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Review

The Impact of Disasters on Populations With Health and Health Care Disparities

Jennifer R. Davis, MSPH, Sacoby Wilson, PhD, Amy Brock-Martin, DrPH, Saundra Glover, PhD and Erik R. Svendsen, PhD

Author Affiliations: Departments of Epidemiology and Biostatistics (Ms Davis and Drs Wilson and Svendsen) and Health Services, Policy, and Management (Drs Brock-Martin and Glover); Institute for Families in Society (Dr Wilson); South Carolina Rural Health Research Center (Drs Brock-Martin and Glover); and Institute for the Partnership to Eliminate Health Disparities (Dr Glover), University of South Carolina, Columbia; and the South Carolina Department of Health and Environmental Control, Columbia (Dr Svendsen).

Context:  A disaster is indiscriminate in whom it affects. Limited research has shown that the poor and medically underserved, especially in rural areas, bear an inequitable amount of the burden.

Objective:  To review the literature on the combined effects of a disaster and living in an area with existing health or health care disparities on a community's health, access to health resources, and quality of life.

Methods:  We performed a systematic literature review using the following search terms: disaster, health disparities, health care disparities, medically underserved, and rural. Our inclusion criteria were peer-reviewed, US studies that discussed the delayed or persistent health effects of disasters in medically underserved areas.

Results:  There has been extensive research published on disasters, health disparities, health care disparities, and medically underserved populations individually, but not collectively.

Conclusions:  The current literature does not capture the strain of health and health care disparities before and after a disaster in medically underserved communities. Future disaster studies and policies should account for differences in health profiles and access to care before and after a disaster.

Key Words: healthcare disparities • disasters • socioeconomic factors • rural health services • medically underserved area • surge capacity • review articles • community health planning • community disaster response




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