Hostname: page-component-76fb5796d-2lccl Total loading time: 0 Render date: 2024-04-28T08:16:15.233Z Has data issue: false hasContentIssue false
  • English
  • Français

Hemodialysis Clinics in Flood Zones: A Case Study of Hurricane Harvey

Published online by Cambridge University Press:  01 February 2021

Rebecca Kaiser ,
Ibraheem M. Karaye ,
Temitope Olokunlade ,
Tracy Anne Hammond ,
Daniel W. Goldberg  and
Jennifer A. Horney Open the ORCID record for Jennifer A. Horney [Opens in a new window]
Rebecca Kaiser
Affiliation:
University of Dayton, Dayton, OhioUSA
Ibraheem M. Karaye
Affiliation:
Program in Epidemiology, University of Delaware, Newark, DelawareUSA
Temitope Olokunlade
Affiliation:
Department of Environmental Health, Texas A&M University, College Station, TexasUSA
Tracy Anne Hammond
Affiliation:
Professor, Texas A&M University Department of Computer Science and Engineering, College Station, TexasUSA
Daniel W. Goldberg
Affiliation:
Assistant Professor, Texas A&M University Department of Geography, College Station, TexasUSA
Jennifer A. Horney*
Affiliation:
Program in Epidemiology, University of Delaware, Newark, DelawareUSA
*
Correspondence: Jennifer A. Horney, PhD, MPH, CPH, Professor and Founding Director, Department of Epidemiology, University of Delaware College of Health Sciences, 100 Discovery Blvd, Room 731, Newark, Delaware19713USA, E-mail: horney@udel.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Hurricane Harvey (2017) forced the closure of hemodialysis centers across Harris County, Texas (USA) disrupting the provision of dialysis services. This study aims to estimate the percentage of hemodialysis clinics flooded after Harvey, to identify the proportion of such clinics located in high-risk flood zones, and to assess the sensitivity of the Federal Emergency Management Agency (FEMA) Flood Insurance Rate Maps (FIRMs) for estimation of flood risk.

Methods:

Data on 124 hemodialysis clinics in Harris County were extracted from Medicare.gov and geocoded using ArcGIS Online. The FIRMs were overlaid to identify the flood zone designation of each hemodialysis clinic.

Results:

Twenty-one percent (26 of 124) of hemodialysis clinics in Harris County flooded after Harvey. Of the flooded clinics, 57.7% were in a high-risk flood zone, 30.8% were within 1km of a high-risk flood zone, and 11.5% were not in or near a high-risk flood zone. The FIRMs had a sensitivity of 58%, misidentifying 42% (11 of 26) of the clinics flooded.

Conclusion:

Hurricanes are associated with severe disruptions of medical services, including hemodialysis. With one-quarter of Harris County in the 100-year floodplain, projected increases in the frequency and severity of disasters, and inadequate updates of flood zone designation maps, the implementation of new regulations that address the development of hemodialysis facilities in high-risk flood areas should be considered.

Keywords

dialysis centersflood zoneshurricanenatural disastersspatial analysis
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 2 , April 2021 , pp. 135 - 140
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hurricane Harvey. National Hurricane Center. https://www.nhc.noaa.gov/data/tcr/AL092017_Harvey.pdf. Accessed November 1, 2019.Google Scholar
Houston was a ticking time-bomb for a devastating hurricane like Harvey. Business Insider. https://www.businessinsider.com/hurricane-harvey-why-houston-flooded-2017-8. Accessed November 1, 2019.Google Scholar
Hurricane Harvey aftermath. CNN. https://www.cnn.com/specials/us/hurricane-harvey. Accessed August 1, 2019.Google Scholar
Dialysis care in an emergency: lessons from Hurricane Harvey. Renal and Urology News. https://www.renalandurologynews.com/home/news/nephrology/hemodialysis/dialysis-care-in-an-emergency-lessons-from-hurricane-harvey/. Accessed August 1, 2019.Google Scholar
Lempert, KD, Kopp, JB. Hurricane Sandy as a kidney failure disaster. Am J Kidney Dis. 2013;61(6):865.CrossRefGoogle ScholarPubMed
Saran, R, Bragg-Gresham, JL, Rayner, HC, et al. Nonadherence in hemodialysis: associations with mortality, hospitalization, and practice patterns in the DOPPS. Kidney Int. 2003;64(1):254–262.CrossRefGoogle ScholarPubMed
Leggat, JE, Orzol, SM, Hulbert-Shearon, TE, et al. Noncompliance in hemodialysis: predictors and survival analysis. Am J Kidney Dis. 1998;32(1):139–145.CrossRefGoogle ScholarPubMed
Sherman, RA, CODY, RP, Matera, JJ, Rogers, ME, Solanchick, JC. Deficiencies in delivered hemodialysis therapy due to missed and shortened treatments. Am J Kidney Dis. 1994;24(6):921–923.CrossRefGoogle ScholarPubMed
Anderson, AH, Cohen, AJ, Kutner, NG, Kopp, JB, Kimmel, PL, Muntner, P. Missed dialysis sessions and hospitalization in hemodialysis patients after Hurricane Katrina. Kidney Int. 2009;75(11):1202–1208.CrossRefGoogle ScholarPubMed
Kimmel, PL, Peterson, RA, Weihs, KL, et al. Psychosocial factors, behavioral compliance and survival in urban hemodialysis patients. Kidney Int. 1998;54(1):245–254.CrossRefGoogle ScholarPubMed
Held, PJ, Port, FK, Wolfe, RA, et al. The dose of hemodialysis and patient mortality. Kidney Int. 1996;50(2):550–556.CrossRefGoogle ScholarPubMed
Kimmel, PL, Varela, MP, Peterson, RA, et al. Interdialytic weight gain and survival in hemodialysis patients: effects of duration of ESRD and diabetes mellitus. Kidney Int. 2000;57(3):1141–1151.CrossRefGoogle ScholarPubMed
LeMaistre, F, Sterling, J, Miller, C, Molony, D. ESRD patient mortality increased maximally at 90 days after Hurricane Harvey. Kidney Int Rep. 2019;4(7):S17–S18.CrossRefGoogle Scholar
What does the 1% flood standard mean? Revisiting the 100-year flood. Association of State Floodplain Managers. http://www.asfpmfoundation.org/ace-images/forum/2004_Forum_BackgroundPapers.pdf?pagename=forum/2004_Forum_BackgroundPapers.pdf#page=128. Accessed August 1, 2019.Google Scholar
Brody, SD, Gunn, J, Peacock, W, Highfield, WE. Examining the influence of development patterns on flood damages along the Gulf of Mexico. J Plan Educ Res. 2011;31(4):438–448.CrossRefGoogle Scholar
Brody, SD, Blessing, R, Sebastian, A, Bedient, P. Examining the impact of land use/land cover characteristics on flood losses. J Environmental Planning and Management. 2014;57(8):1252–1265.CrossRefGoogle Scholar
Brody, SD, Highfield, WE, Wilson, M, Lindell, MK, Blessing, R. Understanding the motivations of coastal residents to voluntarily purchase federal flood insurance. J Risk Res. 2017;20(6):760–775.CrossRefGoogle Scholar
Cutter, SL, Emrich, CT, Gall, M, Reeves, R. Flash flood risk and the paradox of urban development. Nat Hazards Rev. 2018;19(1):05017005.CrossRefGoogle Scholar
Living with Houston flooding. Rice University’s Baker Institute for Public Policy. https://scholarship.rice.edu/bitstream/handle/1911/99717/bi-pub-livingfloodinghouston-120617_kF7klri.pdf?sequence=1. Accessed August 14, 2019.Google Scholar
Houston a Year after Harvey: Where We Are and Where We Need to Be. Rice University. https://scholarship.rice.edu/bitstream/handle/1911/102793/bi-pub-blackburnharveyanniv-081018.pdf?sequence=1. Accessed August 14, 2019.Google Scholar
Blessing, R, Sebastian, A, Brody, SD. Flood risk delineation in the United States: how much loss are we capturing? Nat Hazards Rev. 2017;18(3):04017002.CrossRefGoogle Scholar
Highfield, WE, Norman, SA, Brody, SD. Examining the 100-year floodplain as a metric of risk, loss, and household adjustment. Risk Anal. 2013;33(2):186–191.CrossRefGoogle ScholarPubMed
Harris County community profile and housing market analysis. Harris County Web site. https://docplayer.net/20185241-Harris-county-community-profile-housing-market-analysis.html. Accessed August 14, 2019.Google Scholar
Dialysis facility compare. The Official US Government Site for Medicare. https://www.medicare.gov/dialysisfacilitycompare/#results&type=CS&loc=HOUSTON%2C%20TX&lat=29.7601927&lng=-95.3693896&sort=12%7CASC&dist=25&paging=1. Accessed February 1, 2020.Google Scholar
Medicare coverage of kidney dialysis and kidney transplant services. Centers for Medicare and Medicaid Services. https://www.medicare.gov/Pubs/pdf/10128-Medicare-Coverage-ESRD.pdf. Accessed January 17, 2020.Google Scholar
GIS data sets. Houston-Galveston Area Council. http://www.h-gac.com/gis-applications-and-data/datasets.aspx. Accessed January 15, 2020.Google Scholar
Harvey inundation boundaries. Harris County Flood Control District. http://www.arcgis.com/home/item.html?id=a8e2870263a04940a9ee20d439f19991. Accessed January 15, 2020.Google Scholar
Definitions of FEMA flood zone designations. Federal Emergency Management Agency. https://snmapmod.snco.us/fmm/document/fema-flood-zone-definitions.pdf. Accessed January 19, 2020.Google Scholar
Knutson, T, Camargo, SJ, Chan, JC, et al. Tropical cyclones and climate change assessment: Part I: detection and attribution. Bull Am Meteorol Soc. 2019;100(10):1987–2007.CrossRefGoogle Scholar
Zhu, L, Quiring, SM. Variations in tropical cyclone precipitation in Texas (1950 to 2009). J Geophys Res Atmos. 2013;118(8):3085–3096.CrossRefGoogle Scholar
Zhu, L, Quiring, SM, Emanuel, KA. Estimating tropical cyclone precipitation risk in Texas. Geophys Res Lett. 2013;40(23):6225–6230.CrossRefGoogle Scholar
Sirbaugh, PE, Bradley, RN, Macias, CG, Endom, EE. The Houston flood of 2001: the Texas Medical Center and lessons learned. Clin Pediatr Emerg Med. 2002;3(4):275–283.CrossRefGoogle Scholar
Kopp, JB, Ball, LK, Cohen, A, et al. Kidney patient care in disasters: lessons from the hurricanes and earthquake of 2005. Clin J Am Soc Nephrol. 2007;2(4):814–824.CrossRefGoogle ScholarPubMed
Ifudu, O, Chan, E, Paul, H, et al. Anemia severity and missed dialysis treatments in erythropoietin-treated hemodialysis patients. ASAIO J. 1996;42(3):146–149.Google ScholarPubMed
Rahman, M, Fu, P, Sehgal, AR, Smith, MC. Interdialytic weight gain, compliance with dialysis regimen, and age are independent predictors of blood pressure in hemodialysis patients. Am J Kidney Dis. 2000;35(2):257–265.CrossRefGoogle ScholarPubMed
Pisoni, RL, Gillespie, BW, Dickinson, DM, Chen, K, Kutner, MH, Wolfe, RA. The Dialysis Outcomes and Practice Patterns Study (DOPPS): design, data elements, and methodology. Am J Kidney Dis. 2004;44:7–15.CrossRefGoogle ScholarPubMed
Curtis, S, Fair, A, Wistow, J, Val, DV, Oven, K. Impact of extreme weather events and climate change for health and social care systems. Environmental Health. 2017;16(1):128.CrossRefGoogle ScholarPubMed
Yuma, P, Powell, T, Scott, J, Vinton, M. Resilience and coping for the healthcare community: a post-disaster group work intervention for healthcare and social service providers. J Family Strengths. 2019;19(1):8.Google Scholar
Executive Order, #2006-05: Construction activities in special flood hazard areas. State of Illinois Executive Department. https://www2.illinois.gov/Documents/ExecOrders/2006/execorder2006-5.pdf. Accessed August 10, 2019.Google Scholar
Karaye, IM, Ross, AD, Horney, JA. Self-rated mental and physical health of U.S. Gulf Coast residents. J Community Health. 2020;45:598–605.CrossRefGoogle ScholarPubMed
Nielsen, ER, Schumacher, RS. Dynamical mechanisms supporting extreme rainfall accumulations in the Houston tax day 2016 flood. Mon Weather Rev. 2020;148(1):83–109.CrossRefGoogle Scholar
Zhang, W, Villarini, G, Vecchi, GA, Smith, JA. Urbanization exacerbated the rainfall and flooding caused by hurricane Harvey in Houston. Nature. 2018;563(7731):384–388.CrossRefGoogle ScholarPubMed
Pralle, S. Drawing lines: FEMA and the politics of mapping flood zones. Clim Change. 2019;152(2):227–237.CrossRefGoogle Scholar
Kousky, C, Kunreuther, H. Improving flood insurance and flood-risk management: insights from St. Louis, Missouri. Nat Hazards Rev. 2010;11(4):162–172.CrossRefGoogle Scholar
Christian, J, Duenas-Osorio, L, Teague, A, Fang, Z, Bedient, P. Uncertainty in floodplain delineation: expression of flood hazard and risk in a Gulf Coast watershed. Hydrol Process. 2013:27(19):2774–2784.CrossRefGoogle Scholar