Grant Number:	1R21CA304866-01 Interpret this number
Primary Investigator:	Kresovich, Jacob
Organization:	H. Lee Moffitt Cancer Ctr & Res Inst
Project Title:	The Influence of Extreme Weather Events on Emergency Department Utilization Among Cancer Patients in Florida
Fiscal Year:	2025

Extreme weather is becoming more frequent and severe in the United States, posing serious health risks to vulnerable populations, including people with cancer. Cancer patients, already burdened by the physical and psychological effects of cancer and its treatment, may be especially sensitive to extreme weather. Despite evidence that extreme weather affects emergency department (ED) visitation rates in the general population and disrupts cancer care delivery, little is known about the effects of extreme weather events on cancer patients’ healthcare utilization. Over the last decade, ED visits by cancer patients have risen by 67%, contributing to financial toxicities and poor health outcomes. However, no studies have yet examined the role of extreme weather on ED utilization of cancer patients. Understanding these effects will be essential for developing resilient healthcare systems that ensure people with cancer receive timely and appropriate care. Here, we propose the first-ever population-based epidemiologic study to investigate the relationship between extreme weather events and ED utilization rates in cancer patients. Our study will focus on identifying potential disparities, characterizing the most environmentally sensitive groups of cancer patients, and describing the medical reasons for ED visits following extreme weather events. We hypothesize that extreme weather events disproportionally increase ED utilization and hospitalization rates in cancer patients. To test this hypothesis, we will spatiotemporally link high-resolution heat index data and Federal Emergency Management Agency disaster declarations to residential zip codes for all ED visits in the OneFlorida+ Data Trust from 2012 to 2023. This comprehensive linkage will allow us to conduct a case-crossover study, comparing the strength of associations between extreme weather events, specifically severe storms and heat, and ED visits among adults, both with and without a recent cancer diagnosis. Case-crossover designs are ideal for examining the effects of short-term exposures on acute health events and inherently control for time-invariant confounders, can be extended to account for time-varying factors (e.g., seasonality, cancer treatments), and allow for subgroup analyses using stratified models. We propose the following aims: 1) Quantify and compare extreme weather event associations with ED visits and hospitalization rates in patients with and without a recent cancer diagnosis; 2) Identify clinical and sociodemographic factors that modify the relationship between extreme weather and ED visits and hospitalization rates in cancer patients; and 3) Characterize the medical reasons for ED visits and hospitalization following extreme weather events in cancer patients. Impact: As extreme weather events are affecting more Americans, it will be critical to anticipate and address the needs of cancer patients before disaster strikes. Results from this study will inform the development of resilient healthcare systems and guide the creation of tailored emergency preparedness strategies.





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