Severe weather events exacerbate existing health disparities due to poorly managed non-communicable diseases (NCDs). Our objective is to understand the experiences of staff, providers, and administrators (employees) of Federally Qualified Health Centers (FQHCs) in Puerto Rico and the US Virgin Islands (USVI) in providing care to patients living with NCDs in the setting of recent climate-related extreme events.

We used a convergent mixed-methods study design. A quantitative survey was distributed to employees at 2 FQHCs in Puerto Rico and the USVI, assessing experience with disasters, knowledge of disaster preparedness, the relevance of NCDs, and perceived gaps. Qualitative in-depth interviews explored their experience providing care for NCDs during recent disasters. Quantitative and qualitative data were merged using a narrative approach.

Through the integration of quantitative and qualitative data, we recognize: (1) significant gaps in confidence and preparedness of employees with a need for more training; (2) challenges faced by persons with multiple NCDs, especially cardiovascular and mental health disorders; and (3) most clinicians do not discuss disaster preparedness with patients but recognize their important role in community resilience.

With these results, we recommend strengthening the capacity of FQHCs to address the needs of their patients with NCDs in disasters.

This study compared the per capita annual global incidence rate of disasters caused by natural hazards with the annual world real gross domestic product, GDP (per global capita), as reported during 1961 through 2020.

Sixty (60) values for the world real GDP per global capita (in constant 2015 $USD) were compared to corresponding annual values for global incidence rates for five natural disaster subgroups and then for a total of twelve individual disaster types that comprise the subgroups; each expressed as an annual global incidence rate (in terms of annual incidence per 100,000 persons). Calculations of multiple linear regression, ANOVA, and Pearson’s correlation coefficient were performed for comparing population-adjusted values for GDP to corresponding values.

Four out of five hydrological and meteorological disasters were found to have a positive correlation with GDP. Results of the analysis revealed a relatively high degree of correlation between world GDP and the annual incidence of flood and storm disasters (P = 6.21 × 10−10 and P = 4.23 × 10−4, respectively). The annual incidence of heat waves and cold weather disasters also appeared to correlate with GDP (P = .002 and P = .019, respectively). In comparison, wet landslides indicated no such correlation (P = .862). No significant associations were found among the seven other individual biological, climatological, and geophysical disasters and GDP.

The global incidence of four extreme weather (hydrometeorological) disasters appear to be positively associated with world real GDP during 1961-2020. These findings contradict previous postulates that the risk of disaster incidence is inversely associated with the capacity of the population.

This manuscript summarizes the global incidence, exposures, mortality, and morbidity associated with extreme weather event (EWE) disasters over the past 50 years (1969-2018).

A historical database (1969-2018) was created from the Emergency Events Database (EM-DAT) to include all disasters caused by seven EWE hazards (ie, cyclones, droughts, floods, heatwaves, landslides, cold weather, and storms). The annual incidence of EWE hazards and rates of exposure, morbidity, and mortality were calculated. Regression analysis and analysis of variance (ANOVA) calculations were performed to evaluate the association between the exposure rate and the hazard incidence rate, as well as the association between morbidity and mortality incidence rates and rates of human exposure and annual EWE incidence.

From 1969-2018, 10,009 EWE disasters caused 2,037,415 deaths and 3,998,466 cases of disease. A reported 7,350,276,440 persons required immediate assistance. Floods and storms were the most common. Most (89%) of EWE-related disaster mortality was caused by storms, droughts, and floods. Nearly all (96%) of EWE-related disaster morbidity was caused by cold weather, floods, and storms. Regression analysis revealed strong evidence (R2 = 0.88) that the annual incidence of EWE disasters is increasing world-wide, and ANOVA calculations identified an association between human exposure rates and hazard incidence (P value = .01). No significant trends were noted for rates of exposure, morbidity, or mortality.

The annual incidence of EWEs appears to be increasing. The incidence of EWEs also appears to be associated with rates of human exposure. However, there is insufficient evidence of an associated increase in health risk or human exposures to EWEs over time.

This paper reports on undergraduate health care students’ perception of societal vulnerability to disasters in the context of population aging. Forecast increases in extreme weather events are likely to have a particularly devastating effect on older members of the community.

Undergraduate paramedicine and nursing students were surveyed using the Perceptions of Ageing and Disaster Vulnerability Scale (PADVS) to determine their views on the risks posed to older members of the community by disasters. Data analysis included a comparison of subscales relating to isolation, health system readiness, declining function, and community inclusiveness.

Students reported a moderate level of concern about disaster vulnerability. Students who had previously completed another university degree reported significantly higher levels of concern than those without a prior degree. Australian students reported lower concern about societal vulnerability compared to a previously reported cohort of Japanese students.

Our study suggests current education of future health care students does not promote adequate levels of awareness of the health-related challenges posed by disasters, particularly among older members of the community. Without addressing this gap in education, the risk of negative outcomes for both unprepared first responders and older members of the community is significant. (Disaster Med Public Health Prep. 2019;13:449-455)