The Impact of Disasters on Populations With Health and Health Care Disparities

Davis, Jennifer R.; Wilson, Sacoby; Brock-Martin, Amy; Glover, Saundra H.; Svendsen, Erik

doi:10.1017/s1935789300002391

Cited by 98 publications

(93 citation statements)

References 120 publications

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“…4-7 While surge capacity refers to the provision of medical care to a large volume of persons during the acute response 8 ; we define secondary surge capacity as the sustained ability of a health care system to expand operational resources to meet the increased and/or fluctuating demand for medical care services throughout long-term recovery. The current disaster literature has examined surge capacity constraints during the initial response 9,10 , but has largely overlooked the surging demand in health services to address the ballooning of incident or existing chronic disease in the aftermath of a disaster.…”

Section: Introductionmentioning

confidence: 99%

Secondary Surge Capacity: A Framework for Understanding Long-Term Access to Primary Care for Medically Vulnerable Populations in Disaster Recovery

et al. 2012

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Disasters create a secondary surge in casualties due to the sudden increase in need for long-term healthcare within the disaster population. Surging demands for medical care in the months after a disaster place excess strain on an overtaxed health care system operating at maximum or reduced capacity. Amplified demand met by diminishing supply likely disrupts the provision of and access to routine health services in the months post-disaster. Health disparities within vulnerable disaster populations present before the disaster are often exacerbated by systematic differences in access to primary care after the disaster. The following article applies a leading health services use model to identify areas of vulnerability that perpetuate health disparities for at-risk populations seeking entry into a frayed health system recovering from a disaster. We propose a framework to understand the role of the medical system in modifying the health impact of the secondary surge on vulnerable populations. Baseline assessment of existing needs and the anticipation of ballooning chronic health care needs following the acute response for at-risk populations are vulnerability gaps currently overlooked in national surge capacity plans.

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Section: Introductionmentioning

confidence: 99%

Secondary Surge Capacity: A Framework for Understanding Long-Term Access to Primary Care for Medically Vulnerable Populations in Disaster Recovery

et al. 2012

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“…11 Davis et al found that few studies focused on the specific impact of disasters on preexisting health disparities. 12 …”

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confidence: 99%

Using Appendiceal Perforation Rates to Measure Impact of a Disaster on Healthcare System Effectiveness

Mack

Rust²,

Baltrus³

et al. 2013

Southern Medical Journal

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Objectives To understand baseline inequities in appendiceal perforation rates and the impact of hurricane destruction on the healthcare system with respect to perforation rates and racial disparities. Methods We used claims data extracted from Medicaid Analytic Extract files to identify appendicitis diagnoses in children and adolescents based on International Classification of Diseases-9 codes and appendectomy procedures based on Current Procedural Terminology codes in the hurricane-affected states of Mississippi and Louisiana. County-level summary data obtained from 2005 Area Resource Files were used to determine high and low hurricane-affected areas. We estimated logistic regression models, mutually adjusting for race, sex, and age, to examine disparities and mixed logistic regression models to determine whether county-level effects contributed to perforation rates. Results There were nine counties in the high-impact area and 133 counties in the low-impact area. Living in the high- or low-impact area was not associated with a statistically different rate of perforation before or after Hurricane Katrina; however, living in the high-impact area was associated with a change from a lower risk (odds ratio [OR] 0.62) of perforation prehurricane to a higher risk (OR 1.14) posthurricane compared with those living in the low-impact areas. African Americans had statistically higher perforation rates than whites in the high-impact areas both before (OR 1.46) and after (OR 1.71) Hurricane Katrina. Conclusions Health professionals and hospital systems were able to maintain effective levels of care before and after Hurricane Katrina; however, perforation rates in African Americans suggest ongoing racial disparities during disasters.

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“…As the other disasters have previously illustrated, there is a constant struggle to mitigate selection bias in epidemiologic studies of disaster populations. This is even more of a concern when there is the likelihood of health disparities across race [47] and lack of trust in public officials who some may think should have prevented the EPHD. Distrust is a very normal response because trust has been broken in EPHDs, and such affected communities are often already socio-economically disadvantaged [48].…”

Section: Resultsmentioning

confidence: 99%

Epidemiologic Methods Lessons Learned from Environmental Public Health Disasters: Chernobyl, the World Trade Center, Bhopal, and Graniteville, South Carolina

Svendsen

Runkle

Dhara

et al. 2012

IJERPH

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Background: Environmental public health disasters involving hazardous contaminants may have devastating effects. While much is known about their immediate devastation, far less is known about long-term impacts of these disasters. Extensive latent and chronic long-term public health effects may occur. Careful evaluation of contaminant exposures and long-term health outcomes within the constraints imposed by limited financial resources is essential. Methods: Here, we review epidemiologic methods lessons learned from conducting long-term evaluations of four environmental public health disasters involving hazardous contaminants at Chernobyl, the World Trade Center, Bhopal, and Graniteville (South Carolina, USA). Findings: We found several lessons learned which have direct implications for the on-going disaster recovery work following the Fukushima radiation disaster or for future disasters. Interpretation: These lessons should prove useful in understanding and mitigating latent health effects that may result from the nuclear reactor accident in Japan or future environmental public health disasters.

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The Impact of Disasters on Populations With Health and Health Care Disparities

Cited by 98 publications

References 120 publications

Secondary Surge Capacity: A Framework for Understanding Long-Term Access to Primary Care for Medically Vulnerable Populations in Disaster Recovery

Secondary Surge Capacity: A Framework for Understanding Long-Term Access to Primary Care for Medically Vulnerable Populations in Disaster Recovery

Using Appendiceal Perforation Rates to Measure Impact of a Disaster on Healthcare System Effectiveness

Epidemiologic Methods Lessons Learned from Environmental Public Health Disasters: Chernobyl, the World Trade Center, Bhopal, and Graniteville, South Carolina

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