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Where the Heart Lies: Cardiac Events and the Thomas Fire

Authors: Sophia Arabadjis*, University of California, Stuart Sweeney, University of California Santa Barbara
Topics: Medical and Health Geography, Hazards, Risks, and Disasters, Population Geography
Keywords: wildfire, health, cardiac events, clinical partnerships, evacuation orders
Session Type: Paper
Presentation File: No File Uploaded

It is well documented that extreme climate events have detrimental effects on the health of local communities including elevated incident of injury, infectious disease and mental health conditions. More recent research has shown that exposure to hurricanes, earthquakes and tsunamis are associated with an increased incidence of cardiac events and mortality at the population level. However, similar research on the effects of wildfires and cardiac event incidence has largely been limited to smoke and particulate level exposure as opposed to more direct exposures such as evacuation orders. In this paper we (clinicians + geographers) examine the effects of mandatory and voluntary evacuation orders on the risk of cardiac event using data from a local hospital system during the period of the Thomas Fire. The Thomas Fire burned from December 2017 through early January 2018, consuming 440 square miles and displacing nearly 105,000 residents. We use administrative clinical data from the local hospital over the 2016 - 2019 period coupled with patient-level address to determine exposure, and then model risk using a time-sensitive hazards model (Aalen's additive hazard model). Descriptive results of the time series suggest a departure from the normal seasonality of cardiac events in the area, and differential risk. Understanding baseline risk of cardiac events within a local population is an important step in preparation for emergency and medical services; evacuation orders may pose additional, cumulative risk that both emergency and medical services need to be prepared for in case of wildfire.

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