Hurricane Matthew: Effect on Healthcare and Community Resilience

Dr Mantravadi’s research interests are in health economics research, outcomes research, modeling, pharmacoeconomics, and economic evaluation. Dr Mantravadi conducts research on the application of econometric techniques. Other research interests include healthcare application of biostatistics, health information technology/GIS, and health administration/ management.
Strong, accessible health systems and connectedness within community infrastructure affects community resilience in the face of public health emergencies and natural disasters.
This article was co-written with Dr Haris Alibasic

Recent instances of hurricanes have renewed the nation's interest in community resilience. Far-reaching impacts of such extreme weather events contain economic, environmental, and social characteristics.

Under social consequences, in the post-hurricane disaster assessment and analysis, communities are faced with significant health effects on the most vulnerable population. As noted in the Bureau of Epidemiology report1 from 2015, the State of Florida is the most prone to the deadliest of hurricanes and the health effects of hurricanes and tropical storms is significant. Therefore a more rapid deployment of resilience-related measures to address community health dynamic in emergency preparedness and disaster recovery need to be considered. Communities are on the front lines of extreme weather events and they must plan for these events with or without state and federal support. Within those parameters, they must, and should, include all aspects and all levels of infrastructure and institutional knowledge and support to incorporate public health into planning. Strong, accessible health systems and connectedness within the community infrastructure affects community resilience in the face of public health emergencies and natural disasters. Thus, healthcare and system infrastructure influence community resilience and sustainability.

However, healthcare systems and access to care is affected during hurricanes, as evident from Hurricane Matthews' impact on Florida’s, Georgia’s, and the Carolinas’ hospitals. Surgeries and outpatient appointments were cancelled, and physicians were encouraged to discharge patients.2 Many Florida healthcare systems were evacuated during the storm and its aftermath, leading to a lack of healthcare safety net for those who needed care during the storm. The Veterans Affairs facilities in Florida and South Carolina were evacuated3; during such evacuations, inpatients are transferred to other facilities.2 Such health facility evacuations lead to potential issues during transition of care for inpatients. Another major issue that arose for heathcare access was to ensure that patients have access to medications during the storm and its aftermath, for at least 1 week.2 Vulnerable patients faced both cost barriers that affected their health status and access to care/medications.4 In addition, the impending stress created by the natural disaster affects health status, as well, an example being Medicare patients on dialysis who will be left without treatment.4

South Carolina’s Grenville Health System helped the community establish resilience during such a tumultuous time, by offering to provide medical assistance and services at shelters, in the wake of the health system evacuations.5 Aetna health plans also contributed to improved community resilience by opening Resources for Living, services regarding shelters and community resources, regardless of plan enrollment.6 Furthermore, the most important factor affecting community is personal and community-based support from the healthcare system; a culture of health is created when the leadership communicates with hurricane-experienced hospital staff members, who also are a part of the local community,2 and generate trust. 

Community resilience best practices recommendations from the National Preparedness and Response Science Board’s Community Health Recommendations were implemented during the wake of Hurricane Mathew. Ensuring access to medications, and alternatives for those with medical equipment—such as oxygen therapy, and dialysis—illustrates how communities systems strengthen and promote access to healthcare services.7 Expanding collaboration and trust within healthcare services and emergency management organizations is evident with assistance from hospitals, community based organizations and stakeholders, and health plans.7 Finally, high-risk patients were engaged, and healthcare organizations and systems throughout Florida, Georgia, and the Carolinas had plans to sustain operations and service for at risk individuals while addressing new cases7.

References
1. Bureau of Epidemiology and CDC (2015). Health Effects of Tropical Storms and Hurricanes in Florida. http://www.floridahealth.gov/environmental-health/climate-and-health/_documents/tc-profile.pdf  Accessed October 24, 2016
2. Mohney G. How Florida hospitals are preparing for Hurricane Matthew. http://abcnews.go.com/Health/florida-hospitals-preparing-hurricane-matthew/story?id=42618587 Accessed October 30, 2016
3. US Department of Veterans Affairs. VA facilities across the southeast prepare for Hurricane Matthew. http://www.blogs.va.gov/VAntage/31765/va-facilities-across-the-southeast-prepare-for-hurricane-matthew/ Accessed November 2, 2016
4. Gorenstein, D. Health problems can make running from Hurricane Matthew more complicated. 2016. https://www.marketplace.org/2016/10/06/world/hurricane-health-story Assessed Nov 1, 2016
5. Osby L. Health care system gears up for Hurricane Matthew. http://www.greenvilleonline.com/story/news/2016/10/05/health-care-system-gears-up-matthew/91627722/ Accessed October 30, 2016
6. Aetna helps members affected by Hurricane Matthew. https://news.aetna.com/2016/10/aetna-helps-members-affected-hurricane-matthew/ Accessed October 30, 2016
7. Community Resilience. http://www.phe.gov/Preparedness/planning/abc/Pages/community-resilience.aspx#Footnote1 Accessed November 27, 2016

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