Logo preload
close Logo



Recent hurricanes, wildfires and now the COVID-19 pandemic have pushed the disaster response systems to its limit. To talk about this topic, we interviewed Sue Anne Bell, PhD, FNP-BC, FAAN and Assistant Professor at the University of Michigan School of Nursing, where her research, supported by the National Institutes of Health, focuses on the health and well-being of aging populations in the context of disasters and public health emergencies.

She will present the conference ‘A Health Policy Hurricane: Promoting Healthy Aging in a Changing Climate’ at the MSO Symposium 2022.

¿In Which ways the climate change is contributing to multiple detrimental effects on the health of older adults and their communities?

Older age itself does not necessarily mean an individual will be more at risk to the advancing effects of climate change. Social isolation, frailty, chronic and comorbid diseases, and cognitive impairments such as dementia—all issues common among older adults—do, however. These become more challenging to address during weather and climate-related events, such as extreme heat, which is linked to more deaths than any other type of weather event. Current estimates put 85% of US older adults as having one or more chronic diseases, most of which require regular and supportive health care. When a community is affected by a disaster, the loss of critical infrastructure that community has affects health care services as well. Older adults depend on functioning communities to stay healthy.

¿What kind of effects do these natural disasters or events such as the pandemic generate in the older adults?

I believe we will continue to understand the effects of the pandemic on older adults for years to come, just as we are still seeing long-term effects after catastrophic disasters such as Hurricane Maria.  Worsening of chronic conditions, difficulty accessing healthcare and greater challenges in meeting daily needs due to supply shortages and infrastructure disruptions are a few examples from both the COVID-19 pandemic and disaster events that specifically affect older adults. Some of our team’s research has shown that availability of healthcare providers declines over time in disaster-affected areas. We’ve also studied home-based care disaster planning, observing that economic circumstances impact patient’s ability to plan effectively for a disaster, and straining home health provider resources. And as a clinician working in disaster response, most of the care I have provided in the days and weeks after a disaster is basic primary care and management of chronic health conditions such as diabetes, high blood pressure, cancer, and kidney disease.

¿What are the policy and scientific needs around aging and disaster: mitigation, preparedness, response and recovery? What strategies are being promoted to deal with this situation?

Change needs to happen at the individual level, the community level and the policy level—and although change takes time, more action is needed now. For individuals, opportunities for intervention need to focus on taking action—as in being prepared—BEFORE disasters happen and BEFORE healthcare needs become urgent. We need to be talking with our patients about climate change, and about disasters and their health. This should be a part of patient visits, especially with those who have chronic conditions, those who rely on caregivers or those who use electrically dependent equipment. Community level action is important as well—mitigation activities like strengthing community organizations and building social networks, so that communities are well-connected and ready to support each other in the event of a disaster. Finally, we need policy action on climate and health urgently. The Inflation Reduction Act of 2022 is one example that has specific impact for Puerto Rico. Beyond this, specific needs that are urgent include clear recognition by policymakers at all levels of government of the climate emergency, an emphasis on emergency management reform, and a greater focus–including funding–for supportive health care specific to older adults.