Long-term Effects of Disasters on Health Care Utilization: Hurricane Katrina and Older Individuals with Diabetes

Quast, Troy; Feng, Lijuan

doi:10.1017/dmp.2018.128

Cited by 13 publications

(7 citation statements)

References 19 publications

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“…The trend in screening participation rates shown in this study seems consistent with the tendency to refrain from usual health maintenance services for chronic diseases and other decreases after a major disaster. For example, in the three years following Hurricane Katrina, the proportion of residents undergoing diabetes care was lower than in the pre-disaster period 28 ; mental health utilization among the United States military veterans also declined in the months following the disaster 29 . After a large-scale disaster, both short-term and long-term medical interruptions are important, and recovery efforts need to be focused on.…”

Section: Discussionmentioning

confidence: 99%

The long term participation trend for the colorectal cancer screening after the 2011 triple disaster in Minamisoma City, Fukushima, Japan

Saito

Ozaki

Murakami

et al. 2021

Sci Rep

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Colorectal cancer (CRC) screening is a well-established cancer screening method, and its effectiveness depends on maintaining a high participation rate in the target population. In this study, we analyzed the trends in CRC screening participation rates over 10 years in Minamisoma City, where residents were forced to evacuate after the 2011 triple disaster in Fukushima, Japan. The immunochemical fecal occult blood test is provided as municipal CRC screening. We calculated the annual CRC screening participation rate and analyzed the factors associated with participation in screening. Overall, 4069 (12.3%) and 3839 (11.7%) persons participated in CRC screening in 2009 and 2010, respectively; however, the number decreased significantly to 1090 (3.4%) in 2011 when the earthquake occurred. Over the following 3 years, the rate gradually recovered. Multivariable logistic analysis showed that age < 65 years, living alone, and evacuation were significant associated factors for non-participation after 2011 (p < 0.05). In conclusion, the CRC screening participation rate decreased significantly during the Great East Japan Earthquake but recovered over the next 3 years. Further analysis of factors preventing CRC screening participation and research on the long-term effects of its post-disaster decline are important to consider in assessing the need for intervention in post-disaster cancer screening.

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Section: Discussionmentioning

confidence: 99%

The long term participation trend for the colorectal cancer screening after the 2011 triple disaster in Minamisoma City, Fukushima, Japan

Saito

Ozaki

Murakami

et al. 2021

Sci Rep

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“…Our estimates may partly reflect interruptions in care that later manifested in increased mortality. For instance, in the 3 years following Hurricane Katrina, older individuals with diabetes who lived in affected areas were less likely to obtain cholesterol, HbA 1c , and microalbumin screens (14). Dialysis patients faced challenges obtaining care following Katrina due to problems with dialysis unit function and supplies (28).…”

Section: Discussionmentioning

confidence: 99%

“…Dialysis patients impacted by Katrina had higher hospitalization rates (12) but not 6-month mortality risk (13). Seniors with diabetes had reduced rates of maintenance screens following the storm (14). Individuals with diabetes in areas impacted by Superstorm Sandy had higher emergency department visit and hospitalization rates (1,15,16).…”

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confidence: 99%

Long-term Effects of Disasters on Seniors With Diabetes: Evidence From Hurricanes Katrina and Rita

2019

Self Cite

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To estimate the long-run mortality effects of Hurricanes Katrina and Rita on seniors with diabetes. RESEARCH DESIGN AND METHODS We performed a retrospective cohort analysis of Medicare enrollment and claims data covering four states and ∼10 years. Affected individuals were identified by whether they lived in a county that suffered a high impact and were stratified by whether they moved to a different county following the storms. Propensity scores matched affected and comparison subjects based on demographic and socioeconomic characteristics and the presence of chronic conditions. Our sample consisted of 170,328 matched affected subjects. RESULTS The affected subjects had a nearly 40% higher all-cause mortality risk in the 1st month after the storms, but the difference fell to <6% by the end of the full observation period. The mortality risks of heart disease and nephritis also exhibited the largest differences immediately following the storms. Among the affected subjects, the all-cause mortality risk was higher for those who moved to a different county, with an especially large difference among those who moved to an affected county. CONCLUSIONS The propensity matching procedure resulted in the comparison and affected groups having similar observable characteristics. However, we only examined the extreme outcome of mortality, our definition of affected was somewhat crude, and our sample did not include individuals enrolled in Medicare Advantage. Our findings highlight the importance of the immediate response to disasters, yet also demonstrate the long-lasting impact disasters can have. Disasters can pose severe immediate challenges to individuals with diabetes, including disrupted access to health care providers, difficulty in obtaining proper nutrition, damaged or lost medications, and challenges in monitoring glucose levels (1). However, the longer-term effects of disasters are less understood. Generally, less attention is paid to effects from disasters as time passes. Further, it is difficult to associate outcomes with disasters significantly later due to challenges in obtaining complete longitudinal data and the occurrence of confounding events. However, there may be significant long-term effects of disasters on those with diabetes. Some individuals may not recover from the initial impact due to the trauma.

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“…DRs are also used to determine which counties are eligible for public assistance only, or public and individual assistance. Following similar studies that use DRs as a metric for damage, counties receiving public and individual assistance were considered to have the most severe need for post-disaster food, shelter, water, and medical needs and were classified as “high-damage,” counties receiving public assistance only were classified as “low-damage”, and counties that did not receive any DR as “no damage” [ 61 – 64 ].…”

Section: Methodsmentioning

confidence: 99%

Differences in county-level cardiovascular disease mortality rates due to damage caused by hurricane Matthew and the moderating effect of social capital: a natural experiment

McCann

Szaflarski

2023

BMC Public Health

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Background As the climate continues to warm, hurricanes will continue to increase in both severity and frequency. Hurricane damage is associated with cardiovascular events, but social capital may moderate this relationship. Social capital is a multidimensional concept with a rich theoretical tradition. Simply put, social capital refers to the social relationships and structures that provide individuals with material, financial, and emotional resources throughout their lives. Previous research has found an association between high levels of social capital and lower rates of cardiovascular (CVD) mortality. In post-disaster settings, social capital may protect against CVD mortality by improving access to life-saving resources. We examined the association between county-level hurricane damage and CVD mortality rates after Hurricane Matthew, and the moderating effect of several aspects of social capital and hurricane damage on this relationship. We hypothesized that (1) higher (vs. lower) levels of hurricane damage would be associated with increased CVD mortality rates and (2) in highly damaged counties, higher (vs. lower) levels of social capital would be associated with lower CVD mortality. Methods Analysis used yearly (2013-2018) county-level sociodemographic and epidemiological data (n = 183). Sociodemographic data were compiled from federal surveys before and after Hurricane Matthew to construct, per prior literature, a social capital index based on four dimensions of social capital (sub-indices): family unity, informal civil society, institutional confidence, and collective efficacy. Epidemiological data comprised monthly CVD mortality rates constructed from monthly county-level CVD death counts from the CDC WONDER database and the US Census population estimates. Changes in CVD mortality based on level of hurricane damage were assessed using regression adjustment. We used cluster robust Poisson population average models to determine the moderating effect of social capital on CVD mortality rates in both high and low-damage counties. Results We found that mean levels of CVD mortality increased (before and after adjustment for sociodemographic controls) in both low-damage counties (unadjusted. Mean = 2.50, 95% CI [2.41, 2.59], adjusted mean = 2.50, 95% CI [2.40, 2.72]) and high-damage counties (mean = 2.44, CI [2.29, 2.46], adj. Mean = 2.51, 95% CI [2.49, 2.84]). Among the different social capital dimensions, institutional confidence was associated with reduced initial CVD mortality in low-damage counties (unadj. IRR 1.00, 95% CI [0.90, 1.11], adj. IRR 0.91 CI [0.87, 0.94]), but its association with CVD mortality trends was null. The overall effects of social capital and its sub-indices were largely nonsignificant. Conclusion Hurricane damage is associated with increased CVD mortality for 18 months after Hurricane Matthew. The role of social capital remains unclear. Future research should focus on improving measurement of social capital and quality of hurricane damage and CVD mortality data.

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Long-term Effects of Disasters on Health Care Utilization: Hurricane Katrina and Older Individuals with Diabetes

Cited by 13 publications

References 19 publications

The long term participation trend for the colorectal cancer screening after the 2011 triple disaster in Minamisoma City, Fukushima, Japan

The long term participation trend for the colorectal cancer screening after the 2011 triple disaster in Minamisoma City, Fukushima, Japan

Long-term Effects of Disasters on Seniors With Diabetes: Evidence From Hurricanes Katrina and Rita

Differences in county-level cardiovascular disease mortality rates due to damage caused by hurricane Matthew and the moderating effect of social capital: a natural experiment

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