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Climate-related disaster impact on health care infrastructure in the USA
Journal article   Peer reviewed

Climate-related disaster impact on health care infrastructure in the USA

Kevin Chang, Kevin Smiley, Jana Hirsch, Lauren Clay and Yvonne Michael
Annals of epidemiology, v 85, pp 133-133
Sep 2023
DOI: https://doi.org/10.1016/j.annepidem.2023.06.020

Abstract

Accessibility Environment Health Natural disaster Climate Change Health Care Public Health
Research on postdisaster health care accessibility and availability has largely focused on the short-term impacts of isolated disasters on specific health care services. We examined the distribution of health care facilities and climate-related weather disasters across counties in the United States across a 15-year period. Linking longitudinal data on disasters, health care, and demographic and socioeconomic characteristics, we created an annual panel dataset of counties in the United States from 2000 to 2014 (N = 3108). National Establishment Time Series data measured change in health care facilities, categorized into drug stores, hospitals, and ambulatory care. Using data from Spatial Hazards and Events Losses Database for the United States, we classified county-level disasters as moderate and severe. We used autoregressive linear models to estimate the per-capita number of health care establishments in 2014 associated with the total number of moderate and severe disasters (2000–2013), after adjustment for health care establishments, total population, and poverty in 2000. Each additional moderate disaster was associated with a significant increase in hospital infrastructure (0.14, 95% confidence interval [CI]: 0.02 to 0.25) while an increase in severe disasters was associated with a significant decrease in hospital infrastructure (−0.28, 95% CI: −0.45 to −0.12). Similar relationships were found with ambulatory care facilities (2.49, 95% CI: 0.89 to 4.09 and −5.78, 95% CI: −8.13 to −3.43, respectively). The association between disasters and drug store facilities was not statistically significant. Given the increasing number and severity of climate-related disasters, the loss of health care facilities following severe disasters may lead to poor health outcomes, especially among vulnerable populations.

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