Experts recommend preparedness to manage chronic diseases in case of disaster-related resource disruption. This study’s goal is to identify factors underlying personal medical preparedness (PMP) among participants from a hurricane-prone region.

A cross-sectional survey was completed during the 2023 Atlantic hurricane season with 120 insured adults age ≥50 in Southeast Louisiana with hypertension and ≥1 regular medication. PMP was measured using the validated Household Emergency Preparedness Instrument Access and Functional Needs Section (HEPI-AFN). Multivariable logistic regression analysis tested associations between PMP and exposure variables, including demographics, health, and hurricane experience.

The sample included 50% women, 43% Black, with mean age 62.6 (SD = 8.1) years and mean 51.3 (SD = 18.1) years living in hurricane-impacted area. Participants were prepared on an average 79% (SD = 21) of applicable HEPI-AFN items; 42 (35%) were prepared on 100% of PMP items. The most missed item was having 2 weeks of extra medication; open-responses noted refill policies as a common barrier to PMP. No factors were associated with increased odds of PMP.

While many participants in this insured, disaster-experienced sample are medically prepared, restrictive pharmaceutical refill policies may be a barrier. Research is needed to understand the impact of prescription refill and other policies on PMP.

After Hurricane Ida, faith-based organizations were vital to disaster response. However, this community resource remains understudied. This exploratory study examines local faith-based organizational involvement in storm recovery by evaluating response activities, prevalence and desire for formal disaster education, coordination with other organizations, effect of storm damage on response, and observations for future response.

An exploratory survey was administered to community leaders throughout the Bayou Region of Louisiana consisting of questions regarding demographics, response efforts, coordination with other organizations, formal disaster training, the impact of storm damage on ability to respond, and insights into future response.

Faith-based organizations are active during storm response. There is a need and desire for formal disaster education. Many organizations experienced storm damage but continued serving their community. Other emerging themes included: importance of clear communications, building stronger relationships with other organizations prior to a disaster, and coordination of resources.

Faith-based organizations serve an important role in disaster response. Though few have formal training, they are ready and present in the area of impact, specifically in hurricane response. In the midst of organizational and personal damage, these organizations respond quickly and effectively to provide a necessary part of the disaster management team.

The threat of novel pathogens and natural hazards is increasing as global temperatures warm, leading to more frequent and severe occurrences of infectious disease outbreaks and major hurricanes. The COVID-19 pandemic amplified the need to examine how risk perceptions related to hurricane evacuations shift when vaccines become available. This study explores individuals’ expected evacuation plans during the early stages of COVID-19 vaccine availability.

In March 2021, an online survey was disseminated in Puerto Rico and the US Virgin Islands.

An overwhelming majority (72.6%) of respondents said that their vaccination status would not affect their hurricane evacuation intentions. The unvaccinated were significantly more likely to consider evacuating during a hurricane than the vaccinated. Even with vaccines available, respondents suggested they were less likely to evacuate to a shelter during the 2021 season than prior to the COVID-19 pandemic. Respondents generally believed that the risk of contracting COVID-19 at a shelter was greater than the risk of sheltering-in-place during a hurricane.

Government officials need to develop and communicate clear information regarding evacuation orders for municipalities that may be more impacted than others based on the trajectory of the storm, social determinants of health, and other factors like living in a flood zone.

Given the US population concentration near coastal areas and increased flooding due to climate change, public health professionals must recognize the psychological burden resulting from exposure to natural hazards.

We performed a systematic search of databases to identify articles with a clearly defined comparison group consisting of either pre-exposure measurements in a disaster-exposed population or disaster-unexposed controls, and assessment of mental health, including but not limited to, depression, post-traumatic stress (PTS), and anxiety.

Twenty-five studies, with a combined total of n =616 657 people were included in a systematic review, and 11 studies with a total of 2012 people were included in a meta-analysis of 3 mental health outcomes. Meta-analytic findings included a positive association between disaster exposure and PTS (n = 5, g = 0.44, 95% CI 0.04, 0.85), as well as depression (n = 9, g = 0.28, 95% CI 0.04, 0.53), and no meaningful effect size in studies assessing anxiety (n = 6, g = 0.05 95% CI −0.30, 0.19).

Hurricanes and flooding were consistently associated with increased depression and PTS in studies with comparison groups representing individuals unaffected by hazards.

Hurricane Ida delivered record rainfall to the northeast, resulting in 11 deaths in New York City. We review these deaths, identify risk factors, and discuss solutions to prevent recurrence.

Deaths were confirmed by multiple sources. Locations of the deceased were obtained from obituaries and plotted on the NYC.gov flood-hazard map. Risk factor information of the decedents was collected when available. Current emergency response plans and mitigation efforts were identified on the NYC.gov officially sanctioned website.

All descendants resided in basement apartments. None of the deaths occurred in a location previously designated a “flood risk zone.” While a flash flood emergency was issued during Hurricane Ida, guidance was not provided during the emergency. Flooding was compounded by the city’s aging infrastructure and lack of green space.

Aging infrastructure, lack of pre-notification, illegal basement apartments, and lack of a planned response all appear to have played a role in these 11 deaths.

Patients undergoing maintenance hemodialysis face heightened vulnerability during disasters like tropical cyclones, yet there is sparse research on their treatment-related challenges and countermeasures. This scoping review aims to highlight the issues maintenance hemodialysis patients encounter following tropical cyclones.

A systematic scoping review of 19 articles from 2000 to 2023 was conducted, evaluating eligibility against predefined criteria.

Hemodialysis patients encounter substantial challenges during and after tropical cyclones in the United States, Puerto Rico, Australia, and Taiwan. Thematic analysis identified 3 themes related to “challenges” (Hemodialysis health-related challenges, socially relevant challenges, and challenges of management inefficiencies). “Recommendations” comprised 4 themes and 4 phases across the “mitigation phase” (fortifying healthcare infrastructure and mobilizing community-focused risk mitigation initiatives), “preparedness” (emergency plan development, training, and patient education), “response” (activation of emergency plans and providing emergency healthcare services), and “recovery” (intersectoral collaboration for recovery and rebuilding).

This scoping review underscores challenges confronted by patients undergoing maintenance hemodialysis post-tropical cyclones, highlighting the urgent need for targeted strategies to ensure the continuity of dialysis care during and after such disasters.

Cancer patients are among the most vulnerable populations during and after a disaster. We evaluated the impact of treatment interruption on the survival of women with gynecologic cancer in Puerto Rico following Hurricanes Irma and María.

A retrospective cohort study among a clinic-based sample of women with gynecological cancer diagnosed between January 2016 and September 2017 (n = 112) was done. Women were followed from their diagnosis until December 2019, to assess vital status. Kaplan-Meier survival curves and Cox proportional hazards models were performed.

Mean age was 56 (± 12.3) years; corpus uteri (58.9%) was the most common gynecologic cancer. Predominant treatments were surgery (91.1%) and chemotherapy (44.6%). Overall, 75.9% were receiving treatment before the hurricanes, 16.1% experienced treatment interruptions, and 8.9% died during the follow-up period. Factors associated with treatment interruption in bivariate analysis included younger age (≤55 years), having regional/distant disease, and receiving > 1 cancer treatment (P < 0.05). Crude analysis revealed an increased risk of death among women with treatment interruption (HR: 3.88, 95% CI: 1.09-13.77), persisting after adjusting for age and cancer stage (HR: 2.49, 95% CI: 0.69-9.01).

Findings underscore the detrimental impact of treatment interruption on cancer survival in the aftermath of hurricanes, emphasizing the need for emergency response plans for this vulnerable population.

The aim of this work was to determine the impact of Moral Distress (MD) in emergency physicians, nurses, and emergency medical service staff at the Rand Memorial Hospital (RMH) in the Bahamas, and the impact of Hurricane Dorian and the COVID-19 pandemic on Moral Distress.

A cross-sectional study utilizing a 3-part survey, which collected sociodemographic information, Hurricane Dorian and COVID-19 experiences, as well as responses to a validated modified Moral Distress Scale (MDS).

Participants with 2 negatively impactful experiences from COVID-19 had statistically significantly increased MD compared to participants with only 1 negatively impactful experience (40.4 vs. 23.6, P = 0.014). Losing a loved one due to COVID-19 was associated with significantly decreased MD (B = - 0.42, 95% CI -19.70 to -0.88, P = 0.03). Losing a loved one due to Hurricane Dorian had a non-statistically significant trend towards higher MD scores (B = 0.34, 95% CI -1.23 to 28.75, P = 0.07).

The emergency medical staff at the RMH reported having mild - moderate MD. This is one of the first studies to look at the impact of concurrent disasters on MD in emergency medical providers in the Bahamas.

Ideally, mosquito control programs (MCPs) use surveillance to target control measures to potentially dangerous mosquito populations. In North Carolina (NC), where there is limited financial support for mosquito control, communities may suffer from mosquito-related issues post-hurricane due to lack of existing MCPs. Here, study objectives were to (1) investigate the emergency response of a subset of NC counties post-Hurricane Florence and (2) develop guidelines and policy recommendations to assist MCPs in post-hurricane mosquito control response.

A survey was administered to a subset of eastern NC counties (an area previously impacted by hurricanes) with various levels of MCPs (from none to well-developed).

All respondents indicated that having Federal Emergency Management Agency (FEMA) training would be helpful in developing a post-hurricane emergency response plan for mosquito control. There was concern related to a lack of knowledge of emergency control methods (eg, aerial/ground, adulticiding/larviciding) post-hurricane. MCP structure (eg, infrastructure, resources, operational plans/policies) could facilitate response activities and help ensure necessary emergency financial support from agencies such as FEMA.

Mosquito control post-hurricane protects public health. Public health and other agencies can be networking resources for MCPs. Policy recommendations include implementation of routine FEMA assistance training workshops to improve an understanding of processes involved in assistance and reimbursement.

The aim of this study was to look at a cohort of adolescents who were already enrolled in a randomized controlled trial to see (1) how demographics were associated with hurricane impact, and (2) how hurricane impact was associated with reported asthma quality of life.

One hundred fifty-one adolescents ages 11-17 and their parents enrolled in a randomized controlled trial at 2 sites in southeastern North Carolina completed questions about asthma quality of life, demographics, and the impact of Hurricane Matthew.

The most common effects of Hurricane Matthew were that the family’s home was damaged or flooded (32.5%), the school was damaged or flooded (31.8%), and the home had mold or mildew as a result of flooding or damage (25.8%). Problems with access to care were more common for families whose adolescent was non-White (P = 0.04), on Medicaid (P = 0.05), or if the family spoke Spanish at home (P < 0.001). Being affected by the hurricane was negatively associated with asthma quality of life.

Hurricane Matthew had significant impact on the health of adolescents with asthma in the affected region, especially in the most vulnerable populations. Providers should ensure that families of adolescents with asthma have a hurricane plan to mitigate impact on their children’s health.

To explore the health impacts of Hurricane Maria (HM) on HIV care outcomes among people living with HIV who use drugs.

Using data from an ongoing cohort study in San Juan, Puerto Rico (Proyecto PACTo), we measured differences in HIV care outcomes (viral load, viral suppression, and CD4 counts) before and after HM using assessments conducted at 6-month intervals. Generalized estimating equations were used to assess factors associated with HIV care outcomes.

All HIV care outcomes showed a deterioration from pre-HM values to post-HM values (mean viral load increased, CD4 counts decreased, and rate of viral suppression decreased) after controlling for pre-HM sociodemographic and health characteristics. In addition to HM, age (aIRR = 1·01), being homeless (aIRR = 0·78) and having health insurance (aIRR = 1·6) were independently associated with viral suppression.

219 participants completed follow-up visits between April 2017 and January 2018, before and after HM.

People living with HIV who use drugs in Puerto Rico experienced poorer HIV outcomes following HM. Socio-environmental factors contributing to these outcomes is discussed in the context of disaster response, recovery, and program planning.

The objective of this study was to assess recovery of Aransas County, Texas households 2 years after Category 4 Hurricane Harvey made landfall.

A 2-stage cluster sampling method used to conduct a Community Assessment for Public Health Emergency Response (CASPER) on May 3 - 4 and May 18 - 19, 2019. A household-based survey was administered through face-to-face interviews, selected through systematic random sampling using weighted analysis of the county population. Field teams collected 175 surveys (83.3% completion rate).

Approximately 57% households experienced repairable damage, 23% had destroyed homes, and 19% had minimal damage. 38% stated having ‘no need,’ 18% needed financial assistance, 16% needed household repairs, and over 8% had behavioral health needs. 17% experiencing a behavioral health concern were seeking services. Of the 35% of households who did not seek services, 14% felt there was no need, and 4% were not aware of the resources available.

Households reported high levels of preparedness, but gaps remain in evacuation intention and behavioral health care access. CASPERs are effective in assessing long-term recovery of communities impacted by major disasters.

Indoor mold after flooding poses health risks, including rare but serious invasive mold infections. The purpose of this study was to evaluate use of International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes for mold infection and mold exposure in Houston, Texas, during the year before and the year after Hurricane Harvey.

This study used data from MarketScan, a large health insurance claims database.

The incidence of invasive mold infections remained unchanged in the year after Hurricane Harvey; however, the incidence of diagnosis codes for mold exposure nearly doubled compared with the year before the hurricane (6.3 vs 11.0 per 100 000 enrollees, rate ratio: 1.7, 95% confidence interval 1.0–3.1).

Diagnosis codes alone may not be sufficiently sensitive to detect changes in invasive mold infection rates within this population and time frame, demonstrating the need for more comprehensive studies.

Research indicates that greater exposure to Hurricane Sandy is associated with increased mental health difficulties. This study examined whether Project Restoration, a program that linked adults into mental health care (L2C), was effective in reducing post-Sandy mental health difficulties as compared to a cohort of adults matched on mental health difficulties that were not linked into post-Sandy mental health care.

Project Restoration participants (n = 52) with elevated self-reported mental health difficulties had the option to enroll into L2C. Project LIGHT (n = 63) used similar methodologies but did not have a L2C component and served as the matched control group.

Multivariable modeling showed significant decreases in all mental health difficulties except for depression in the Project Restoration group, whereas there were no significant decreases in LIGHT. The decrease in anxiety from baseline to follow-up was significantly greater for Project Restoration as compared to LIGHT.

Findings confirm the powerful impact community outreach and treatment have on reducing mental health difficulties after a disaster.

In times of repeated disaster events, including natural disasters and pandemics, public health workers must recover rapidly to respond to subsequent events. Understanding predictors of time to recovery and developing predictive models of time to recovery can aid planning and management.

We examined 681 public health workers (21-72 y, M(standard deviation [SD]) = 48.25(10.15); 79% female) 1 mo before (T1) and 9 mo after (T2) the 2005 hurricane season. Demographics, trauma history, social support, time to recover from previous hurricane season, and predisaster work productivity were assessed at T1. T2 assessed previous disaster work, initial emotional response, and personal hurricane injury/damage. The primary outcome was time to recover from the most recent hurricane event.

Multivariate analyses found that less support (T1; odds ratio [OR] = .74[95% confidence interval [CI] = .60-.92]), longer previous recovery time (T1; OR = 5.22[95%CI = 3.01-9.08]), lower predisaster work productivity (T1; OR = 1.98[95%CI = 1.08-3.61]), disaster-related personal injury/damage (T2; OR = 3.08[95%CI = 1.70-5.58]), and initial emotional response (T2; OR = 1.71[95%CI = 1.34-2.19]) were associated with longer recovery time (T2).

Recovery time was adversely affected in disaster responders with a history of longer recovery time, personal injury/damage, lower work productivity following prior hurricanes, and initial emotional response, whereas responders with social support had shorter recovery time. Predictors of recovery time should be a focus for disaster preparedness planners.