Wiciak Michelle Teresa, Perez Stephen, Richards Tess, Escobar Karla, Evans Dabney P, Nunez-Smith Marcella, Hassan Saria
Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States.
Hubert Department of Global Health, Emory Rollins School of Public Health, Atlanta, GA, United States.
Front Public Health. 2025 Sep 12;13:1606631. doi: 10.3389/fpubh.2025.1606631. eCollection 2025.
Extreme weather events, like hurricanes Irma and Maria, have disproportionately impacted individuals with non-communicable diseases (NCDs) in the U.S. Virgin Islands (USVI), exacerbating health disparities due to healthcare disruptions. The USVI and other Caribbean islands face increased morbidity and mortality from NCDs from rising risk factors and lack of improving in quality of care. This study explores the experiences of individuals with NCDs during these hurricanes to identify strategies for improving disaster preparedness and response.
A mixed-methods cross-sectional study was conducted at a Federally Qualified Health Center (FQHC) in St. Thomas, USVI. One-hundred and thirteen quantitative surveys assessed preparedness, healthcare access, and mental health impacts. Fifteen semi-structured qualitative interviews provided deeper insights into patient experiences and coping strategies. Data integration followed a narrative approach.
Quantitative findings revealed nearly one third of participants struggled to manage their NCDs post-disaster, citing stress-related exacerbation of conditions (42.3%), lack of medication access (34.6%), and disrupted healthcare services (34.6%). Mental health burdens were significant, with nearly a third reporting anxiety (28%) and depression (27.8%), and 5.2% meeting PTSD criteria. Many participants (39.7%) had not received disaster preparedness information tailored to NCDs, with only 47.5% receiving guidance from healthcare providers. Qualitative interviews underscored these findings, highlighting that NCD management was deprioritized post-disaster due to immediate survival needs. Participants emphasized the role of family and community support in coping, yet also noted mental health stigma and limited healthcare access as ongoing barriers. Preferred communication strategies included social media, radio, and trusted sources.
Findings reveal critical gaps in disaster preparedness for persons with NCDs in the USVI. Strengthening healthcare infrastructure, enhancing mental health support, and providing targeted education can improve resilience and reduce morbidity in future disasters.
像飓风“厄玛”和“玛丽亚”这样的极端天气事件，对美属维尔京群岛（美属维京群岛）患有非传染性疾病（NCDs）的个人产生了不成比例的影响，由于医疗保健中断，加剧了健康差距。美属维尔京群岛和其他加勒比岛屿因风险因素上升和医疗质量缺乏改善，非传染性疾病导致的发病率和死亡率不断增加。本研究探讨了非传染性疾病患者在这些飓风期间的经历，以确定改善灾难准备和应对的策略。
在美属维尔京群岛圣托马斯的一家联邦合格健康中心（FQHC）进行了一项混合方法横断面研究。113份定量调查问卷评估了准备情况、医疗保健获取情况和心理健康影响。15次半结构化定性访谈提供了对患者经历和应对策略的更深入见解。数据整合采用叙述性方法。
定量研究结果显示，近三分之一的参与者在灾后难以管理他们的非传染性疾病，原因包括与压力相关的病情加重（42.3%）、无法获得药物（34.6%）以及医疗服务中断（34.6%）。心理健康负担很重，近三分之一的人报告有焦虑（28%）和抑郁（27.8%），5.2%符合创伤后应激障碍标准。许多参与者（39.7%）没有收到针对非传染性疾病的灾难准备信息，只有47.5%的人从医疗保健提供者那里获得了指导。定性访谈强调了这些发现，突出表明由于眼前的生存需求，灾后非传染性疾病管理被置于次要地位。参与者强调了家庭和社区支持在应对中的作用，但也指出心理健康污名化和有限的医疗保健获取仍然是障碍。首选的沟通策略包括社交媒体、广播和可靠来源。
研究结果揭示了美属维尔京群岛非传染性疾病患者在灾难准备方面的关键差距。加强医疗基础设施、加强心理健康支持以及提供有针对性的教育可以提高恢复力，并在未来灾难中降低发病率。
