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Huang W, Gao Y, Xu R, Yang Z, Yu P, Ye T, Ritchie EA, Li S, Guo Y. Health Effects of Cyclones: A Systematic Review and Meta-Analysis of Epidemiological Studies. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:86001. [PMID: 37639476 PMCID: PMC10461789 DOI: 10.1289/ehp12158] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND More intense cyclones are expected in the future as a result of climate change. A comprehensive review is urgently needed to summarize and update the evidence on the health effects of cyclones. OBJECTIVES We aimed to provide a systematic review with meta-analysis of current evidence on the risks of all reported health outcomes related to cyclones and to identify research gaps and make recommendations for further research. METHODS We systematically searched five electronic databases (MEDLINE, Embase, PubMed, Scopus, and Web of Science) for relevant studies in English published before 21 December 2022. Following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines, we developed inclusion criteria, screened the literature, and included epidemiological studies with a quantitative risk assessment of any mortality or morbidity-related outcomes associated with cyclone exposures. We extracted key data and assessed study quality for these studies and applied meta-analyses to quantify the overall effect estimate and the heterogeneity of comparable studies. RESULTS In total, 71 studies from eight countries (the United States, China, India, Japan, the Philippines, South Korea, Australia, Brazil), mostly the United States, were included in the review. These studies investigated the all-cause and cause-specific mortality, as well as morbidity related to injury, cardiovascular diseases (CVDs), respiratory diseases, infectious diseases, mental disorders, adverse birth outcomes, cancer, diabetes, and other outcomes (e.g., suicide rates, gender-based violence). Studies mostly included only one high-amplitude cyclone (cyclones with a Saffir-Simpson category of 4 or 5, i.e., Hurricanes Katrina or Sandy) and focused on mental disorders morbidity and all-cause mortality and hospitalizations. Consistently elevated risks of overall mental health morbidity, post-traumatic stress disorder (PTSD), as well as all-cause mortality or hospitalizations, were found to be associated with cyclones. However, the results for other outcomes were generally mixed or limited. A statistically significant overall relative risk of 1.09 [95% confidence interval (CI): 1.04, 1.13], 1.18 (95% CI: 1.12, 1.25), 1.15 (95% CI: 1.13, 1.18), 1.26 (95% CI: 1.05, 1.50) was observed for all-cause mortality, all-cause hospitalizations, respiratory disease, and chronic obstructive pulmonary disease hospitalizations, respectively, after cyclone exposures, whereas no statistically significant risks were identified for diabetes mortality, heart disease mortality, and preterm birth. High between-study heterogeneity was observed. CONCLUSIONS There is generally consistent evidence supporting the notion that high-amplitude cyclones could significantly increase risks of mental disorders, especially for PTSD, as well as mortality and hospitalizations, but the evidence for other health outcomes, such as chronic diseases (e.g., CVDs, cancer, diabetes), and adverse birth outcomes remains limited or inconsistent. More studies with rigorous exposure assessment, of larger spatial and temporal scales, and using advanced modeling strategy are warranted in the future, especially for those small cyclone-prone countries or regions with low and middle incomes. https://doi.org/10.1289/EHP12158.
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Affiliation(s)
- Wenzhong Huang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yuan Gao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Zhengyu Yang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tingting Ye
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Elizabeth A. Ritchie
- School of Earth Atmosphere and Environment, Monash University, Melbourne, Victoria, Australia
- Department of Civil Engineering, Monash University, Melbourne, Victoria, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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2
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Ghosh AK, Shapiro MF, Abramson D. Closing the Knowledge Gap in the Long-Term Health Effects of Natural Disasters: A Research Agenda for Improving Environmental Justice in the Age of Climate Change. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15365. [PMID: 36430084 PMCID: PMC9692460 DOI: 10.3390/ijerph192215365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/09/2022] [Accepted: 11/19/2022] [Indexed: 06/16/2023]
Abstract
Natural disasters continue to worsen in both number and intensity globally, but our understanding of their long-term consequences on individual and community health remains limited. As climate-focused researchers, we argue that a publicly funded research agenda that supports the comprehensive exploration of these risks, particularly among vulnerable groups, is urgently needed. This exploration must focus on the following three critical components of the research agenda to promote environmental justice in the age of climate change: (1) a commitment to long term surveillance and care to examine the health impacts of climate change over their life course; (2) an emphasis on interventions using implementation science frameworks; (3) the employment of a transdisciplinary approach to study, address, and intervene on structural disadvantage among vulnerable populations. Without doing so, we risk addressing these consequences in a reactive way at greater expense, limiting the opportunity to safeguard communities and vulnerable populations in the era of climate change.
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Affiliation(s)
- Arnab K. Ghosh
- Department of Medicine, Weill Cornell Medical College, Cornell University, Ithaca, NY 10065, USA
| | - Martin F. Shapiro
- Department of Medicine, Weill Cornell Medical College, Cornell University, Ithaca, NY 10065, USA
| | - David Abramson
- School of Global Public Health, New York University, 715/719 Broadway 12th Floor Room 1214, New York, NY 10003, USA
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3
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Ghosh AK, Demetres MR, Geisler BP, Ssebyala SN, Yang T, Shapiro MF, Setoguchi S, Abramson D. Impact of Hurricanes and Associated Extreme Weather Events on Cardiovascular Health: A Scoping Review. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:116003. [PMID: 36448792 PMCID: PMC9710380 DOI: 10.1289/ehp11252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The frequency and destructiveness of hurricanes and related extreme weather events (e.g., cyclones, severe storms) have been increasing due to climate change. A growing body of evidence suggests that victims of hurricanes have increased incidence of cardiovascular disease (CVD), likely due to increased stressors around time of the hurricane and in their aftermath. OBJECTIVES The objective was to systematically examine the evidence of the association between hurricanes (and related extreme weather events) and adverse CVD outcomes with the goal of understanding the gaps in the literature. METHODS A comprehensive literature search of population-level and cohort studies focused on CVD outcomes (i.e., myocardial infarction, stroke, and heart failure) related to hurricanes, cyclones, and severe storms was performed in the following databases from inception to December 2021: Ovid MEDLINE, Ovid EMBASE, Web of Science, and The Cochrane Library. Studies retrieved were then screened for eligibility against predefined inclusion/exclusion criteria. Studies were then qualitatively synthesized based on the time frame of the CVD outcomes studied and special populations that were studied. Gaps in the literature were identified based on this synthesis. RESULTS Of the 1,103 citations identified, 48 met our overall inclusion criteria. We identified articles describing the relationship between CVD and extreme weather, primarily hurricanes, based on data from the United States (42), Taiwan (3), Japan (2), and France (1). Outcomes included CVD and myocardial infarction-related hospitalizations (30 studies) and CVVD-related mortality (7 studies). Most studies used a retrospective study design, including one case-control study, 39 cohort studies, and 4 time-series studies. DISCUSSION Although we identified a number of papers that reported evaluations of extreme weather events and short-term adverse CVD outcomes, there were important gaps in the literature. These gaps included a) a lack of rigorous long-term evaluation of hurricane exposure, b) lack of investigation of hurricane exposure on vulnerable populations regarding issues related to environmental justice, c) absence of research on the exposure of multiple hurricanes on populations, and d) absence of an exploration of mechanisms leading to worsened CVD outcomes. Future research should attempt to fill these gaps, thus providing an important evidence base for future disaster-related policy. https://doi.org/10.1289/EHP11252.
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Affiliation(s)
- Arnab K. Ghosh
- Department of Medicine, Weill Cornell Medical College, Cornell University, New York, New York, USA
| | - Michelle R. Demetres
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, New York, USA
| | - Benjamin P. Geisler
- Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Shakirah N. Ssebyala
- Department of Medicine, Weill Cornell Medical College, Cornell University, New York, New York, USA
| | - Tianyi Yang
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Martin F. Shapiro
- Department of Medicine, Weill Cornell Medical College, Cornell University, New York, New York, USA
| | - Soko Setoguchi
- Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA
| | - David Abramson
- Center of Public Health Disaster Science, School of Global Public Health, New York University, New York, New York, USA
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Begum TF, Lin Z, Primeau M, Lin S. Assessing short-term and long-term mental health effects among older adults after Hurricane Sandy. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 825:153753. [PMID: 35151740 DOI: 10.1016/j.scitotenv.2022.153753] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/29/2022] [Accepted: 02/04/2022] [Indexed: 05/16/2023]
Abstract
BACKGROUND Few studies have evaluated the long-term effects of disasters on older adults. We examined if older individuals experienced increased mental health (MH) effects immediately and long-term after Hurricane Sandy and if these effects varied by socioeconomic status (SES), disease subtypes, number of comorbidities, and length of stay. METHODS We identified older patients (≥64 years) with hospital admissions and Emergency Department (ED) visits (2001-2015) with primary diagnosis of MH diseases using the New York State discharged data. We quantified both short-term (immediately post-Sandy) and long-term effects (3-month, 1-year, 2-year, and 3-year) following Hurricane Sandy, and used the pre-Sandy period in the affected counties as the control period. Poisson regression was used to compare daily counts of MH cases overall and by multiple strata pre-/post Sandy. FINDINGS Older individuals had significantly increased risk of MH ED visits immediately (32%), and 3-months, 1, 2, and 3-years after Sandy (2%, 9%, 15%, and 10%, respectively). MH hospital admissions did not increase immediately, but significantly increased by 8% a year later. Males and those with low SES had delayed, but increased risks of MH 1-3 years after Sandy (RRs range: 1.14-1.71). The top MH subtypes after Sandy were psychosis, mood disorders, substance abuse, suicide, and anxiety (RRs range: 1.12-2.62). After Sandy, patients with ≥8 comorbidities increased from 15% to >25%, along with their length of hospital stay. CONCLUSION We found long-term adverse effects of MH after Sandy, especially among vulnerable populations, which may help plan future disaster preparedness and recovery efforts.
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Affiliation(s)
- Thoin F Begum
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, United States
| | - Ziqiang Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, United States; Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, United States
| | - Mike Primeau
- Office of Health Emergency Preparedness, New York State Department of Health, Albany, NY, United States
| | - Shao Lin
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, United States; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, United States.
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5
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Mozhaeva I. Inequalities in Utilization of Institutional Care Among Older People in Estonia. Health Policy 2022; 126:704-714. [DOI: 10.1016/j.healthpol.2022.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 01/07/2021] [Accepted: 04/17/2022] [Indexed: 11/30/2022]
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Nielsen VM, Song G, Ojamaa LS, Blodgett RP, Rocchio CM, Pennock JN. The COVID-19 Pandemic and Access to Selected Ambulatory Care Services Among Populations With Severely Uncontrolled Diabetes and Hypertension in Massachusetts. Public Health Rep 2022; 137:344-351. [PMID: 35086370 PMCID: PMC8900223 DOI: 10.1177/00333549211065515] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES The outbreak of COVID-19 in Massachusetts may have reduced ambulatory care access. Our study aimed to quantify this impact among populations with severely uncontrolled diabetes and hypertension; these populations are at greatest risk for adverse outcomes caused by disruptions in care. METHODS We analyzed multidisciplinary ambulatory electronic health record data from MDPHnet. We established 3 cohorts of patients with severely uncontrolled diabetes and 3 cohorts of patients with severely uncontrolled hypertension using 2017, 2018, and 2019 data, then followed each cohort through the subsequent 15 months. For the diabetes cohorts, we generated quarterly counts of glycated hemoglobin A1c (HbA1c) tests. For the hypertension cohorts, we generated monthly counts of blood pressure measurements. Finally, we assessed telehealth use among the 2019 diabetes and hypertension cohorts from January 2020 through March 2021. RESULTS HbA1c testing and blood pressure monitoring dropped considerably during the pandemic compared with previous years. In the 2019 diabetes cohort, HbA1c measurements declined from 44.0% in January-March 2020 (baseline) to 15.9% in April-June 2020 and was 11.8 percentage points below baseline in January-March 2021. In the 2019 hypertension cohort, blood pressure measurements declined from 40.0% in January 2020 to 4.5% in April 2020 and was 23.5 percentage points below baseline in March 2021. Telehealth use increased precipitously during the pandemic but was not uniform across subpopulations. CONCLUSIONS Access to selected diabetes and hypertension services declined sharply during the pandemic among populations with severely uncontrolled disease. Although telehealth is an important strategy, ensuring equity in access is essential. Telehealth hybrid models can also minimize disruptions in care.
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Affiliation(s)
- Victoria M. Nielsen
- Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston MA, USA
| | - Glory Song
- Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston MA, USA
| | - Lea Susan Ojamaa
- Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston MA, USA
| | - Ruth P. Blodgett
- Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston MA, USA
| | | | - Jena N. Pennock
- Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston MA, USA
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Quantifying Disaster Impacts on Local Public Health Agency's Leadership, Staffing, and Provision of Essential Public Health Services. Disaster Med Public Health Prep 2021; 16:1552-1557. [PMID: 34396948 DOI: 10.1017/dmp.2021.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The objective of this study is to assess the impact that natural disaster response has on local health departments' (LHD) ability to continue to provide essential public health services. METHODS A web-based survey was sent to all North Carolina Local Health Directors. The survey asked respondents to report on LHD functioning following Hurricanes Florence (2018) and Dorian (2019). RESULTS After Hurricane Florence, the positions who most frequently had regular duties postponed or interrupted were leadership (15 of 48; 31.3%), and professional staff (e.g., nursing and epidemiology: 11 of 48; 22.9%). Staffing shelters for all phases - from disaster response through long-term recovery - was identified as a burden by LHDs, particularly for nursing staff. Approximately 66.6% of LHD jurisdictions opened an Emergency Operations Center (EOC) or activated Incident Command System in response to both hurricanes. If an EOC was activated, the LHD was statistically, significantly more likely to report that normal duties had been interrupted across every domain assessed. CONCLUSIONS The ability of LHDs to perform regular activities and provide essential public health services is impacted by their obligations to support disaster response. Better metrics are needed to measure the impacts to estimate indirect public health impacts of disasters.
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Shin SH, Ji H. Health risks of natural hazards and resilience resources: Evidence from a U.S. nationwide longitudinal study. Soc Sci Med 2021; 281:114110. [PMID: 34139633 DOI: 10.1016/j.socscimed.2021.114110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/28/2021] [Accepted: 06/03/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although natural disasters can threaten health and well-being, some people show greater resilience to their effects than others. Identifying the characteristics related to resilience has important implications for reducing the health risks in the aftermath of a disaster. OBJECTIVE Using the Conservation of Resources Theory as a framework, we study the role of resources in moderating the adverse effects of natural disasters on people's health and coping behaviors. METHOD We match 20,658 unique individuals aged 50 or older from the 2012-2016 waves of the Health and Retirement Study to the county-level annual natural hazard data provided by the Federal Emergency Management Agency. Using individual-fixed effect models, we first model whether the experience of natural disasters can predict people's health and coping behaviors. We then explore heterogeneity in such effects by interacting individual- and county-level resilience resources with the number of natural disasters. RESULTS The results show that with increased exposure to natural disasters, older adults are more likely to experience difficulties performing instrumental daily activities. They also tend to have fewer overnight hospital stays, higher out-of-pocket medical expenses, and increased alcohol dependency. However, older adults with certain socio-economic characteristics ‒ white, higher education, higher income, and homeownership ‒ are better able than others to mitigate any adverse health effects of natural disasters. One significant community-level resource is a robust healthcare capacity in a county with a high ratio of healthcare practitioners, where older adults are more likely to seek hospital care and have lower alcohol dependency. CONCLUSIONS Health resilience can be improved by strengthening community-level healthcare capacity, with a particular focus on residents with lower socio-economic resources. Failing to address healthcare provision inequalities may exacerbate health disparities.
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Affiliation(s)
- Su Hyun Shin
- University of Utah, Department of Family & Consumer Studies, 225 South 1400 East, Alfred Emery Building, Room 236, Salt Lake City, UT, 84112, USA.
| | - Hyunjung Ji
- University of Alabama, Department of Political Science, Ten Hoor Hall, Suite 310. Tuscaloosa, AL, 35487, USA.
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9
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After the Storm: Short-term and Long-term Health Effects Following Superstorm Sandy among the Elderly. Disaster Med Public Health Prep 2019; 13:28-32. [PMID: 30841951 DOI: 10.1017/dmp.2018.152] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Investigate short- and long-term effects of Superstorm Sandy on multiple morbidities among the elderly. METHODS We examined emergency department visits; outpatient visits; and hospital admissions for cardiovascular disease (CVD), respiratory disease, and injury among residents residing in 8 affected counties immediately, 4 months, and 12 months following Superstorm Sandy. Control groups were defined as visits/admissions during the identical time window in the 5 years before (2007-2011) and 1 year after (2013-2014) the storm in affected and nonaffected counties in New York. We performed Poisson regression to test whether there was an association of increased visits/admissions for periods following Superstorm Sandy while controlling for covariates. RESULTS We found that the risk for CVD, respiratory disease, and injury visits/admissions was more than twice as high immediately, 4 months, and 12 months after the storm than it was in the control periods. Women were at greater risk at all time periods for CVD (risk ratio [RR], 2.04) and respiratory disease (RRs: 1.89 to 1.92). Whites had higher risk for CVD, respiratory disease, and injury than other racial groups during each period. CONCLUSION We observed increases in CVD, respiratory disease, and injury up to a year following Superstorm Sandy. Findings demonstrate the need to incorporate short- and long-term health effects into public health recovery. (Disaster Med Public Health Preparedness. 2019;13:28-32).
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10
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Burger J, Gochfeld M, Lacy C. Concerns and future preparedness plans of a vulnerable population in New Jersey following Hurricane Sandy. DISASTERS 2019; 43:658-685. [PMID: 30990925 PMCID: PMC9647963 DOI: 10.1111/disa.12350] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Knowing how people prepare for disasters is essential to developing resiliency strategies. This study examined recalled concerns, evacuation experiences, and the future preparedness plans of a vulnerable population in New Jersey, United States, following Hurricane Sandy in 2012. Understanding the responses of minority communities is key to protecting them during forthcoming disasters. Overall, 35 per cent of respondents were not going to prepare for an event. Intended future preparedness actions were unrelated to respondents' ratings of personal impact. More Blacks and Hispanics planned on preparing than Whites (68 versus 55 per cent), and more Hispanics planned on evacuating than did others who were interviewed. A higher percentage of respondents who had trouble getting to health centres were going to prepare than others. Respondents' concerns were connected to safety and survival, protecting family and friends, and having enough food and medicine, whereas future actions included evacuating earlier and buying sufficient supplies to shelter in place.
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Affiliation(s)
- Joanna Burger
- Distinguished Professor of Biology, Division of Life Sciences, Environmental and Occupational Health Sciences Institute and School of Public Health, Rutgers University, United States
| | - Michael Gochfeld
- Professor Emeritus, Environmental and Occupational Health Sciences Institute and Robert Wood Johnson Medical School, Rutgers University, United States
| | - Clifton Lacy
- Distinguished Professor of Professional Practice, School of Communication and Information, Clinical Professor of Medicine, Robert Wood Johnson Medical School, and Director, Center for Emergency Preparedness, Infrastructure and Communication, Rutgers University, United States
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11
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Zimmerman R, Foster S, González JE, Jacob K, Kunreuther H, Petkova EP, Tollerson E. New York City Panel on Climate Change 2019 Report Chapter 7: Resilience Strategies for Critical Infrastructures and Their Interdependencies. Ann N Y Acad Sci 2019; 1439:174-229. [PMID: 30875114 DOI: 10.1111/nyas.14010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Rae Zimmerman
- Wagner Graduate School of Public Service, New York University, New York, New York
| | - Sheila Foster
- McCourt School of Public Policy and the School of Law, Georgetown University
| | - Jorge E González
- Mechanical Engineering Department and NOAA-CREST Center, The City College of New York, New York, New York
| | - Klaus Jacob
- Lamont-Doherty Earth Observatory, Columbia University, New York, New York
| | - Howard Kunreuther
- Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Elisaveta P Petkova
- Department of Earth and Environmental Sciences, Columbia University, New York, New York
| | - Ernest Tollerson
- Hudson River Foundation, New York, New York.,Riverkeeper, Ossining, New York.,Environmental Advocates of New York, Albany, New York
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12
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Burger J, Gochfeld M, Lacy C. Ethnic differences in risk: experiences, medical needs, and access to care after hurricane Sandy in new jersey. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2019; 82:128-141. [PMID: 30722754 PMCID: PMC6419501 DOI: 10.1080/15287394.2019.1568329] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This survey investigation assessed an economically challenged and largely minority population regarding concerns, evacuation status, medical needs and access to care during, and after, Hurricane Sandy by ethnicity status for patients using New Jersey's Federally Qualified Health Centers (FQHC). Data obtained contribute to understanding risk from disasters, and improving environmental justice for vulnerable populations following disasters. FQHCs provide medical and dental services for 5% of New Jersey 's population; 95% of those served are uninsured, underinsured, or live below the poverty level. Economically vulnerable individuals are more at risk and were disproportionately harmed by Sandy. There were ethnic differences in days evacuated, days without power and heat, self-rating of personal/family impact, center use, need and access, and interruptions of care and medications. Hispanics and Blacks reported needing centers significantly more than White population. Primary medical conditions were diabetes, asthma, hypertension, and arrhythmia and heart disease, which did not vary ethnically. Understanding medical needs and concerns of vulnerable populations may help policymakers and practitioners prepare and respond promptly to disasters, reducing risk, and building resiliency for the medical care system.
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Affiliation(s)
- Joanna Burger
- Division of Life Sciences, Rutgers University, Piscataway, New Jersey, USA
- Environmental and Occupational Health Science Institute, Rutgers University, Piscataway, New Jersey
| | - Michael Gochfeld
- Environmental and Occupational Health Science Institute, Rutgers University, Piscataway, New Jersey
- Robert Wood Johnson Medical School, Rutgers University, Piscataway, USA
| | - Clifton Lacy
- Robert Wood Johnson Medical School, Rutgers University, Piscataway, USA
- Center for Disaster Preparedness and Emergency Response, and School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA
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13
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Hernández D, Chang D, Hutchinson C, Hill E, Almonte A, Burns R, Shepard P, Gonzalez I, Reissig N, Evans D. Public Housing on the Periphery: Vulnerable Residents and Depleted Resilience Reserves post-Hurricane Sandy. J Urban Health 2018; 95:703-715. [PMID: 30088128 PMCID: PMC6181816 DOI: 10.1007/s11524-018-0280-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Hurricane Sandy was the greatest natural disaster to ever impact public housing residents in New York City. It affected approximately 80,000 residents in 400 buildings in 33 developments throughout the city. The storm left residents without power, heat, or running water, yet many chose not to evacuate. This qualitative study was conducted to understand the impact of Sandy among this socially, physically, and geographically vulnerable population. It is the first known study to examine the impact of disasters in high-rise, high-density public housing as a unique risk environment. Findings demonstrate (1) broad impacts to homes, health and access to resources, (2) complex evacuation decision-making, (3) varied sources of support in the response and recovery phases, and (4) lessons learned in preparedness. Results are contextualized within an original conceptual framework-"resilience reserve"-that explains the phenomenon of delayed recovery stemming from enactments of resilience to manage chronic hardship leaving vulnerable populations without the requisite capacity to take protective action when facing acute adversity. We discuss recommendations to establish and replenish the resilience reserve that include personal, institutional, and structural facets.
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Affiliation(s)
- Diana Hernández
- Sociomedical Sciences Department, Columbia University, New York, NY, USA.
| | - David Chang
- WE ACT for Environmental Justice, New York, NY, USA
| | - Carole Hutchinson
- Sociomedical Sciences Department, Columbia University, New York, NY, USA
| | - Evanah Hill
- Sociomedical Sciences Department, Columbia University, New York, NY, USA
| | - Amenda Almonte
- Sociomedical Sciences Department, Columbia University, New York, NY, USA
| | - Rachel Burns
- Sociomedical Sciences Department, Columbia University, New York, NY, USA
| | | | - Ingrid Gonzalez
- Office of Emergency Preparedness and Response, Department of Health and Mental Hygiene, New York, NY, USA
| | - Nora Reissig
- Formerly at Family Services Department, New York City Housing Authority, New York, NY, USA
| | - David Evans
- Sociomedical Sciences Department, Columbia University, New York, NY, USA
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14
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Emergency Department and Inpatient Health Care Services Utilization by the Elderly Population: Hurricane Sandy in The State of New Jersey. Disaster Med Public Health Prep 2018; 12:730-738. [PMID: 29562948 DOI: 10.1017/dmp.2018.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE In this investigation, we reported the increase in emergency department and inpatient admission cases during the month of November 2012 post Hurricane Sandy as compared with baseline (November 2010, 2011, and 2013) for elderly patients aged 65 and up. METHODS Medical claims data for patients aged 65 and over treated at emergency department and inpatient health care facilities in New Jersey were analyzed to examine the surge in frequencies of diagnoses treated immediately following Hurricane Sandy. The differences were quantified using gap analysis for 2 years before and 1 year after the event. RESULTS There was an average increase of 1700 cases for the month of November 2012 relative to baseline for the top 15 most frequently diagnosed emergency department medical conditions. On a daily basis, a volume increase by an average 57 cases could be expected, including significant numbers of limb fractures and other trauma cases for these most frequently encountered medical conditions. CONCLUSIONS Understanding the surge level in medical services needed in emergency departments and inpatient facilities during a natural disaster aftermath is critical for effective emergency preparation and response for the elderly population. (Disaster Med Public Health Preparedness. 2018;12:730-738).
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