The Impact of Power Outages on Cardiovascular Hospitalizations Among Medicare Fee-for-service Enrollees in New York State, 2017-2018
Power outages are common. They can result in exposure to extreme temperatures by shutting off temperature-controlling devices, and thereby also cause stress. Consequently, outages may precipitate cardiovascular disease (CVD)-related hospitalizations. We assessed this relationship among older adults....
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| Published in: | Epidemiology (Cambridge, Mass.) Vol. 36; no. 4; p. 458 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
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United States
01.07.2025
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| ISSN: | 1531-5487, 1531-5487 |
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| Abstract | Power outages are common. They can result in exposure to extreme temperatures by shutting off temperature-controlling devices, and thereby also cause stress. Consequently, outages may precipitate cardiovascular disease (CVD)-related hospitalizations. We assessed this relationship among older adults.
We leveraged 2017-2018 data from 245,452 New York State Medicare Fee-for-Service beneficiaries (65+ years) with 390,530 CVD hospitalizations. Using NY Department of Public Services data, we calculated total hours without power 1 day, 1-2 days, and 1-3 days before case and control periods, with an outage ZIP Code Tabulation Area (ZCTA)-hour defined based on ≥10% of customers in a ZCTA-hour without power in primary analyses. We used a case-crossover study design and ran conditional logistic regression to assess associations separately within each urbanicity level: New York City (NYC), non-NYC urban, and rural areas. We additionally stratified models by warm versus cool season, individual-level age and sex, and ZCTA-level socioeconomic factors. Secondarily, we considered emergency (n = 298,910) and nonemergency hospitalizations separately.
We generally observed null associations between power outages and all CVD hospitalizations across New York State and within subgroups. For example, in NYC, we observed a rate ratio of 1.05 (95% confidence interval: 0.85, 1.30) for each additional power outage hour 1 day prior.
The case-crossover design we used eliminated time-fixed confounding, but there were a limited number of exposed cases, limiting statistical power. Future studies should investigate co-occurring severe weather, span additional years, and evaluate other and broader geographic areas. |
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| AbstractList | Power outages are common. They can result in exposure to extreme temperatures by shutting off temperature-controlling devices, and thereby also cause stress. Consequently, outages may precipitate cardiovascular disease (CVD)-related hospitalizations. We assessed this relationship among older adults.BACKGROUNDPower outages are common. They can result in exposure to extreme temperatures by shutting off temperature-controlling devices, and thereby also cause stress. Consequently, outages may precipitate cardiovascular disease (CVD)-related hospitalizations. We assessed this relationship among older adults.We leveraged 2017-2018 data from 245,452 New York State Medicare Fee-for-Service beneficiaries (65+ years) with 390,530 CVD hospitalizations. Using NY Department of Public Services data, we calculated total hours without power 1 day, 1-2 days, and 1-3 days before case and control periods, with an outage ZIP Code Tabulation Area (ZCTA)-hour defined based on ≥10% percent of customers in a ZCTA-hour without power in primary analyses. We used a case-crossover study design and ran conditional logistic regression to assess associations separately within each urbanicity level: New York City (NYC), non-NYC urban, and rural areas. We additionally stratified models by warm versus cool season, individual-level age and sex, and ZCTA-level socioeconomic factors. Secondarily, we considered emergency (n = 298,910) and non-emergency hospitalizations separately.METHODSWe leveraged 2017-2018 data from 245,452 New York State Medicare Fee-for-Service beneficiaries (65+ years) with 390,530 CVD hospitalizations. Using NY Department of Public Services data, we calculated total hours without power 1 day, 1-2 days, and 1-3 days before case and control periods, with an outage ZIP Code Tabulation Area (ZCTA)-hour defined based on ≥10% percent of customers in a ZCTA-hour without power in primary analyses. We used a case-crossover study design and ran conditional logistic regression to assess associations separately within each urbanicity level: New York City (NYC), non-NYC urban, and rural areas. We additionally stratified models by warm versus cool season, individual-level age and sex, and ZCTA-level socioeconomic factors. Secondarily, we considered emergency (n = 298,910) and non-emergency hospitalizations separately.We generally observed null associations between power outages and all CVD hospitalizations across New York State and within sub-groups. For example, in NYC, we observed a rate ratio of 1.05 (95% CI: 0.85-1.30) for each additional power outage hour 1 day prior.RESULTSWe generally observed null associations between power outages and all CVD hospitalizations across New York State and within sub-groups. For example, in NYC, we observed a rate ratio of 1.05 (95% CI: 0.85-1.30) for each additional power outage hour 1 day prior.The case-crossover design we used eliminated time-fixed confounding, but there were a limited number of exposed cases, limiting statistical power. Future studies should investigate co-occurring severe weather, span additional years, and evaluate other and broader geographic areas.CONCLUSIONSThe case-crossover design we used eliminated time-fixed confounding, but there were a limited number of exposed cases, limiting statistical power. Future studies should investigate co-occurring severe weather, span additional years, and evaluate other and broader geographic areas. Power outages are common. They can result in exposure to extreme temperatures by shutting off temperature-controlling devices, and thereby also cause stress. Consequently, outages may precipitate cardiovascular disease (CVD)-related hospitalizations. We assessed this relationship among older adults. We leveraged 2017-2018 data from 245,452 New York State Medicare Fee-for-Service beneficiaries (65+ years) with 390,530 CVD hospitalizations. Using NY Department of Public Services data, we calculated total hours without power 1 day, 1-2 days, and 1-3 days before case and control periods, with an outage ZIP Code Tabulation Area (ZCTA)-hour defined based on ≥10% of customers in a ZCTA-hour without power in primary analyses. We used a case-crossover study design and ran conditional logistic regression to assess associations separately within each urbanicity level: New York City (NYC), non-NYC urban, and rural areas. We additionally stratified models by warm versus cool season, individual-level age and sex, and ZCTA-level socioeconomic factors. Secondarily, we considered emergency (n = 298,910) and nonemergency hospitalizations separately. We generally observed null associations between power outages and all CVD hospitalizations across New York State and within subgroups. For example, in NYC, we observed a rate ratio of 1.05 (95% confidence interval: 0.85, 1.30) for each additional power outage hour 1 day prior. The case-crossover design we used eliminated time-fixed confounding, but there were a limited number of exposed cases, limiting statistical power. Future studies should investigate co-occurring severe weather, span additional years, and evaluate other and broader geographic areas. |
| Author | Do, Vivian McBrien, Heather Kathleen Kioumourtzoglou, Marianthi-Anna Edmondson, Donald Casey, Joan Allison |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/40125837$$D View this record in MEDLINE/PubMed |
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| Keywords | Power outage Electricity Medicare Cardiovascular diseases Hospitalizations |
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| Snippet | Power outages are common. They can result in exposure to extreme temperatures by shutting off temperature-controlling devices, and thereby also cause stress.... |
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| SubjectTerms | Aged Aged, 80 and over Cardiovascular Diseases - epidemiology Cross-Over Studies Fee-for-Service Plans - statistics & numerical data Female Hospitalization - statistics & numerical data Humans Male Medicare - statistics & numerical data New York - epidemiology United States |
| Title | The Impact of Power Outages on Cardiovascular Hospitalizations Among Medicare Fee-for-service Enrollees in New York State, 2017-2018 |
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