“…In addition to the immediate impact of the disaster, secondary effects of disasters such as infrastructure damage, lack of sanitation, impact on health care workforce, distribution of resources, and increased psychosocial needs have been shown to impact public health and health care utilization in the aftermath of a disaster. 1,2 A number of studies have documented the increased risk of communicable diseases, 3,4 the psychosocial impact related to disasters (increased alcohol abuse, anxiety, post-traumatic stress disorder, and depression), [5][6][7] increased chronic health exacerbations such as chronic obstructive pulmonary disease (COPD), [8][9][10] and decreased facility utilization for operative procedures and deliveries as well as decreased health care utilization for HIV, malaria, and other infectious diseases (ID). 2 Few studies have evaluated the impact that disasters have had on health care utilization in the months and years following a disaster.…”