Chapter 4: The Nurse’s Role and the Impact of Disasters on the Community

Impact of Disasters: Communities

The direct impact of disasters on community health may include large numbers of injuries and deaths that overwhelm the local emergency response services and health systems. Damage to the health services infrastructure, roads and transportation, and communication systems; reduced resources, such as available health care staff; and increased need for additional equipment can impede health care providers’ abilities to care for victims in the immediate response. It also affects the provision of follow-up care, which may have negative consequences for morbidity and mortality in the community. A significant risk of communicable diseases from a contaminated water supply, deceased animals, standing water, or other environmental factors may exist. Overcrowded health care facilities or living conditions compound the risk of infectious diseases. Food and water shortages pose a significant threat to the population, especially if the community is geographically challenging for responders to access. In addition, the psychological and psychosocial effects of witnessing and surviving catastrophic events may be substantial.

Indirect impacts on health because of disasters may include disruptions in modes of communication such as telephones, internet connections, and television services. Transportation may become limited due to damaged roads or highway infrastructure and vehicles. Community utilities, including electricity, water, and sewer systems, may be damaged or experience service disruptions.

Some communities are at greater risk during and following a disaster. Large populations, limited escape routes, population congestion, dense infrastructure, and low socioeconomic status increase community vulnerability (Donner & Rodriquez, 2011). Impoverished communities often have inadequate infrastructure to withstand a disaster and have disproportionately larger vulnerable populations.

A resilient community has the ability to recover from a disaster and can sustain itself in the face of hardship. Social connectedness is an essential characteristic of community resilience (Urban Footprint, 2023). Community members participate in their community, fostering a sense of togetherness and of feeling valued. Resilient communities also have social connections that provide emotional and physical support (Urban Footprint, 2023). Local organizations are trusted and provide needed community resources, such as food banks and financial assistance. Strong health care systems and government are prepared for disaster and recovery and have access to resources such as clean water and medical equipment. These communities continuously work on building resilience by improving social connections, ensuring government involvement in disaster management, improving risk communication to the entire community and vulnerable groups, improving community members’ physical and mental health, and increasing community social and economic health (Urban Footprint, 2023).

Impact of Disasters: Vulnerable Populations

Vulnerable populations are those with characteristics that affect their capacity to anticipate, respond to, and recover from the impact of disasters. The most vulnerable populations are low-income populations, older adults, and ethnic and racial minorities.

Those of low socioeconomic status are less prepared for disasters (Substance Abuse and Mental Health Services Administration [SAMHSA], 2017). This population often lacks the resources to afford mitigation efforts, such as strengthening household structures and purchasing disaster insurance. Financial resources are most often used for immediate needs rather than to prepare for a potential disaster in the future. Even more vulnerable are people with lower incomes who are also experiencing homelessness, women, or residents of public housing because they often lack finances and resources needed in case of evacuation (SAMHSA, 2017). These groups are less likely to evacuate prior to a disaster. Following a disaster, low-income populations have greater difficulty obtaining aid, housing loans, food assistance, assistance with evacuation and transportation, and access to medical resources (Martin, 2019; SAMHSA, 2017). Consequences of disaster for low-income populations include greater incidence of homelessness, unemployment, injury, mortality, economic loss, depression, and posttraumatic stress (SAMHSA, 2017).

Older adults are more vulnerable to disasters as compared to other age groups (American Red Cross, 2020). Mortality rates within this population following disasters are greater because older adults are more likely to have chronic conditions, comorbidities, cognitive impairment, and medication needs. A greater number of older adults are dependent on assistive devices and caregiver support and are socially isolated.