Understanding the Impacts of Maritime Disruption Transportation to Hospital-Based Acute Health Care Supplies and Personnel in Coastal and Geographically Isolated Communities.

OBJECTIVE: This study aimed to identify maritime transportation disruption impacts on available health care supplies and workers necessary to deliver hospital-based acute health care in geographically isolated communities post-disaster. METHODS: Semi-structured interviews were conducted with 25 key informants knowledgeable about the hospital-based acute health care supply chain and workforce emergency management plans and procedures in 2 coastal communities in British Columbia. These locations were accessed primarily through maritime transportation, including one urban center and one smaller, more remote community. Interview transcriptions were thematically analyzed. RESULTS: Critical vulnerabilities to hospital-based acute health care delivery due to a maritime transportation disruption identified include lack of information about the existing supply chain, lack of formal plans and agreements, and limited local supply storage and workforce capacity. Measures to decrease vulnerability and enhance system capacity can be fostered to enhance acute health care system resilience for these and other geographically isolated communities. CONCLUSIONS: A maritime transportation disruption has the potential to impact the availability of hospital-based health care supplies and health care personnel necessary to deliver acute health care in coastal communities post-disaster. Multisector engagement is required to address complex interdependencies and competing priorities in emergency response. Additional research and public-private collaboration is necessary to quantify potential impacts of maritime transportation disruption on the acute health care system. (Disaster Med Public Health Preparedness. 2019;13:440-448).

Perceptions of Risk and Vulnerability Following Exposure to a Major Natural Disaster: The Calgary Flood of 2013.

Many studies have examined the general public's flood risk perceptions in the aftermath of local and regional flooding. However, relatively few studies have focused on large-scale events that affect tens of thousands of people within an urban center. Similarly, in spite of previous research on flood risks, unresolved questions persist regarding the variables that might influence perceptions of risk and vulnerability, along with management preferences. In light of the opportunities presented by these knowledge gaps, the research reported here examined public perceptions of flood risk and vulnerability, and management preferences, within the city of Calgary in the aftermath of extensive flooding in 2013. Our findings, which come from an online survey of residents, reveal that direct experience with flooding is not a differentiating factor for risk perceptions when comparing evacuees with nonevacuees who might all experience future risks. However, we do find that judgments about vulnerability-as a function of how people perceive physical distance-do differ according to one's evacuation experience. Our results also indicate that concern about climate change is an important predictor of flood risk perceptions, as is trust in government risk managers. In terms of mitigation preferences, our results reveal differences in support for large infrastructure projects based on whether respondents feel they might actually benefit from them.