In the aftermath of severe natural disasters, most public and governmental attention traditionally centers on immediate recovery efforts, focusing on restoring infrastructure and emergency services. However, new research conducted by teams from Drexel University and the University of Maryland reveals a critical yet often overlooked consequence of these catastrophic climate events: a sustained reduction in access to essential health care services. This long-term impact poses significant risks to community health, persisting well beyond the initial period of disaster response and recovery.
Analyzing data collected from over 3,000 counties across the United States between 2000 and 2014, researchers identified a clear and statistically robust correlation between the occurrence of severe natural disasters—including heatwaves, droughts, floods, and wildfires—and the subsequent loss of health care infrastructure. This infrastructure includes both hospitals and outpatient care facilities, which form the backbone of community health services. The comprehensive nature of the dataset allowed the team to assess fluctuating facility presence within counties over a 15-year period, providing a national scope rarely achieved in previous investigations.
One of the novel elements of this study lies in its breadth: instead of concentrating on single high-profile events like Hurricane Katrina or Sandy, the study encompassed all climate-related disasters that caused measurable damage or fatalities across the country. This national-scale perspective enabled the detection of systemic patterns linking disaster severity to reductions in outpatient care availability. Facilities were categorized based on their presence status—whether counties never had, lost, gained, or consistently maintained health care sites—offering nuanced insights into infrastructural dynamics over time.
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A crucial methodological advance in the research was the classification of disasters using a standardized impact scale derived from the Spatial Hazards and Events Losses database. Each event was categorized as minor, moderate, or major according to fatalities and property damage per capita. This approach allowed the researchers to isolate the effects of event severity on health facility longevity, revealing that moderate to major disasters significantly heightened the risk of outpatient practice closures, even when controlling for confounding factors such as county population size and poverty levels.
Interestingly, the study found outpatient care facilities are far more vulnerable to permanent closure following severe climate events compared to hospitals. This trend calls attention to the fragility of decentralized, community-based health resources, which are critical for ongoing disease management, preventive care, and routine medical services. The loss of such outpatient capacities can exacerbate health disparities, especially in socioeconomically disadvantaged areas already struggling with access to care.
Contrary to expectations, the researchers discovered no significant association between climate disasters and closures of pharmacies. This unexpected finding may be partially explained by the already widespread phenomenon of “pharmacy deserts”—areas with chronically limited pharmacy access—particularly in racially segregated and economically marginalized communities. The rise of pharmacy benefit managers and the growing shift toward online pharmaceutical services have also reshaped access patterns, possibly buffering pharmacies against disaster-related closures but raising broader concerns about equitable access.
Socioeconomic factors emerged as key modifiers of health care infrastructure resilience in the face of natural disasters. Counties experiencing sustained losses of health facilities often exhibited higher poverty rates and greater racial segregation. In contrast, communities that either retained or expanded their health care resources after disasters typically had lower poverty levels and presumably more robust institutional support. These findings emphasize the intersectionality between disaster impact, structural inequality, and health system vulnerability.
The study’s senior author, Dr. Yvonne Michael, Professor of Epidemiology, highlighted the profound implications of the findings, stressing that “the consequences of severe climatic disasters extend beyond immediate physical damage to human health, manifesting as persistent reductions in health care access that can last for years.” This enduring deficit could hinder the recovery trajectory of affected populations, potentially leading to worsened health outcomes and increased chronic disease burden over time.
Given projections from the World Economic Forum indicating that by 2050 climate change could be responsible for an estimated 14.5 million deaths globally, alongside trillions of dollars in economic losses and significant costs borne by health care systems, the study underscores an urgent need for strategic investments in disaster resilience. Public health infrastructure must be designed not only for emergency response but also for long-term sustainability and rapid recovery in disaster-prone regions.
The lead author, Kevin Chang, MD, a medical student during the research, emphasized that “without comprehensive policy interventions and financial commitments to strengthen health infrastructure, communities will continue to face interruptions in care and compromised health outcomes after disasters.” He advocates for integrating disaster planning with health system preparedness to mitigate the observed trend of facility closures following climate-induced catastrophic events.
The research team notes that their findings likely underestimate the full scale of the problem. With climate-induced natural disasters increasing in frequency and severity, as well as rising costs associated with recovery efforts, future studies should investigate the multifaceted determinants underpinning the observed relationship between disasters and health infrastructure loss. Specific areas for further exploration include the role of local and federal policies, funding mechanisms, and community resilience initiatives that might buffer or exacerbate health care disruptions.
Moreover, this study did not encompass certain types of medical facilities such as community health centers, urgent care clinics, or long-term care providers, leaving open questions about how these critical components of the health system respond to climate disasters. Understanding their resilience or vulnerability is essential to constructing a comprehensive disaster response framework that adequately addresses all layers of health care delivery.
The findings also highlight important social justice dimensions. More affluent, politically connected communities tend to mobilize resources more effectively to restore health institutions post-disaster. In contrast, marginalized communities frequently lack such networks, making recovery substantially more difficult and deepening existing health inequities. Collaborative efforts and targeted support are therefore vital to ensure equitable recovery and to prevent widening disparities in care access triggered by environmental calamities.
In conclusion, this landmark longitudinal study sheds new light on the pervasive and enduring challenges posed by climate-related natural disasters to the US health care infrastructure. Its results call for urgent, coordinated responses combining public health investment, disaster preparedness, and policy reforms tailored to address socioeconomic inequalities. With climate threats escalating, ensuring resilient and accessible health care systems is paramount for safeguarding population health in the decades ahead.
Subject of Research: People
Article Title: Healthcare Access in the Aftermath: A Longitudinal Analysis of Disaster Impact on US Communities
News Publication Date: 5-May-2025
Web References:
https://www.mdpi.com/1660-4601/22/5/733
https://www.weforum.org/publications/quantifying-the-impact-of-climate-change-on-human-health/
https://www.healthaffairs.org/doi/10.1377/hlthaff.2024.00192
References:
Michael, Y., Chang, K., Hirsch, J. A., & Clay, L. (2025). Healthcare Access in the Aftermath: A Longitudinal Analysis of Disaster Impact on US Communities. International Journal of Environmental Research and Public Health, 22(5), 733. https://doi.org/10.3390/ijerph22050733
Keywords: Climate change
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