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Trial of a Survey Instrument to Establish the Hurricane Preparedness of and Medical Impact on a Vulnerable, Older Population

Published online by Cambridge University Press:  17 February 2017

E. Paul Cherniack*
Affiliation:
Division of Geriatric Medicine and Gerontology, University of Miami Miller School of Medicine, Miami, Florida, USA GRECC and Geriatrics and Extended Care Service, Miami Veterans Affairs Healthcare System, Miami, Florida, USA
Lauran Sandals
Affiliation:
Division of Geriatric Medicine and Gerontology, University of Miami Miller School of Medicine, Miami, Florida, USA GRECC and Geriatrics and Extended Care Service, Miami Veterans Affairs Healthcare System, Miami, Florida, USA
Linda Brooks
Affiliation:
Nursing Service, Miami Veterans Affairs Healthcare System, Miami, Florida, USA
Michael J. Mintzer
Affiliation:
Division of Geriatric Medicine and Gerontology, University of Miami Miller School of Medicine, Miami, Florida, USA GRECC and Geriatrics and Extended Care Service, Miami Veterans Affairs Healthcare System, Miami, Florida, USA
*
E. Paul Cherniack, MD, Miami VAHCS, Room 1D200, 1201 NW 16 St., Miami, FL 33125 USA, E-mail: [email protected]

Abstract

Introduction: Millions of vulnerable, elderly individuals live in coastal areas susceptible to hurricanes and are at risk for adverse health outcomes. The purpose of this study was to determine the status of preparedness for and possible health consequences of a hurricane on a vulnerable, but experienced, elderly population.

Problem: Preparedness guidelines have been published, but it is unclear how well-prepared elderly individuals are for hurricanes, and what impact hurricanes may have on their health.

Methods: Five hundred forty-seven ambulatory patients who attended an urban teaching hospital's geriatrics clinic in Florida were surveyed. A 25-question survey that asked whether subjects followed the American Red Cross guidelines for hurricane preparation was developed. The participants were asked what hurricane supplies they had, and whether they would need to evacuate or utilize storm-proof window shutters. They also were queried about definitions and their understanding of hurricane warnings. Three possible health impacts during the two weeks following Hurricane Wilma in 2005 were asked: (1) falls; (2) missed medication; and (3) missed doctor's appointments. An additional 105 patients in the same clinic were asked about the same three health outcomes one and one-half years after the hurricane struck.

Results: Two-thirds of respondents were missing at least one supply item. A multivariate analysis indicated that there was no relationship between the subjects' demographic characteristics and the possession of the suggested disaster supplies. Although 36% would need to evacuate, only 56% of these 36% had a plan. Only 63% had storm-proof windows or shutters, and of these, only 46% could install them. Gasoline-powered electrical generators can be useful, but also a source of morbidity or mortality following a hurricane. For example, this study found that 28% of respondents had generators, but only 46% knew how to use them. Subjects immediately after the hurricane rmsstd fewer doses of medication than at other times (3.4% vs. 6.7%; p <0.0001) and fell slighdy less often (8.8% vs. 12.9%; p <0.0001). However, there were significandy more missed doctors appointments after the hurricane (11.6% vs. 0.1%, p <0.0001).

Conclusions: The survey indicated that even a well-experienced population lacks adequate hurricane preparation. Most still are vulnerable in at least one aspect of preparation. The elderly may be more likely to miss medical appointments immediately following a hurricane. Interventions to improve hurricane preparedness should be piloted.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

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References

1. US Department of Commerce, National Oceanic and Atmospheric Administration National Weather Service: Hurricanes…Unleashing nature's fury: A preparedness guide, 1996. Available at http://www.srh.noaa.gov/fwd/hurricanes.pdf. Accessed 05 June 2007.Google Scholar
2. US Census Bureau: Current population reports: Population projections: States 1895–2025, 1997. Available at http://www.census.gov/prod/2/pop/p25/p25-1131.pdf. Accessed 05 June 2007.Google Scholar
3. Pew Center on Global Climate Change: Hurricanes and global warming FAQs. Available at http://www.pewclimate.org/hurricanes.cfm#freq. Accessed 05 June 2007.Google Scholar
4. National Climatic Data Center, US Deptartment of Commerce, National Oceanic and Atmospheric Administration Satellite and Information Service: Climate of 2005 Atlantic Hurricane Season. Available at http://www.ncdc.noaa.gov/oa/climate/research/2O05/hurricanesO5.html. Accessed 05 June 2007.Google Scholar
5. Hyer, K, Brown, LM, Berman, A: Establishing and refining hurricane response systems for long-term care facilities. Health Affairs 2006; 25: 407411.CrossRefGoogle ScholarPubMed
6. US Centers for Disease Control and Prevention (CDC): Preliminary medical examiner reports of mortality associated with Hurricane Charley—Florida, 2004. MMWR 2004; 53(36): 835837.Google Scholar
7. CDC: Rapid assessment of the needs and health status of older adults after Hurricane Charley—Charlotte, DeSoto, and Hardee Counties, Florida, August 27–31, 2004. MMWR 2004; 53(36): 837840.Google Scholar
8. CDC: Morbidity Surveillance After Hurricane Katrina—Arkansas, Louisiana, Mississippi, and Texas, September 2005 MMWR 2006; 55(26): 727731.Google Scholar
9. Gagnon, EB, Aboutanos, MB, Malhotra, AK, et al. : In the wake of Hurricane Isabel: A prospective study of postevent trauma and injury control strategies. Am Surg 2005; 71(3): 194197.CrossRefGoogle Scholar
10. Hendrickson, LA, Vogt, RL, Goebert, D, et al. : Morbidity on Kauai before and after Hurricane Iniki. Prev Med 1997; 26 (5 Pt 1): 711716.CrossRefGoogle ScholarPubMed
11. Gong, Z, Chai, C, Tu, C, et al. : Injuries after a typhoon in China. N Engl J Med 2007; 356(2): 196197.CrossRefGoogle ScholarPubMed
12. McNabb, SJN, Kelso, KY, Wilson, SA, et al. : Hurricane Andrew-related illnesses and injuries in Louisiana, 1992; South Med J 1995; 88(6): 615618.CrossRefGoogle ScholarPubMed
13. Kohn, R, Levav, I, Garcia, ID et al. : Prevalence, risk factors and aging vulnerability for psychopathology following a natural disaster in a developing country. Int J Geriatr Psychiatry 2005; 20(9): 835841.CrossRefGoogle ScholarPubMed
14. Blake, ES, Jarrell, JD, Rappoport, EN et al. : The deadliest, costliest, and most intense United States tropical cyclones from 1851 to 2005 (and other frequently requested hurricane facts). Available at http://www.nhc.noaa.gov/gifs/table11.gif. Accessed 05 June 2007.Google Scholar
15. National Oceanic and Atmospheric Administration, National Weather Service Forecast Office, Miami-South Florida: Hurricane Wilma. 2007. Available at http://www.srh.noaa.gov/mfl/events/?id=wilma. Accessed 05 June 2007.Google Scholar
17. Florida Sun-Sentinel: The 11 worst hurricanes. Available at http://www.sunsentinel.com/news/weather/hurricane/sfl-aug2001hurricanehistory,0,5857394.storygallery. Accessed 05 June 2007.Google Scholar
18. CDC: Monitoring poison control center data to detect health hazards during hurricane season—Florida, 2003–2005. MMWR 2006; 55(15): 426428.Google Scholar
19. American Red Cross: Hurricane. Available at http://www.redcross.org/general/0,1082,0_587_,00.html. Accessed 05 June 2007.Google Scholar
20. US Census Bureau: Miami-Dade County QuickFacts, 2005. Available at http://qiiickfacts.census.gov/qfd/states/12/12086.html. Accessed 10 December 2007.Google Scholar
21. Kay, J: Hurricane season starts, but most are unready, poll says. Boston Globe 01 June 2007.Google Scholar
22. Merzer, M: Miami Herald. May 31, 2007. http://www.miamiherald.com/460/story/123971.html#x. Accessed 31 May 2007.Google Scholar