Disaster healthcare disparities solutions: Part 3—Recovery and mitigation


  • Angela Pettit Cornelius, MD, MA https://orcid.org/0000-0002-0405-1433
  • Douglas Mark Char, MD
  • Leah Gustafson Ista, MD, MSPH
  • Samantha Noll, MD
  • Frank Quintero, DO, MBA
  • Heather Rybasack-Smith, MD, MPH
  • Jennie Wang, DO, MPH
  • Robert P. Weinberg, DO, JD, MMSc
  • Sharon E. Mace, MD




healthcare disparities, disaster healthcare disparities, solutions for disaster healthcare disparities, disaster solutions


The purpose of this study was to explore the potential solutions for disaster healthcare disparities. This paper is the third of a three-part series that was written by the Disaster Healthcare Disparities Workgroup of the American College of Emergency Physicians Disaster Preparedness and Response Committee. The committee conducted a literature review and chose articles most representative and demonstrative of solutions to disaster healthcare disparities found in a past workgroup product. Many solutions for disaster healthcare disparities seen during recovery and mitigation were found. Some of these solutions have been successfully implemented and some remain theoretical. Solutions for disaster healthcare disparities seen during recovery and mitigation are achievable but there is still much work to do. Many of these solutions can be advocated for by nondisaster specialists.

Author Biographies

Angela Pettit Cornelius, MD, MA

Associate Professor, TCU/UNT School of Medicine Fort Worth; Department of Emergency Medicine, John Peter Smith Hospital, Fort Worth Emergency Medicine Residency, Fort Worth, Texas; Associate Professor, Department of Emergency Medicine, Ochsner Louisiana State University Academic Medical Center, Shreveport, Louisiana

Douglas Mark Char, MD

Professor of Emergency Medicine, Department of Emergency Medicine, Washington University, St. Louis, Missouri

Leah Gustafson Ista, MD, MSPH

Emergency Medicine, Altru Health System, Grand Forks, North Dakota

Samantha Noll, MD

Assistant Professor, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado

Frank Quintero, DO, MBA

Northern Westchester Hospital/Northwell Health, Mt. Kisco, New York

Heather Rybasack-Smith, MD, MPH

Assistant Professor, Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island

Jennie Wang, DO, MPH

Brown University Emergency Medicine, Providence, Rhode Island

Robert P. Weinberg, DO, JD, MMSc

Principles and Practice of Clinical Research (PPCR), TH Chan Harvard School of Public Health; Mass College of Pharmacy & Health Sciences, Boston, Massachusetts

Sharon E. Mace, MD

Professor of Medicine, Department of Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University; Director of Research, Emergency Services Institute; Director of Research, Department of Emergency Medicine, Cleveland Clinic, Cleveland, Ohio


Louissaint N: Building community resilience through health equity. Domestic Preparedness. April 6, 2017. Available at https://domesticpreparedness.com/articles/building-community-resiliencethrough-health-equity. Accessed August 23, 2023.

Lichtveld M: Disasters through the lens of disparities: Elevate community resilience as an essential public health service. Am J Public Health. 2018; 108(1): 28-30. DOI: 10.2105/AJPH.2017.304193.

ReliefWeb: Phases of disaster recovery: Emergency response for the long term—World. 2013. Available at https://reliefweb.int/report/world/phases-disaster-recovery-emergency-response-long-term. Accessed September 6, 2023.

Weinger A: How to leverage matching gifts in disaster relief fundraising. Available at https://blog.rkdgroup.com/how-to-leveragematching-gifts-in-disaster-relief-fundraising. Accessed September 2, 2023.

Double the Donation: 11 unique fundraising ideas for emergencies and disasters. Available at https://doublethedonation.com/fundraising-ideas-for-emergencies-and-disasters/. Accessed September 2, 2023.

United Way: Generous donors lift disaster relief fund. Spur matching challenge—United way of the Battle Creek and Kalamazoo region. Available at https://changethestory.org/generous-donors-liftdisaster-relief-fund-spur-matching-challenge/. Accessed September 2, 2023.

US Small Business Administration: About targeted EIDL advance and supplemental targeted advance. Available at https://www.sba.gov/funding-programs/loans/covid-19-relief-options/covid-19-economic-injury-disaster-loan/about-targeted-eidl-advancesupplemental-targeted-advance. Accessed September 2, 2023.

USAGov: Financial assistance after a disaster. Available at https://www.usa.gov/disaster-financial-help. Accessed September 2, 2023.

US Small Business Administration: COVID-19 economic injury disaster loan. Available at https://www.sba.gov/funding-programs/loans/covid-19-relief-options/eidl. Accessed September 2, 2023.

Substance Abuse and Mental Health Services Administration: Disaster preparedness, response, and recovery. 2022. Available at https://www.samhsa.gov/disaster-preparedness. Accessed September 2, 2023.

FEMA: New FEMA guide helps build private-public partnerships. 2021. Available at https://www.fema.gov/blog/new-femaguide-helps-build-private-public-partnerships. Accessed September 2, 2023.

Berg BM, Musigdilok VV, Haro TM, et al.: Public-private partnerships: A whole community approach to addressing children’s needs in disasters. Clin Pediatr Emerg Med. 2014; 15(4): 281-288. DOI: 10.1016/j.cpem.2014.10.003.

The Journal of Healthcare Contracting: Strategic national stockpile collaboration with private sector strengthens national security and preparedness. Available at https://www.jhconline.com/strategicnational-stockpile-collaboration-with-private-sector-strengthensnational-security-and-preparedness.html. Accessed September 2, 2023.

Burrington I: What happens to the internet after a disaster? New York intelligencer. 2017. Available at https://nymag.com/intelligencer/2017/10/what-happens-to-the-internet-after-a-disaster.html. Accessed September 2, 2023.

German K, Keane S: When a hurricane blows out your internet, a drone can drop an instant Wi-Fi network. CNET. Available at https://www.cnet.com/tech/tech-industry/features/when-ahurricane-blows-out-your-internet-a-drone-can-drop-an-instantwi-fi-network/. Accessed September 2, 2023.

Martin C, Teles D: Improving the disaster aid application process will ensure victims aren’t left behind. Urban Institute. 2018. Available at https://www.urban.org/urban-wire/improving-disaster-aid-application-process-will-ensure-victims-arent-left-behind. Accessed September 2, 2023.

American Red Cross: Community partners assist with disaster relief efforts. 2018. Available at https://www.redcross.org/local/texas/central-and-south-texas/about-us/news-and-events/news/community-partners.html. Accessed September 2, 2023.

US GAO: Disaster recovery: Additional actions needed to identify and address potential recovery barriers. 2021. Available at https://www.gao.gov/products/gao-22-104039. Accessed September 2, 2023.

Health.gov: Social determinants of health-healthy people. Available at https://health.gov/healthypeople/priority-areas/socialdeterminants-health. Accessed February 15, 2023.

Alcendor DJ: Racial disparities-associated COVID-19 mortality among minority populations in the US. J Clin Med. 2020; 9(8): 2442. DOI: 10.3390/jcm.9082442.

Grigsby-Toussaint DS, Shin JC, Jones A: Disparities in the distribution of COVID-19 testing sites in Black and Latino areas in New York city. Prev Med. 2021; 147: 106463. DOI: 10.1016/j.ypmed.2021.106463.

US Department of Health and Human Services: Increase the proportion of adults with broadband internet—HC/HIT-05—Healthy People 2030. Available at https://health.gov/healthypeople/objectives-and-data/browse-objectives/neighborhood-and-builtenvironment/increase-proportion-adults-broadband-internethchit-05. Accessed September 2, 2023.

Richards E, Aspegren E, Mansfield E: A year into the pandemic, thousands of students still can’t get reliable WiFi for school. The Digital Divide Remains Worse than Ever. USA Today. February 4, 2021. Available at https://www.usatoday.com/story/news/education/2021/02/04/covid-online-school-broadband-internetlaptops/3930744001/. Accessed February 1, 2024.

Federal Communications Commission: Emergency broadband benefit. 2023. Available at https://www.fcc.gov/broadbandbenefit. Accessed September 2, 2023.

Partner F: Cox Communications commits $60 million to close the digital learning gap. Fair360. 2020. Available at https://www.fair360.com/cox-communications-commits-60-million-to-close-thedigital-learning-gap-2/. Accessed September 2, 2023.

Boston.gov: The racial justice and health equity initiative. 2015. Available at https://www.boston.gov/sites/default/files/file/2021/03/BPHC%20RJHEI%202015%20Overview%20FINAL.pdf. Accessed February 1, 2024.

Rossi M: Infrastructural health equity and racial justice for youth in New York city public schools and public spaces. Scholars Strategy Network. 2022. Available at https://scholars.org/contribution/infrastructural-health-equity-and-racial. Accessed September 2, 2023.

Boston.gov: Racial justice: City of Boston. 2023. Available at https://www.boston.gov/equity-and-inclusion/racial-justice. Accessed September 2, 2023.

Boston.gov: An executive order relative to racial equity and leadership. 2019. Available at https://www.boston.gov/sites/default/files/embed/e/executive_order.pdf. Accessed February 1, 2024.

Raker EJ, Arcaya MC, Lowe SR, et al.: Mitigating health disparities after natural disasters: Lessons from the RISK project. Health Aff. 2020; 39(12): 2128-2135. DOI: 10.1377/hlthaff.2020.01161.

World Meteorological Organization: Weather-related disasters increase over past 50 years, causing more damage but fewer deaths. 2021. Available at https://public.wmo.int/en/media/press-release/weather-related-disasters-increase-over-past-50-years-causingmore-damage-fewer. Accessed September 2, 2023.

Nationalarchives: UN climate change conference (COP26) at the SEC–Glasgow 2021. Available at https://webarchive.nationalarchives.gov.uk/ukgwa/20230401054904mp_/https://ukcop26.org/. Accessed September 2, 2023.

Fawzy S, Osman AOI, Doran J, et al.: Strategies for mitigation of climate change: A review. Environ Chem Lett. 2020; 18: 2069-2094. DOI: 10.1007/s10311-020-01059-w.

NASA: Responding to climate change. 2023. Available at https://climate.nasa.gov/solutions/adaptation-mitigation. Accessed September 2, 2023.

Arcaya M, Raker E, Waters MC: The social consequences of disasters: Individual and community change. Ann Rev Sociol. 2020; 46: 671-691. DOI: 10.1146/annurev-soc-121919-054827.

Mayo Clinic: Resilience: Build skills to endure hardship. 2022. Available at https://www.mayoclinic.org/tests-procedures/resiliencetraining/in-depth/resilience/art-20046311. Accessed September 2, 2023.

Chandra A (ed.): Building Community Resilience to Disasters: A Way Forward to Enhance National Health Security. Santa Monica, CA: RAND Corporation, 2011.

Fund TBA: The bill Anderson fund. Available at https://billandersonfund.org/impact-3. Accessed September 2, 2023.

State of Louisiana: Louisiana’s comprehensive master plan for a sustainable coast. 2017. Available at http://coastal.la.gov/wpcontent/uploads/2017/04/2017-Coastal-Master-Plan_Web-Single-Page_CFinal-with-Effective-Date-06092017.pdf. Accessed February 1, 2024.

Krieger J, Higgins DL: Housing and health: Time again for public health action. Am J Public Health. 2002; 92(5): 758-768.

FEMA: Resilience Implementation and Strategic Enhancements (RISE). 2020. Available at https://dos.ny.gov/system/files/documents/2020/06/community_resilience_c-rise.pdf. Accessed February 1, 2024.

FEMA: 5 reasons building codes should matter to you. 2021. Available at https://www.fema.gov/blog/5-reasons-building-codesshould-matter-you. Accessed September 25, 2023.

FEMA: Flood insurance. 2023. Available at https://www.fema.gov/flood-insurance. Accessed September 2, 2023.

FEMA: Effectively expanding community engagement. 2021. Available at https://www.fema.gov/case-study/effectively-expandingcommunity-engagement. Accessed September 2, 2023.

Centers for Disease Control and Prevention: COVID-19 vaccine equity for racial and ethnic minority groups. 2022. Available at https://www.cdc.gov/coronavirus/2019-ncov/community/healthequity/vaccine-equity.html. Accessed September 2, 2023.

ASPE: Disparities in COVID-19 vaccination rates across racial and ethnic minority groups in the United States. Available at https://aspe.hhs.gov/reports/disparities-covid-19-vaccination-rates-acrossracial-ethnic-minority-groups-united-states. Accessed September 2, 2023.

Odone A, Ferrari A, Spagnoli F, et al.: Effectiveness of interventions that apply new media to improve vaccine uptake and vaccine coverage: A systematic review. Hum Vaccin Immunother. 2015; 11(1): 72-82. DOI: 10.4161/hv.34313.

FEMA: Regulations and guidance. 2023. Available at https://www.fema.gov/emergency-managers/risk-management/hazard-mitigation-planning/regulations-guidance. Accessed September 2, 2023.

Gougelet RM: Chapter 27—Disaster mitigation. In Ciottone GR (ed.): Ciottone’s Disaster Medicine. 2nd ed. Amsterdam: Elsevier, 2016: 160-166. DOI: 10.1016/B978-0-323-28665-7.00027-3.

FEMA: Hazard mitigation assistance grants. 2020. Available at https://www.fema.gov/grants/mitigation. Accessed September 2, 2023.

Delaware Valley Regional Planning Commission: Integrating hazard mitigation and comprehensive planning. Available at https://www.dvrpc.org/resiliency/hmp/. Accessed September 2, 2023.

Energy.gov: Federal financial assistance programs for resilience activities. Available at https://www.energy.gov/scep/slsc/federal-financial-assistance-programs-resilience-activities. Accessed September 2, 2023.

Planning for Hazards Land Use Solutions for Colorado: Funding strategy for mitigation projects. Available at https://planningforhazards.com/funding-strategy-mitigation-projects. Accessed September 2, 2023.



How to Cite

Cornelius, A. P., D. M. Char, L. G. Ista, S. Noll, F. Quintero, H. Rybasack-Smith, J. Wang, R. P. Weinberg, and S. E. Mace. “Disaster Healthcare Disparities Solutions: Part 3—Recovery and Mitigation”. American Journal of Disaster Medicine, vol. 19, no. 2, Apr. 2024, pp. 109-17, doi:10.5055/ajdm.0474.




Similar Articles

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)