Healthcare Access in the Aftermath: A Longitudinal Analysis of Disaster Impact on US Communities

Kevin Chang (), Jana A. Hirsch, Lauren Clay and Yvonne L. Michael
Additional contact information
Kevin Chang: College of Medicine, Drexel University, 60 N. 36th Street, Philadelphia, PA 19104, USA
Jana A. Hirsch: Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA
Lauren Clay: Department of Emergency and Disaster Health Systems, University of Maryland Baltimore County, Baltimore, MD 21250, USA
Yvonne L. Michael: Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA

IJERPH, 2025, vol. 22, issue 5, 1-13

Abstract: Research on climate-related disasters and healthcare infrastructure has largely focused on short-term, localized impacts. This study examined the long-term association between climate-related disasters and healthcare facilities across 3108 contiguous United States counties from 2000 to 2014. Utilizing databases like the National Establishment Time Series and the Spatial Hazards and Events Losses Database, we classified county-level infrastructure changes (“never had”, “lost”, “gained”, and “always had”) and disaster severity (minor, moderate, severe), respectively. Autoregressive linear models were used to estimate the total number of moderate and severe disasters (2000–2013) associated with the change in the number of healthcare establishments in 2014, after adjusting for healthcare establishments, total population, and poverty in 2000. Results demonstrate that an increase in one moderate disaster was significantly associated with increased hospital infrastructure (Count, 0.14; 95% CI, 0.03–0.25), while severe disasters were significantly associated with a decrease (Count, −0.31; 95% CI, −0.47–−0.14). Similar but stronger associations were observed for ambulatory care (Moderate: Count, 2.52; 95% CI 0.91–4.12 and Severe: Count, −5.99; 95% CI, −8.53–−3.64, respectively). No significant associations were found among pharmacies. These findings highlight the varying impacts of climate-related disasters on healthcare accessibility. Future initiatives should prioritize strengthening existing infrastructure and enhance disaster recovery strategies.

Keywords: environmental health; disasters; healthcare accessibility; longitudinal studies; United States; health infrastructure (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
References: Add references at CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/22/5/733/pdf (application/pdf)
https://www.mdpi.com/1660-4601/22/5/733/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:22:y:2025:i:5:p:733-:d:1649447

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().