ADDRESSING DISRUPTIONS IN CARE: A STUDY OF CHRONIC DISEASE EXACERBATIONS IN AN UNDERSERVED COMMUNITY FOLLOWING HURRICANE IDA Y Zhang 1 BS; M Watson 2 BS, J Lee 3 BS, K Bonner 3 MD
1 Department of General Internal Medicine, Tulane University School of Medicine, New Orleans, LA. 2 Department of Neuroscience, Tulane University School of Science and Engineering, New Orleans, LA. 3 Department of Family Medicine, Tulane University School of Medicine, New Orleans, LA
INTRODUCTION: Medically underserved communities have a higher prevalence of chronic diseases compared to the general population and are more vulnerable during disruptions of care following natural disasters. The compounding of lifelong socioeconomic pressures, chronic health burden, and acute mental and physical stress can all factor into poorer health outcomes, which calls for systemic attention, intervention, and prevention. STUDY: This is a retrospective review of patients from an underserved community in New Orleans seen at a primary care clinic over a one-month period following hurricane Ida’s landfall in August 2021. Patient demographics, medical history, vitals, and lab values were collected. Patient reports of disruptions in care were recorded. In the month following hurricane Ida, a total of 237 patients were scheduled for visits, of which only 148(62.4%) presented to clinic (56.8% male, mean age=50.9 years, 51.4% African American). The prevalence of hypertension, diabetes, and chronic kidney disease (CKD) were 56.8%, 18.4%, and 14% respectively. Newly collected vitals and labs were used to compare against patients’ pre-storm baselines. Notably, mean systolic blood pressure increased by 7.4 mmHg in those with hypertension, hemoglobin A1c increased by 0.32% in those with diabetes, and creatinine increased by 0.14 mg/dL in those with CKD (all p<0.001). Based on clinical notes, 18.4% of all patients reported gaps in medication access; 34.2% reported experiencing delays/cancellations of care; 52.6% reported significant displacement-induced stressors. DISCUSSION: Underserved communities are at higher risk for complications of chronic health diseases due to healthcare disruptions following natural disasters. Systemic awareness for comorbidity exacerbation following disasters, development of training courses for primary care providers and pharmacy staff to promote proactive outreach and creation of standardized disaster preparation procedures is needed to address disruptions in care and minimize health disparities in vulnerable populations during climate disasters.
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