ABSTRACT
At least 30% of the mortality following the 2017 Hurricanes Irma and Maria in the U.S. mainland and territories can be attributed to poorly controlled non-communicable diseases (NCDs), including diabetes, cardiovascular disease, respiratory conditions, cancer, and mental health disorders. Without access to healthcare facilities, services, and personnel, exacerbations of these conditions are inevitable and can lead to death. These same conditions disproportionately affect minority populations. In this chapter, we provide a framework, based on the Socio-Ecological Model, that describes the factors that drive the effect of disasters on NCDs, the disproportionate effect of disasters on historically marginalized populations, and thus, how disasters worsen health disparities. We then apply this framework to our experience working with federally qualified health centers in Puerto Rico and the U.S. Virgin Islands (serving uninsured and underinsured populations) to propose strategies to increase the preparedness and resilience of vulnerable individuals with NCDs.
