Rickless David S, Wilt Grete E, Sharpe J Danielle, Molinari Noelle, Stephens William, LeBlanc Tanya Telfair
Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Geospatial Research, Analysis, and Services Program, Atlanta, GA, USA.
Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA, USA.
Disaster Med Public Health Prep. 2021 Mar 15;17:e12. doi: 10.1017/dmp.2020.421.
When Hurricane Harvey struck the coastline of Texas in 2017, it caused 88 fatalities and over US $125 billion in damage, along with increased emergency department visits in Houston and in cities receiving hurricane evacuees, such as the Dallas-Fort Worth metroplex (DFW).This study explored demographic indicators of vulnerability for patients from the Hurricane Harvey impact area who sought medical care in Houston and in DFW. The objectives were to characterize the vulnerability of affected populations presenting locally, as well as those presenting away from home, and to determine whether more vulnerable communities were more likely to seek medical care locally or elsewhere.
We used syndromic surveillance data alongside the Centers for Disease Control and Prevention Social Vulnerability Index to calculate the percentage of patients seeking care locally by zip code tabulation area. We used this variable to fit a spatial lag regression model, controlling for population density and flood extent.
Communities with more patients presenting for medical care locally were significantly clustered and tended to have greater socioeconomic vulnerability, lower household composition vulnerability, and more extensive flooding.
These findings suggest that populations remaining in place during a natural disaster event may have needs related to income, education, and employment, while evacuees may have more needs related to age, disability, and single-parent household status.
2017年飓风“哈维”袭击得克萨斯州海岸线时，造成88人死亡，损失超过1250亿美元，同时休斯敦以及接收飓风撤离人员的城市（如达拉斯 - 沃思堡都会区，简称DFW）的急诊科就诊人数增加。本研究探讨了来自受飓风“哈维”影响地区、在休斯敦和DFW寻求医疗护理的患者的脆弱性人口统计学指标。目的是描述当地就诊的受影响人群以及离家就诊人群的脆弱性，并确定更脆弱的社区是否更有可能在当地或其他地方寻求医疗护理。
我们使用症状监测数据以及疾病控制与预防中心社会脆弱性指数，按邮政编码分区计算在当地寻求护理的患者百分比。我们使用该变量拟合空间滞后回归模型，控制人口密度和洪水范围。
当地有更多患者寻求医疗护理的社区明显聚集，且往往具有更大的社会经济脆弱性、更低的家庭构成脆弱性和更广泛的洪水。
这些发现表明，在自然灾害事件中留在原地的人群可能有与收入、教育和就业相关的需求，而撤离人员可能有更多与年龄、残疾和单亲家庭状况相关的需求。
