Homeland Security Watch

News and analysis of critical issues in homeland security

January 22, 2014

Promoting research on healthcare system recovery following disasters

Filed under: General Homeland Security — by Arnold Bogis on January 22, 2014

After a hurricane, tornado or other disaster hits, lots of newspaper ink (and pixels) are spent on stories about the impact on people’s lives, homes, and their communities’  infrastructure.  Little attention is paid to their health or the impact on their communities’ healthcare system.  Where there is little attention paid to a topic often there is little money available for researching that topic.

Thanks to funds appropriated as part of the Hurricane Sandy relief act (or, more accurately, the Disaster Relief Appropriations Act of 2013), that is beginning to change.  According to HHS:

Over the next two years, the U.S. Depart­ment of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR) will dedicate $8.6 million to support research that examines long-term recovery of health systems and communities in areas of the country hard hit by Hurricane Sandy in October 2012.

ASPR collaborated with the New York Academy of Medicine and the Institute of Medicine to engage the research community and examine how the response to Hurricane Sandy and recovery could be enhanced through scientific research. Experts from state health departments, community health organizations, federal government, and academic institutions identified some rapid research that could promote ongoing long­-term recovery efforts.

ASPR awarded it’s grants last October to the following recipients:

  • American College of Emergency Physicians, Irving, Texas – approximately $444,000 to study how health care systems were impacted negatively before, during, and after Hurricane Sandy and to develop comprehensive recommendations on how to strengthen health care systems going forward to treat patients effectively during disaster events:
  • Columbia University, New York City – approximately $596,000 to assess how community-level factors such as economic development, communication, and social connections influence mental and behavioral health recovery in the aftermath of Hurricane Sandy, and a second grant of approximately $276,000 to assess the resilience of residents of high-rise public housing in responding to Sandy’s impact.
  • New York University School of Medicine, New York City – approximately $752,000 to assess the resilience and response of a complex regional health care system impacted by Hurricane Sandy and the evaluation of patient care during and after the disaster.
  • RAND Corporation, Santa Monica, Calif. – approximately $657,000 to explore how partnerships between local health departments and community-based organizations contribute to the public health system’s ability to respond to and recover from emergencies and contribute to resilience.
  • Rowan University School of Osteopathic Medicine, Stratford, N.J.– approximately $681,000 to examine how social networks within neighborhoods play a critical role in determining resilience of older Americans exposed to disasters.
  • University of Delaware, Newark– approximately $574,000 to identify critical factors that influence community resilience and use these factors to create a computer program that supports community resilience in New York City after Hurricane Sandy.
  • University of Maryland, Baltimore – approximately $417,000 to determine how social connections in a community of Maryland watermen influence their individual behavior and how the behavior impacts disaster recovery after Hurricane Sandy.
  • University of Pittsburgh – approximately $576,000 to study ways to minimize disruptions of access to primary health care services during recovery from major disasters, especially for at-risk populations.

The Centers for Disease Control and Prevention (CDC) and the National Institute of Health National Institute of Environmental Health Sciences (NIEHS) also awarded research grants funded by the Disaster Relief Act.

More recently, a kickoff meeting was held in New York City at Columbia’s Mailman School of Public Health that brought together all of the grant recipients, as well as public health officials from some of the area impacted by Sandy.

How can Hurricane Sandy’s impact on the healthcare system inform future disaster planning and responses? Can research on this cataclysmic disaster help us to better integrate organizations, agencies, or services across the healthcare, public health, and emergency response systems? How do we better communicate with different cultural groups and communities before, during and after a disaster?

These were just a few of the questions on best practices tackled by a joint Hurricane Sandy meeting on January 7th.  The meeting convened with the U.S. Assistant Secretary for Preparedness and Response, representatives from the CDC and NIEHS, and principal investigators on Sandy recovery projects including the NIH’s Disaster Research Response Project. TheMailman School of Public Health hosted this first meeting as New York City was one of the communities most deeply affected by Sandy and home base to several research award recipients and partners.

Marcienne Wright, a Science Policy Advisor in ASPR who is currently managing this grant portfolio for that office blogged  a summary of that meeting’s outcomes (yes…ASPR has a blog…who knew?):

This week these three agencies did something pretty unusual — we convened a meeting with this group of grantees who will be researching public health, environmental health and healthcare in Sandy-impacted communities along with their public health and community partners. The meeting’s goal was to encourage grantees to explore opportunities for collaboration at the beginning, rather than at the end, of their projects.

Our grantees and their research partners were wildly enthusiastic. Distinct groups of researchers now want to work together to better support community needs in Sandy-impacted areas, do better science without duplication, and advance scientific knowledge on building resilience in these communities.

The research being conducted in Sandy-impacted communities is an example of what’s needed to support the decisions that communities across the country must make after disasters and every day – decisions about infrastructure, policies, procedures, partnerships, coalitions, and funding that drive your community’s resilience.

A better understanding of the science supporting response and recovery is absolutely needed for communities across the country – including yours – to become as ready and resilient as possible so that health stands up to disaster.

Sharing the information gained from this research with the impacted community and the nation is vital to building a country that is resilient to whatever comes our way. These projects as well as future studies initiated by the scientific community hold tremendous potential to bring people together to talk about tough decisions and difficult topics. A bonus to bringing people together for research purposes is that the action can lead to new coalitions, new partnerships and in turn stronger communities.

Potential researchers: think about it; by pursuing this line of inquiry you could help strengthen the health security of our entire nation. To learn about the projects underway now, visit www.hhs.gov/sandy.

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5 Comments »

Comment by William R. Cumming

January 22, 2014 @ 1:14 am

Thanks Arnold and glad some research on this topic underway!

Since 9/11 quite a bit of work on Mass Casualty events which fortunately seem to be few in the USA for various reasons.

I would argue that Storm Sandy should not have adversely impacted the health care system where it landed. But what we learned is that a number of hospitals and congregate health care centers had done little to prepare and if necessary evacuate patients and residents.

Comment by William R. Cumming

January 22, 2014 @ 8:04 am

Dr. Irwin Redliner,M.D. drive sprocket at MAILMAN SCHOOL at Columbia U. on disaster issues!

Comment by John Comiskey

January 22, 2014 @ 2:02 pm

Arnold,

Thanks for a wonderful window into public health.

A concern of mine has been the absence of public health in the HLS domain. In 2009 we had a H1N1 scare that did not materialize into a catastrophe but raised our awareness so much so that Chris Bellavita referred to public health as HLS 3.0 on 1.0 to 4.0 scale of HLS evolution. See: https://www.hsaj.org/?article=8.1.15

Hurricane Katrina and to a lesser degree Superstorm Sandy exposed a vulnerable public health infrastructure.

IMHO, the challenge to the grant research is to identify smart disaster mitigation techniques (resilient construction, road and air access, HVAC technology)and a mobile and reserve public health and medical corp.

Comment by Arnold Bogis

January 23, 2014 @ 1:11 am

Bill, thanks and just FYI on Dr. Redlener (whose work is fantastic and should be of interest to anyone reading this blog), his National Center for Disaster Preparedness is now housed in Columbia University’s Earth Institute instead of their public health school. The website: http://ncdp.columbia.edu/

And I believe you are correct in the general lack of hospital and health system preparedness, though it appears to be improving.

John, I agree with you about the seeming lack of connection between the public health/medical space and homeland security. Until recently I was a contractor at ASPR, so I avoided writing too much on this topic. But now that I’m between jobs (*cough* I’m available for a range of preparedness, response, resilience, nuke/rad, etc. positions *cough*) I plan on diving into this subject with my upcoming posts. In particular, the ESF-8 mission strikes me as both particularly important and not really understood outside of the health arena (and really, not so much even there at the local level).

Comment by William R. Cumming

January 23, 2014 @ 1:35 pm

Thanks Arnold for the link!

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