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Description
Purpose: In 2017, Hurricanes Irma and Maria devastated Puerto Rico, destroying the power grid, and leaving millions without essential services. These hurricanes not only elucidated the importance of emergency preparedness, but also the limited care and resources provided to US territories in response to natural disasters. This study aimed to assess the relationship between emergency preparedness and socioeconomic status among women with gynecological cancers, with a discussion of the impact of Puerto Rico’s status as an unincorporated territory of the United States. Methods: This study used data from a retrospective cohort study of 240 women with gynecological cancers living in Puerto Rico to evaluate the impact of Hurricanes Irma and Maria on emergency preparedness. Data on socioeconomic status (SES) and perceived emergency preparedness were collected through interviews with gynecologic cancer patients. Emergency preparedness was defined as subjective or objective; relying on self-reported feelings of preparedness and a composite score of 6 essential preparedness items including 3-day supplies of water, food, and prescriptions for each household Member; battery-operated radio, flashlight, and a written evacuation plan. Education level and type of insurance were used as proxy measures for SES. Logistic regression was used to ascertain covariate-adjusted odds ratios and 95% confidence intervals for the associations between preparedness and SES before and after the hurricanes. Results: Before the hurricanes, women with a college education were 1.55 times (95% CI: 0.89 – 2.68) as likely to be prepared than women with a high school diploma or less. After the hurricanes, college educated women were 0.53 times (95% CI: 0.29 – 0.98) less likely to be prepared than their counterparts. No differences were found between women with public insurance and women with private insurance regarding preparedness. Prior to the hurricanes, women who reported feeling well prepared were 9.97 times (95% CI: 4.32 – 23.0) as likely to be prepared than women who reported feeling unprepared. Conclusions: This study identified a relationship between education, but not insurance status and emergency preparedness following Hurricanes Irma and Maria. Like previous studies, this study also identified a strong unadjusted relationship between feelings of preparedness and being prepared before and after the hurricanes.
