How do natural disasters impact access to health care?

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That’s a question Dr. Troy Quast, USF College of Public Health (COPH) associate professor of health policy and management, examined in the aftermath of Hurricane Katrina.

And now, again, in the wake of Hurricanes Irma and Maria.

This time the research will focus on Puerto Rico and how residents with breast and colon cancer have had health care disrupted by the storms.

For example, how do you get needed medical care if your doctor has fled the area? What if your pharmacy is closed? If you’ve evacuated to a new city and don’t know where to find a health care professional who can treat you?

“It’s not a question of if health care access has been affected,” said Quast. “The interesting question is how much it has been affected. We decided to focus on breast and colon cancer patients because there is a high incidence of these types of cancer. Using these patients gives us a broader base of people affected by the storms, and that will be helpful in analyzing the effects.”

Troy Quast, PhD, with his research colleagues at the University of Puerto Rico’s Centro Comprensivo de Cancer. (Photo courtesy of Dr. Troy Quast)

Because of his Katrina work, Quast was approached by colleagues at the University of Puerto Rico’s Centro Comprensivo de Cancer to collaborate on the research, which is currently in the grant proposal stage. He recently traveled to the island to meet with researchers and to present his findings on Katrina and its effect on health care access for children and seniors.

The Katrina studies were limited to Medicaid and Medicare recipients. Quast found, for example, that when children who had fled to neighboring Texas after the storm were given a Medicaid waiver, they were able to maintain care. But once the waiver period ended, care fell off.

“Some of the key things we will be looking at with this project are the secondary effects from having a delay in care,” Quast reported. “In the case of the cancer patients, will there be a need for more surgeries later on? Will there be a higher mortality rate?  We’re not just looking at the immediate effects, but also the long-term ramifications. Obviously it’s important to be prompt with health care, even in a natural disaster. But if we can shed light on the longer term effects of this disruption of care, then hopefully we can give policy makers more information that will help them formulate a quick response.”

Story by Donna Campisano USF College of Public Health

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