skip to main content


Title: Compounding hazards and intersecting vulnerabilities: experiences and responses to extreme heat during COVID-19
Abstract Extreme heat is a major threat to human health worldwide. The COVID-19 pandemic, with its complexity and global reach, created unprecedented challenges for public health and highlighted societal vulnerability to hazardous hot weather. In this study, we used data from a three-wave nationally representative survey of 3036 American adults to examine how the COVID-19 pandemic affected extreme heat vulnerability during the summer of 2020. We used mixed effects models to examine the roles of socio-demographic characteristics and pandemic-related factors in the distribution of negative heat effects and experiences across the United States. The survey findings show that over a quarter of the US population experienced heat-related symptoms during the summer of 2020. Mixed effects models demonstrate that among all socio-economic groups, those who were most vulnerable were women, those in low-income households, unemployed or on furlough, and people who identify as Hispanic or Latino or as other non-white census categories (including Asian, American Indian or Alaska Native, Native Hawaiian or other Pacific Islander, and multi-racial US residents). The study findings indicate that millions of people in the US had difficulty coping with or responding to extreme heat because of the direct and indirect effects of the COVID-19 pandemic. Limited access to cooling as well as COVID-19 related social isolation played a major role in adverse heat health effects. Geographically, the South and the West of the US stood out in terms of self-reported negative heat effects. Overall, the study suggests that the intersection of two health hazards—extreme heat and coronavirus SARS-CoV2—amplified existing systemic vulnerabilities and expanded the demographic range of people vulnerable to heat stress.  more » « less
Award ID(s):
2031217
NSF-PAR ID:
10323224
Author(s) / Creator(s):
; ; ;
Date Published:
Journal Name:
Environmental Research Letters
Volume:
16
Issue:
8
ISSN:
1748-9326
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. Importance

    Marked elevation in levels of depressive symptoms compared with historical norms have been described during the COVID-19 pandemic, and understanding the extent to which these are associated with diminished in-person social interaction could inform public health planning for future pandemics or other disasters.

    Objective

    To describe the association between living in a US county with diminished mobility during the COVID-19 pandemic and self-reported depressive symptoms, while accounting for potential local and state-level confounding factors.

    Design, Setting, and Participants

    This survey study used 18 waves of a nonprobability internet survey conducted in the United States between May 2020 and April 2022. Participants included respondents who were 18 years and older and lived in 1 of the 50 US states or Washington DC.

    Main Outcome and Measure

    Depressive symptoms measured by the Patient Health Questionnaire-9 (PHQ-9); county-level community mobility estimates from mobile apps; COVID-19 policies at the US state level from the Oxford stringency index.

    Results

    The 192 271 survey respondents had a mean (SD) of age 43.1 (16.5) years, and 768 (0.4%) were American Indian or Alaska Native individuals, 11 448 (6.0%) were Asian individuals, 20 277 (10.5%) were Black individuals, 15 036 (7.8%) were Hispanic individuals, 1975 (1.0%) were Pacific Islander individuals, 138 702 (72.1%) were White individuals, and 4065 (2.1%) were individuals of another race. Additionally, 126 381 respondents (65.7%) identified as female and 65 890 (34.3%) as male. Mean (SD) depression severity by PHQ-9 was 7.2 (6.8). In a mixed-effects linear regression model, the mean county-level proportion of individuals not leaving home was associated with a greater level of depression symptoms (β, 2.58; 95% CI, 1.57-3.58) after adjustment for individual sociodemographic features. Results were similar after the inclusion in regression models of local COVID-19 activity, weather, and county-level economic features, and persisted after widespread availability of COVID-19 vaccination. They were attenuated by the inclusion of state-level pandemic restrictions. Two restrictions, mandatory mask-wearing in public (β, 0.23; 95% CI, 0.15-0.30) and policies cancelling public events (β, 0.37; 95% CI, 0.22-0.51), demonstrated modest independent associations with depressive symptom severity.

    Conclusions and Relevance

    In this study, depressive symptoms were greater in locales and times with diminished community mobility. Strategies to understand the potential public health consequences of pandemic responses are needed.

     
    more » « less
  2. Background

    Stay-at-home orders were one of the controversial interventions to curb the spread of COVID-19 in the United States. The stay-at-home orders, implemented in 51 states and territories between March 7 and June 30, 2020, impacted the lives of individuals and communities and accelerated the heavy usage of web-based social networking sites. Twitter sentiment analysis can provide valuable insight into public health emergency response measures and allow for better formulation and timing of future public health measures to be released in response to future public health emergencies.

    Objective

    This study evaluated how stay-at-home orders affect Twitter sentiment in the United States. Furthermore, this study aimed to understand the feedback on stay-at-home orders from groups with different circumstances and backgrounds. In addition, we particularly focused on vulnerable groups, including older people groups with underlying medical conditions, small and medium enterprises, and low-income groups.

    Methods

    We constructed a multiperiod difference-in-differences regression model based on the Twitter sentiment geographical index quantified from 7.4 billion geo-tagged tweets data to analyze the dynamics of sentiment feedback on stay-at-home orders across the United States. In addition, we used moderated effects analysis to assess differential feedback from vulnerable groups.

    Results

    We combed through the implementation of stay-at-home orders, Twitter sentiment geographical index, and the number of confirmed cases and deaths in 51 US states and territories. We identified trend changes in public sentiment before and after the stay-at-home orders. Regression results showed that stay-at-home orders generated a positive response, contributing to a recovery in Twitter sentiment. However, vulnerable groups faced greater shocks and hardships during the COVID-19 pandemic. In addition, economic and demographic characteristics had a significant moderating effect.

    Conclusions

    This study showed a clear positive shift in public opinion about COVID-19, with this positive impact occurring primarily after stay-at-home orders. However, this positive sentiment is time-limited, with 14 days later allowing people to be more influenced by the status quo and trends, so feedback on the stay-at-home orders is no longer positively significant. In particular, negative sentiment is more likely to be generated in states with a large proportion of vulnerable groups, and the policy plays a limited role. The pandemic hit older people, those with underlying diseases, and small and medium enterprises directly but hurt states with cross-cutting economic situations and more complex demographics over time. Based on large-scale Twitter data, this sociological perspective allows us to monitor the evolution of public opinion more directly, assess the impact of social events on public opinion, and understand the heterogeneity in the face of pandemic shocks.

     
    more » « less
  3. null (Ed.)
    We examine the uneven social and spatial distributions of COVID-19 and their relationships with indicators of social vulnerability in the U.S. epicenter, New York City (NYC). As of July 17th, 2020, NYC, despite having only 2.5% of the U.S. population, has [Formula: see text]6% of all confirmed cases, and [Formula: see text]16% of all deaths, making it a key learning ground for the social dynamics of the disease. Our analysis focuses on the multiple potential social, economic, and demographic drivers of disproportionate impacts in COVID-19 cases and deaths, as well as population rates of testing. Findings show that immediate impacts of COVID-19 largely fall along lines of race and class. Indicators of poverty, race, disability, language isolation, rent burden, unemployment, lack of health insurance, and housing crowding all significantly drive spatial patterns in prevalence of COVID-19 testing, confirmed cases, death rates, and severity. Income in particular has a consistent negative relationship with rates of death and disease severity. The largest differences in social vulnerability indicators are also driven by populations of people of color, poverty, housing crowding, and rates of disability. Results highlight the need for targeted responses to address injustice of COVID-19 cases and deaths, importance of recovery strategies that account for differential vulnerability, and provide an analytical approach for advancing research to examine potential similar injustice of COVID-19 in other U.S. cities. Significance Statement Communities around the world have variable success in mitigating the social impacts of COVID-19, with many urban areas being hit particularly hard. Analysis of social vulnerability to COVID-19 in the NYC, the U.S. national epicenter, shows strongly disproportionate impacts of the pandemic on low income populations and communities of color. Results highlight the class and racial inequities of the coronavirus pandemic in NYC, and the need to unpack the drivers of social vulnerability. To that aim, we provide a replicable framework for examining patterns of uneven social vulnerability to COVID-19- using publicly available data which can be readily applied in other study regions, especially within the U.S.A. This study is important to inform public and policy debate over strategies for short- and long-term responses that address the injustice of disproportionate impacts of COVID-19. Although similar studies examining social vulnerability and equity dimensions of the COVID-19 outbreak in cities across the U.S. have been conducted (Cordes and Castro 2020, Kim and Bostwick 2002, Gaynor and Wilson 2020; Wang et al. 2020; Choi and Unwin 2020), this study provides a more comprehensive analysis in NYC that extends previous contributions to use the highest resolution spatial units for data aggregation (ZCTAs). We also include mortality and severity rates as key indicators and provide a replicable framework that draws from the Centers for Disease Control and Prevention’s Social Vulnerability indicators for communities in NYC. 
    more » « less
  4. Lin, Chung-Ying (Ed.)
    Background University students are increasingly recognized as a vulnerable population, suffering from higher levels of anxiety, depression, substance abuse, and disordered eating compared to the general population. Therefore, when the nature of their educational experience radically changes—such as sheltering in place during the COVID-19 pandemic—the burden on the mental health of this vulnerable population is amplified. The objectives of this study are to 1) identify the array of psychological impacts COVID-19 has on students, 2) develop profiles to characterize students' anticipated levels of psychological impact during the pandemic, and 3) evaluate potential sociodemographic, lifestyle-related, and awareness of people infected with COVID-19 risk factors that could make students more likely to experience these impacts. Methods Cross-sectional data were collected through web-based questionnaires from seven U.S. universities. Representative and convenience sampling was used to invite students to complete the questionnaires in mid-March to early-May 2020, when most coronavirus-related sheltering in place orders were in effect. We received 2,534 completed responses, of which 61% were from women, 79% from non-Hispanic Whites, and 20% from graduate students. Results Exploratory factor analysis on close-ended responses resulted in two latent constructs, which we used to identify profiles of students with latent profile analysis, including high (45% of sample), moderate (40%), and low (14%) levels of psychological impact. Bivariate associations showed students who were women, were non-Hispanic Asian, in fair/poor health, of below-average relative family income, or who knew someone infected with COVID-19 experienced higher levels of psychological impact. Students who were non-Hispanic White, above-average social class, spent at least two hours outside, or less than eight hours on electronic screens were likely to experience lower levels of psychological impact. Multivariate modeling (mixed-effects logistic regression) showed that being a woman, having fair/poor general health status, being 18 to 24 years old, spending 8 or more hours on screens daily, and knowing someone infected predicted higher levels of psychological impact when risk factors were considered simultaneously. Conclusion Inadequate efforts to recognize and address college students’ mental health challenges, especially during a pandemic, could have long-term consequences on their health and education. 
    more » « less
  5. null (Ed.)
    CONTEXT With the onset of the COVID-19 pandemic, and the resulting response from universities, engineering students find themselves in an unprecedented situation. In addition to stressors related to the curriculum, residential students across the United States are being asked to relocate away from campus and engage in distance learning. At the same time, social distancing requirements are limiting students’ ability to socialize, procure food and supplies, exercise, and remain employed and financially solvent. Some students will fall ill while others face the prospect of sick family members, and even deaths in the family. Prior research suggests that individuals living through this pandemic are likely to face stress, uncertainty, and fear that affects their mental health and academic performance for years to come. PURPOSE OR GOAL The purpose of this study was to understand the ways in which the COVID-19 pandemic is affecting engineering students’ mental wellness, specifically stress, and how the effects differ for different groups of students. The research questions addressed are: 1) What effects has the pandemic had on baseline stress levels, and how do those vary by demographic group? 2) What effects has the pandemic had on quality of life, such as sleep habits and financial security, and how do those vary by demographic group? METHODS An online survey was conducted in the United States in May and June of 2020. More than 800 4-year engineering students who represented many engineering disciplines and universities responded. The survey used a modified version of the Holmes-Rahe Social Readjustment Rating Scale, which is a widely used and validated instrument to measure the effects of certain life events on stress. The data was analysed to determine the average increase in stress levels for students resulting from COVID-19, and which demographic groups have seen the most negative impact. We also report on which stress-inducing life-events were experienced most. OUTCOMES Latinx individuals and international students report statistically significantly higher levels of stress than the baseline population. Engineering students from other historically excluded identities, however,are not facing statistically significantly worse stress than their peers from historically over represented identities. Veterans fare better than the majority population on this metric.The data also indicates that different groups are more likely to experience different negative life-events because of COVID. CONCLUSIONS No previous research has examined the impacts of a global pandemic on engineering student stress and mental wellness. Our findings show that stress and mental wellness need to be understood intersectionally and that some underrepresented groups are disproportionately impacted by COVID-19. Understanding the impacts on students can help universities strategize and allocate limited resources most effectively to support student success. KEYWORDS Mental wellness; COVID-19; stress 
    more » « less