Impact of Extreme Weather on Healthcare Utilization by People with HIV in Metropolitan Miami

Daniel Samano, Shubhayu Saha, Taylor Corbin Kot, JoNell E. Potter and Lunthita M. Duthely
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Daniel Samano: Miller School of Medicine, Department of Neurological Surgery, University of Miami, Miami, FL 33136, USA
Shubhayu Saha: Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
Taylor Corbin Kot: Miller School of Medicine, Department of Public Health Sciences, University of Miami, Miami, FL 33136, USA
JoNell E. Potter: Miller School of Medicine, Department of Obstetrics and Gynecology, University of Miami, Miami, FL 33136, USA
Lunthita M. Duthely: Miller School of Medicine, Department of Obstetrics and Gynecology, University of Miami, Miami, FL 33136, USA

IJERPH, 2021, vol. 18, issue 5, 1-10

Abstract: Extreme weather events (EWE) are expected to increase as climate change intensifies, leaving coastal regions exposed to higher risks. South Florida has the highest HIV infection rate in the United States, and disruptions in clinic utilization due to extreme weather conditions could affect adherence to treatment and increase community transmission. The objective of this study was to identify the association between EWE and HIV-clinic attendance rates at a large academic medical system serving the Miami-Dade communities. The following methods were utilized: (1) Extreme heat index (EHI) and extreme precipitation (EP) were identified using daily observations from 1990–2019 that were collected at the Miami International Airport weather station located 3.6 miles from the studied HIV clinics. Data on hurricanes, coastal storms and flooding were collected from the National Oceanic and Atmospheric Administration Storms Database (NOAA) for Miami-Dade County. (2) An all-HIV clinic registry identified scheduled daily visits during the study period (hurricane seasons from 2017–2019). (3) Daily weather data were linked to the all-HIV clinic registry, where patients’ ‘no-show’ status was the variable of interest. (4) A time-stratified, case crossover model was used to estimate the relative risk of no-show on days with a high heat index, precipitation, and/or an extreme natural event. A total of 26,444 scheduled visits were analyzed during the 383-day study period. A steady increase in the relative risk of ‘no-show’ was observed in successive categories, with a 14% increase observed on days when the heat index was extreme compared to days with a relatively low EHI, 13% on days with EP compared to days with no EP, and 10% higher on days with a reported extreme weather event compared to days without such incident. This study represents a novel approach to improving local understanding of the impacts of EWE on the HIV-population’s utilization of healthcare, particularly when the frequency and intensity of EWE is expected to increase and disproportionately affect vulnerable populations. More studies are needed to understand the impact of EWE on routine outpatient settings.

Keywords: extreme weather events; climate and health; climate change; healthcare access; HIV (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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