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A Geostatistical Analysis of Social Vulnerability and Medical Care Access During Hurricane Harvey

Authors: David Rickless*, CDC/ATSDR, Grete Wilt, CDC/ATSDR and Harvard T.H. Chan School of Public Health, Danielle Sharpe, CDC/ATSDR, Noelle Molinari, CDC, Tanya Telfair LeBlanc, CDC, William Stephens, Texas Informatics
Topics: Hazards and Vulnerability, Medical and Health Geography, Geographic Information Science and Systems
Keywords: Spatial statistics, social vulnerability, natural disasters, medical geography
Session Type: Poster
Presentation File: No File Uploaded


When Hurricane Harvey struck the coastline of Texas on August 25, 2017, it resulted in 88 fatalities and more than $125 billion in damage. Biohazard exposure and injuries from trauma likely contributed to increases in emergency department (ED) visits in Houston and in cities receiving hurricane evacuees, such as Dallas-Fort Worth (DFW).

Drawing on social vulnerability theory, this study explored demographic indicators of vulnerability for patients from the impact area who sought care at EDs and Disaster Medical Assistance Team (DMAT) units, both in DFW and in the Houston area. The objectives were to characterize the vulnerability of affected populations who presented for emergency care locally, as well as those who presented away from home, and to determine whether more vulnerable communities in the disaster area were more likely to seek care locally or elsewhere.

We used ED visit data alongside the Centers for Disease Control and Prevention Social Vulnerability Index (CDC SVI) to calculate the percentage of patients seeking care locally by zip code. Communities with high percentages of patients presenting for care locally were significantly clustered. Controlling for population density and flood extent, we found that communities with more patients presenting locally tended to have greater socioeconomic vulnerability and lower vulnerability based on household composition and disability.

The findings and conclusions in this abstract have not been formally disseminated by the Centers for Disease Control and Prevention or the Agency for Toxic Substances and Disease Registry and should not be construed to represent any agency determination or policy.

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