Electrical power outages and asthma-related emergency department visits in New York City, 2018-2022

BACKGROUND: To minimize the health impacts of power outages, which have steadily increased with climate change and aging infrastructure, it is crucial to recognize their range of effects and identify the most vulnerable individuals and communities. Here, we investigate the health consequences of outages among those with asthma residing in New York City. METHODS: We combined administrative emergency department (ED) visit data from 2018-2022 with two granular power outage data sources: the New York State Department of Public Service (NYSDPS, locality level) and the New York City Housing Authority (NYCHA, building level). We applied an augmented synthetic control approach to four large-scale outages in the NYSDPS data to assess their association with asthma-related ED visits. We used a case-crossover design to assess the impact of same-day, building-level outage exposure in the NYCHA data on asthma-related ED visits. RESULTS: A large, localized outage on July 21, 2019 was associated with 0.20 (95% CI: 0.00, 0.34) per 1,000 sub-daily increases in asthma-related ED visits the same evening of the outage start. For NYCHA residents, in the summer months, outage days were associated with elevated odds of asthma-related ED visits (2.23, 95% CI: 0.92, 5.37), and these effects were particularly relevant for children and for lag days 0-1. CONCLUSION: Climate change impacts communities through severe weather events and their subsequent disruptions to critical infrastructure, such as electricity service. We add to the limited evidence that these disruptions carry health risks, in this case acute care asthma visits.