Preparedness, hurricanes Irma and Maria, and impact on health in Puerto Rico

Abstract

ObjectivesOnly few studies evaluated whether hurricane preparedness impacts health. The PREPARE study addresses this gap. MethodsWe recruited participants who had pertinent pre-hurricane data from the 364 San Juan.Overweight Adults Longitudinal Study (SOALS) and 125 patients with diabetes from Federally Qualified Health Center (COSSMA) in Puerto Rico. Participants aged 42–75 years completed interviews 20–34 months after Hurricanes Irma and Maria. We evaluated associations between self-reported hurricane preparedness and health and other related associations using logistic regression controlling for age, location, education and interview date. ResultsOnly 41% of participants reported high pre-hurricane preparedness; 25% reported gaps (moderate/low availability) in information and 48% reported gaps in resources for hurricane preparedness. Participants reporting lower pre-hurricane preparedness had higher reported hurricane-related detrimental health impact (OR = 1.96; 95% CI: 1.31, 2.95) and higher odds (OR = 2.07; 95% CI: 0.92, 4.68) of developing new non-communicable disease (NCD) compared to others. Post-hurricane drinking water disruption for ≥3 months versus none or less (OR = 2.76; 95% CI: 1.39, 5.47) and similarly diet changes due to cooking/refrigeration access (OR = 1.96; 95% CI: 1.24, 3.07), and diet changes for ≥20 months due to finances/access to shops (OR = 2.83; 95% CI: 1.85, 4.32) were also associated with detrimental health impact. ConclusionLower preparedness was associated with higher detrimental impact of the hurricanes on overall health, and marginally significant impact on NCD. Future preparedness efforts could especially target means of coping with disruption of water services and regular diet, as these were also associated with detrimental health impact.