Health Risk And Vulnerability Of Pregnant Women Under The Impact Of Severe Tropical Cyclone And Large-scale Power Outage

Background and ObjectiveUnder the background of climate change,the frequency and intensity of the hurricane have increased greatly.Severe tropical cyclones,such as typhoons or hurricanes seriously threatens human health.Pregnant women are always an important vulnerable group from extreme weather events.However,whether hurricane exposure is associated with prenatal health is less known,and there are fewer studies on the long-term health impact of hurricanes.In addition,hurricane-related power outages have become more frequent in recent years.However,there is no report on the relationship between a large-scale power outage and maternal health.Vulnerability assessment is conducive to identifying regional risks or optimizing resource allocation.However,the current vulnerability assessment has some limitations.In recent years,machine learning technology has been applied more and more widely,and it has advantages in index screening and model prediction.Based on this,this study intends to study the health risks of pregnant women affected by severe tropical cyclones or large-scale power outages,and apply machine learning to assess the health vulnerability from hurricanes.MethodsIn this study,we took the Super Strom“Sandy”(2012)as a study case and New York State(NYS)as the study site.The health risks of pregnant women in eight counties severely affected by Hurricane Sandy in NYS were estimated by using time series analysis and counter-factual inference methods.The short-term health risk and lasting health impact of the hurricane on pregnant women were investigated.The health risks of pregnant women was analyzed by disease,age,and socioeconomic status.We also used the mixed linear model analysis method to explore the relationship between the visits of pregnancy complications and power outage coverage and duration in eight affected counties of NYS under the background of large-scale power outages.This study improved the traditional vulnerability assessment method,and used the random forest model to screen the key factors affecting the health risk of the hurricane,and built a model to predict the health vulnerability of pregnant women for each community of the eight counties in NYS based on the relationship between the factors and health risks.ResultsThe total pregnancy complications were estimated to increase by 6.3%(95%CI:2.2%,10.5%)during the Hurricane Sandy period in eight affected counties in NYS.And the health impact may last for months or even two years.The health risks of different diseases and social groups are different.For example,there were higher risks for preterm delivery and gestational diabetes,and the low socioeconomic status group.We found that large-scale power outage during the disaster may impact the health of pregnant women.Each 10%increase in coverage of power outage and 10 hours increase in duration of power outage corresponded to an 2.4%(95%CI:0.8%,4.1%)and 11.2%(95%CI:2.9%,20.2%)for pregnancy complications,respectively.The affected pregnancy complications included abortion and preterm delivery,and pregnant women in older and poorer socioeconomic status had a higher risk.In the vulnerability studies,we found that areas with high flood exposure and poor socio-economic status were more vulnerable to a hurricane.The prediction accuracy of regional health vulnerability based on key factors was higher,with an AUC=0.81ConclusionSevere tropical cyclone,such as Hurricane Sandy has both short-term and long-term effects on the health of pregnant women;large-scale power outage may increase the risk of pregnancy health;preterm delivery and low socio-economic groups have higher health risks from the hurricane and power outage;and machine learning-based vulnerability assessment is more practical and may provide a new way for health vulnerability assessment.