Date of Conferral

2-21-2025

Degree

Ph.D.

School

Public Health

Advisor

Chinaro Kennedy

Abstract

Natural disasters pose significant risks to individuals with chronic diseases, exacerbating health disparities through disruptions in healthcare access and systemic vulnerabilities. This study investigated the association between chronic disease-related mortality occurring within 2 months of Hurricane Irma, and whether demographic variables, including age, sex, race, Hispanic ethnicity, poverty, urbanicity, and educational attainment, modified this relationship. This cross-sectional study used the social-ecological model to analyze secondary mortality data from the National Vital Statistics System. Bivariate and multivariate logistic regression revealed that deaths from chronic illnesses, occurring between September 2017 and October 2017, were 2.694 times higher, compared to the same period in 2016 (95% CI: 1.682–4.316, p < .001); this association remained significant even after controlling for demographic factors (OR = 2.240, 95% CI: 1.342–3.739, p = .002). This study also found significant interactions between age, poverty, and urban residence and chronic disease-related mortality within two months following Hurricane Irma, compared to the same time period in 2016. These findings suggest the need for targeted disaster preparedness strategies for high-risk populations. The emphasis should be placed on prioritizing timely access to care in the wake of disasters for low-income older individuals, in urban areas, who are living with chronic illnesses. The implications for positive social change include the potential for policymakers, emergency response personnel, and healthcare organizations to use these insights to enhance emergency response frameworks, improve healthcare accessibility, and implement interventions to reduce unwarranted mortality.

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