Addressing the impact of disasters on public health infrastructure and noncommunicable diseases

Abstract

Worldwide there has been a disease transition to noncommunicable diseases due to population aging, increasing obesity and decreasing physical activity. This combined with an increasing frequency of natural disasters has created challenges for disaster and health systems. Natural disasters can and do damage public health infrastructure such as services and supplies, resulting in acute exacerbation of noncommunicable diseases. To reduce the risk, this research explored the impact of cyclone, flood and storm related disasters on public health infrastructure and the management of noncommunicable diseases in Queensland, Australia, and used the findings to develop mitigation strategies. Data was collected, analysed and integrated over three sequential phases: literature reviews; focus groups and interviews; and a modified Delphi process. People with noncommunicable diseases found to be at greatest risk were those: with cardiovascular, respiratory and renal diseases; undergoing cancer treatment; and with unstable diabetes; and mental health conditions. There were 31 mitigation strategies identified across 12 public health infrastructure themes. Specific strategies include: designated primary healthcare hubs post disaster; streamlining processes for patients to access medication after a disaster; the need for water treatment plants to have back-up power; good hygiene practices implemented at evacuation centres; and consistent and clear messages about where people can go for assistance after a disaster. These findings informed development of a conceptual framework and options for implementing mitigation strategies to sustainably minimise the impact of disasters on people with noncommunicable diseases.