Ethnic differences in risk: experiences, medical needs, and access to care after hurricane Sandy in New Jersey

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.

KEYWORDS:

• Preparedness
• hurricane Sandy
• access to care
• environmental justice
• federally qualified health centers

Acknowledgments

This study was supported by the Centers for Disease Control and Prevention Public Health Preparedness and Response Research to Aid Recovery from Hurricane Sandy (CDC–RFA–13–001) grant to New Jersey Department of Health, which included collaboration with the New Jersey Medical School, Rutgers University, New Jersey Department of Human Services, and the Division of Life Sciences, Rutgers University, as well as the NIEHS Center (P30ES005022). The project and protocol were approved by the New Jersey Primary Care Association (NJPCA), the Directors of the participating Federally Qualified Health Centers, the Rutgers Institutional Review Board (Protocol E14–319, Notice of Exemption), and the New Jersey Department of Health. Thanks are extended to Kathy Grant Davis (former CEO of New Jersey Primary Care Association), her Executive Board, and the Center Directors of the Federally Qualified Health Centers for allowing the interviewing of their patients, their staff for being so accommodating, Clarimel Cepeda, Marta Hernandez, Ahmend Nezar, Alan Perez, and Ana Quintero for aid in interviewing, and all those who patients who consented to be interviewed. This paper represents the views of the authors, and not the funding agencies or the NJPCA.

Additional information

Funding

This work was supported by the Centers for Disease Control and Prevention [CDC–RFA–13–001]; National Institute of Environmental Health Sciences [P30ES005022].