from a spatial clustering analysis.

Kelly Sewell, Sudeshna Paul, Kelley De Polt, Maggie M Sugg, Ronald D Leeper, Douglas Rao, Jennifer D Runkle
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Abstract

Background: Concurrent heatwave and drought events may have larger health impacts than each event separately; however, no US-based studies have examined differential mental health impacts of compound drought and heatwave events in pediatric populations.

Objective: To examine the spatial patterns of mood disorders and suicide-related emergency department (ED) visits in children during heatwave, drought, and compound heatwave and drought events. We tested whether the occurrence of compound heatwave and drought events have a synergistic (multiplicative) effect on the risk of mental health related outcomes in children as compared to the additive effect of each individual climate hazard. Lastly, we identified household and community-level determinants of geographic variability of high psychiatric burden.

Methods: Daily counts of psychiatric ED visits in North Carolina from 2016 to 2019 (May to Sept) for pediatric populations were aggregated at the county scale. Bernoulli cluster analyses identified high-risk spatial clusters of psychiatric morbidity during heatwave, drought, or compound heatwave and drought periods. Multivariate adaptive regression models examined the individual importance of household and community-level determinants in predicting high-risk clustering of mood disorders or suicidality across the three climate threats.

Results: Results showed significant spatial clustering of suicide and mood disorder risks in children during heatwave, drought, and compound event periods. Periods of drought were associated with the highest likelihood of spatial clustering for suicide and mood disorders, where the risk of an ED visit was 4.48 and 6.32 times higher, respectively, compared to non-drought periods. Compounding events were associated with a threefold increase in both suicide and mood disorder-related ED visits. Community and household vulnerability factors that most contributed to spatial clustering varied across climate hazards, but consistent determinants included residential segregation, green space availability, low English proficiency, overcrowding, no broadband access, no vehicle access, housing vacancy, and availability of housing units.

Conclusion: Findings advance understanding on the locations of vulnerable pediatric populations who are disproportionately exposed to compounding climate stressors and identify community resilience factors to target in public health adaptation strategies.

复合干旱和热浪事件对儿童心理健康的影响:空间聚类分析的启示。
背景:同时发生的热浪和干旱事件对健康的影响可能大于单独发生的两种事件对健康的影响;但是,还没有基于美国的研究对复合干旱和热浪事件对儿科人群的不同心理健康影响进行研究:目的:研究热浪、干旱以及复合热浪和干旱事件期间儿童情绪障碍和自杀相关急诊就诊的空间模式。与单个气候灾害的叠加效应相比,我们检验了复合热浪和干旱事件的发生是否会对儿童心理健康相关结果的风险产生协同(倍增)效应。最后,我们确定了造成精神疾病高负担地域差异的家庭和社区层面的决定因素:对 2016 年至 2019 年(5 月至 9 月)北卡罗来纳州儿科精神科急诊室每日就诊人数进行县级汇总。伯努利聚类分析确定了热浪、干旱或复合热浪和干旱期间精神病发病率的高风险空间聚类。多变量适应性回归模型检验了家庭和社区层面的决定因素在预测三种气候威胁下情绪障碍或自杀高风险聚类中的个体重要性:结果表明,在热浪、干旱和复合事件期间,儿童自杀和情绪障碍的风险在空间上有明显的聚集。与非干旱期相比,干旱期的自杀和情绪障碍空间集群可能性最高,ED就诊风险分别高出4.48倍和6.32倍。与自杀和情绪障碍相关的急诊就诊率增加了三倍。造成空间聚集的社区和家庭脆弱性因素因气候灾害而异,但一致的决定因素包括居住隔离、绿地可用性、英语水平低、过度拥挤、无宽带接入、无车辆接入、住房空置和住房单元可用性:研究结果加深了人们对易受复合气候压力影响的儿科弱势群体所在地的了解,并确定了公共卫生适应战略中应针对的社区恢复力因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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