Disruptions in critical infrastructure and an influx of patients can hinder access to and delivery of health care, especially for people in underserved communities. The nation’s health systems and infrastructure will continue to be stressed as extreme weather becomes more severe and diseases continue to emerge. Response activities can divert resources otherwise needed for delivery of routine care for chronic disease patients and persons with disabilities. These interruptions in health care access and delivery for underserved communities can further undermine efforts to ensure health equity.
Resilient and adaptive HPH infrastructure and data systems, including national clinical research capacities, that are ready to respond to public health emergencies and disasters, no matter the threat, will ensure continuous access to health care for all populations. Incorporating multiple threats and climate change considerations into preparedness, mitigation, response, and recovery planning can improve the readiness of HPH systems. Additionally, promoting infectious disease mitigation strategies such as indoor air filtration, ventilation, and air disinfection technologies can further protect patients in health care settings.
Emergency planning should include tiered networks that coordinate national expertise with regional, state, and local capabilities and capacity to increase access to specialty care and surge capacity, including for pre-hospital emergency medical services and post-hospital health care and social services. By expanding agreements permitting providers to offer care outside their licensed jurisdiction during emergencies, states and territories can increase assistance. Standardized guidance and a common platform with resources on liability protection and crisis standards of care implementation can streamline deployment of health workers during an emergency.
Additional resources for HPH infrastructure to strengthen their physical resilience to climate change will improve readiness for the impact of extreme weather events. During a disaster, impacted patients could face barriers to health care access due to their geographical spread, mobility concerns, and transportation needs. To address this, expansion of emergency-use strategies for telehealth, including extended payment benefits for in-home visits, and coordinated development of deployable, telehealth critical care systems to ensure equitable care are necessary to ease the burden of a potential surge on health care facilities and public health infrastructure.
Expanding health system capabilities and capacity also need to reach at-risk individuals and underserved communities. Reaching those populations before a disaster occurs will allow public health authorities to better understand the consequences of emergencies on the most vulnerable and prioritize their health needs in emergency response and recovery planning. Additionally, mental and behavioral health should be integrated into emergency preparedness, response, and recovery plans with dedicated resources aimed towards recovery and long-term resilience.