Chronic Disease After Natural Disasters: Public Health, Policy, and Provider Perspectives

Individuals with chronic conditions require special attention in the planning, response, and recovery phases of disasters, given their unique needs for medication, medical equipment, continued medical care, and the potential for exacerbation of their conditions that require resource-intensive management.

In addition to exacerbating existing disease, disasters also contribute to the development of new chronic illnesses. The estimated cumulative cost of natural disasters in 2017 was over $300 billion. With the expected increase in severity of natural disasters in the setting of climate change, understanding the post-disaster burden of these diseases and the approach by local, state, and federal agencies in preparing for and responding to them in disaster settings is as important as ever.

Over 60% of Americans have at least one chronic condition, and over 40% have multiple. Decades of research have characterized the post-disaster burden of chronic conditions, and authors have more recently begun to discuss how a more unified approach can be taken by public health practitioners and public officials in the disaster sphere to better address the needs of this population across the disaster lifecycle.

The purpose of this report is to provide public and private stakeholders, especially at the state and local levels, with a resource to help them better understand, and support, the needs of this subgroup. We achieve this by providing a review of key research addressing the burden of chronic diseases, their management, and broader solutions across the disaster life cycle followed by 15 interviews conducted with direct service providers, as well as public health and policy leaders working at the local, state, and federal level. Our interviews highlight the strengths and weaknesses that have been experienced or are anticipated in current approaches to this issue and provide direction for next steps in research, policy, and public health practice as more Americans develop chronic conditions.