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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Bibliographic Details
Published in:Epidemiology (Cambridge, Mass.) Vol. 36; no. 4; p. 458
Main Authors: Do, Vivian, McBrien, Heather Kathleen, Edmondson, Donald, Kioumourtzoglou, Marianthi-Anna, Casey, Joan Allison
Format: Journal Article
Language:English
Published: United States 01.07.2025
Subjects:
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
New York
United States
Power outage
Electricity
Medicare
Cardiovascular diseases
Hospitalizations
ISSN:1531-5487, 1531-5487
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Summary: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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ISSN:1531-5487
1531-5487
DOI:10.1097/EDE.0000000000001853