Unequal Threats: Addressing Healthcare Vulnerabilities in Disaster-Prone Regions
The areas of the U.S. that are typically hardest hit by natural disasters — such as the Gulf Coast — often face another significant challenge: the lack of critical healthcare services needed to help communities recover from the devastating effects of pandemics and extreme weather events. Our recently released Restoring the Healthcare Workforce for Equity Program (RHWE) report highlights one particularly alarming risk to these essential services — significant staff shortages and burnout among healthcare workers, particularly among healthcare institutions intended to serve already vulnerable populations.
Community health centers and free and charitable clinics already serve diverse and economically challenged populations, typically with greater chronic conditions and other social risk factors that could make them more vulnerable to disaster impacts. Health centers and clinics, the study found, are also experiencing higher rates of worker losses with fewer resources to retain existing staff compared to other healthcare organizations. This situation poses a potential risk to the care currently received by more than 31.5 million Americans in health centers and 2 million at free and charitable clinics.
For example, counties like Hidalgo and Cameron in Texas experienced disproportionately high rates of COVID-19 cases and deaths. These areas, already vulnerable due to their geographic location along the Gulf Coast and southern border, now face even greater risks as they struggle with diminished healthcare resources.
We are working diligently to prevent future patient care disruptions, especially those in medically underserved communities. Initiatives like RHWE and tools like the Community Disaster Resilience Tool (CDRT) are crucial to these efforts. The RHWE report identified areas with higher-than-average social vulnerability — regions that not only suffered more COVID-19 deaths and cases but are also situated in disaster-prone zones along the Gulf Coast and the southern border between the U.S. and Mexico. These areas, marked on the map with the darkest red shading, are at greater risk for natural disasters and represent places where worsening disparities in healthcare access need to be further assessed and addressed.
RWHE Assesses Disaster Risks Based on Regional Factors
The RHWE initiative, funded by the ), an organization committed to mobilizing philanthropy to strengthen the ability of communities to withstand disasters and recover equitably when they occur, focuses on all individuals working in community health centers (sometimes referred to as Federally Qualified Health Centers or FQHCs), and free and charitable clinics, regardless of specialty or profession.
The program includes a needs assessment, multiple policy briefs and trainings on the impacts of the COVID-19 pandemic on healthcare workforce trends. It highlights greater shortages and burnout among healthcare workers in underserved communities and examines the essential role of leaders and policymakers in fostering positive workplace culture and equitable policies. The findings were released by Healthcare Ready in partnership with Association of Clinicians for the Underserved (ACU) and the National Association of Free and Charitable Clinics (NAFC), underscoring the urgent need for concerted efforts to support these critical healthcare providers.
As noted, the RWHE report also leverages our Community Disaster Resilience Tool (CDRT) to identify areas with specific parameters related to social vulnerability, race, income, age, chronic condition prevalence and housing status. The CDRT is a map-based interactive tool that helps local officials, emergency managers, community leaders, and researchers better understand the nuanced risks their communities. These risks can be due to overlapping vulnerabilities, healthcare infrastructure and exposure to hazards. By highlighting the intersectionality of these statistics, the tool provides a picture of how public health issues can be exacerbated by natural disasters, and which counties are most at risk.
The CDRT includes four different tabs, each providing specific information by county. The Chronic Condition Prevalence tab shows the prevalence of 21 chronic conditions where rates exceed the national average. The Healthcare Infrastructure tab communicates recent COVID-19 data, including active case numbers and vaccination rates, alongside a map for exploring healthcare infrastructure. The Population Information tab highlights statistical data about the public in the region, as well as a breakdown of Federal Disaster Declarations. The Natural Hazards tab displays information on the percentage of the county at elevated risk for earthquakes, floods or wildfires.
The RHWE program and the CDRT tool together provide a roadmap for identifying and addressing the gaps in healthcare access that leave vulnerable populations at greater risk during both pandemics and natural disasters. By prioritizing these areas and ensuring that healthcare workers and infrastructure are adequately supported, we can help safeguard the health and well-being of all communities, particularly those most in need.
For more information about our ongoing efforts to promote equity and resilience in healthcare:
https://healthcareready.org/community-health-centers-and-clinic-resources/