A Systems Framework for Modeling Health Disparities in the Prevalence in Chronic Conditions following a Natural Disaster Event

Natural disaster events impact both the short- and long-term health of a region’s population. Due to variation in the vulnerability among population segments, a severe storm event can be expected over time to have a greater public health impact upon traditionally underserved and medically fragile populations. This research illustrates the causal relationships leading to a change over time in the prevalence of chronic conditions among black and non-black populations within U.S. Hampton Roads. Using a system dynamics approach, the authors develop and integrate a macro model that captures change in regional economic and demographic profiles with a micro model that focuses on access to health services and the ability to respond within the context of the changing regional environment. The authors’ study finds that: (1) the disparity in the prevalence of chronic conditions increases over time following the event, (2) the growth in health disparity may be slowed by regional resiliency intervention policies, and (3) mitigation efforts result in greater reductions in growth of chronic conditions among the black population relative the non-black general population. Knowledge of the disparate impact that such an event will have on the long-term health of underserved and medically fragile populations may be used to inform mitigation investments.