Abstract
Hospitals play a critical role during disasters where they provide critical medical care to disaster victims and help the community to respond more effectively and recover quicker. However, hospitals face risks from the natural environment, such as flood risks. Amid the increasing flood risks due to climate change, it is essential to examine hospitals’ risk exposure. Motivated by this, this paper aims to answer four specific questions related to hospitals in Florida: (1) Are hospitals located in flood zones? (2) What is the relationship between hospital network size and flood hazard? (3) To what extent does hospital flood hazard vary by hospital attributes? (4) How do hospitals’ flood hazards differ from other public structures’ flood hazards? By leveraging two micro-level datasets, we found that approximately 12% of Florida hospitals are in flood zones, and that hospitals’ flood hazard is not influenced by hospital network size or hospital attributes. We also found that hospitals are one of the most flood-prone public structures in our sample, raising questions about public infrastructure in flood management. We conclude by offering recommendations for improving hospital resilience to future flood disasters.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
National structures dataset downloaded from: https://www.sciencebase.gov/catalog/item/4f70b240e4b058caae3f8e1b.
In the USA, an area with at least 1% chance of being flooded annually is designated as Special Flood Hazard Area by the federal administration.
A federal regulation required states to enact certificate of need laws, but that regulation was repealed in 1987, and since its repeal, states, including Florida, have implemented partial or full repeals of certificate of need requirements.
References
Achour N, Miyajima M, Pascale F, Price AD (2014) Hospital resilience to natural hazards: classification and performance of utilities. Disaster Prevent Manag
Agency for Health Care Administration (AHCA) (2021) Emergency preparedness resources. https://ahca.myflorida.com/mchq/emergency_activities/index.shtml
Agency for Health Care Administration (AHCA) (2022) Facility/provider locator. https://www.floridahealthfinder.gov/facilitylocator/FacilitySearch.aspx
Aghapour AH, Yazdani M, Jolai F, Mojtahedi M (2019) Capacity planning and reconfiguration for disaster-resilient health infrastructure. J Build Eng 26:100853
Alabbad Y, Mount J, Campbell AM, Demir I (2021) Assessment of transportation system disruption and accessibility to critical amenities during flooding: Iowa case study. Sci Total Environ 793:148476
American Flood Coalition (2021) The bipartisan infrastructure bill will create flood resilient communities—here’s how. https://floodcoalition.org/2021/11/the-bipartisan-infrastructure-bill-will-create-flood-resilient-communities-heres-how/
American Hospital Association (2022a) Fast facts on U.S. hospitals. https://www.aha.org/statistics/fast-facts-us-hospitals
American Hospital Association (2022b) AHA data hub. https://guide.prod.iam.aha.org/guide/searchResults
Arrighi C, Pregnolato M, Dawson RJ, Castelli F (2019) Preparedness against mobility disruption by floods. Sci Total Environ 654:1010–1022
Brevard SB, Weintraub SL, Aiken JB, Halton EB, Duchesne JC, McSwain NE Jr, Marr AB (2008) Analysis of disaster response plans and the aftermath of Hurricane Katrina: lessons learned from a level I trauma center. J Trauma Acute Care Surg 65(5):1126–1132
Burns LR, McCullough JS, Wholey DR, Kruse G, Kralovec P, Muller R (2015) Is the system really the solution? Operating costs in hospital systems. Med Care Res Rev 72(3):247–272
Chaffee MW, Oster NS, Darling PDA, Jacoby RG, Noji IE, Suner S (2006) The role of hospitals in disaster. Disaster Med, 34
Chletsos M, Saiti A (2019) For-profit Versus not-for-profit hospitals and public hospitals. Strategic Management and Economics in Health Care. Springer, Heidelberg, pp 129–149
Cohen SS, Mulvaney K (2005) Field observations: disaster medical assistance team response for Hurricane Charley, Punta Gorda, Florida, August 2004. Disaster Manag Response 3(1):22–27
de Bruijn KM, Maran C, Zygnerski M, Jurado J, Burzel A, Jeuken C, Obeysekera J (2019) Flood resilience of critical infrastructure: approach and method applied to Fort Lauderdale. Fla Water 11(3):517
Fang Z, Dolan G, Sebastian A, Bedient PB (2014) Case study of flood mitigation and hazard management at the Texas Medical Center in the wake of tropical storm Allison in 2001. Nat Hazards Rev 15(3):05014001
Federal Emergency Management Agency (1997) MultiHazard identification and risk assessment. U. S. Government Printing Office, Washington, DC
Federal Emergency Management Agency (FEMA) (2007) Design guide for improving critical facility safety from flooding and high winds: providing protection to people and buildings. https://www.fema.gov/media-library/assets/documents/8811
Fekete A (2019) Critical infrastructure and flood resilience: cascading effects beyond water. Water 6(5):1370
Florida Division of Emergency Management (2020) Statewide Emergency Shelter Plan. Available at https://portal.floridadisaster.org/shelters/External/Current/2020%20SESP/2020%20SESP%20Main%20Text.pdf
Franz B, Cronin CE, Rodriguez V, Choyke K, Simon JE, Hall MT (2021) For-profit hospitals as anchor institutions in the United States: a study of organizational stability. BMC Health Serv Res 21(1):1–9
Gao L, Wu Q, Li Y, Ding D, Hao Y, Cui Y, Sun H (2018) How prepared are hospitals’ emergency management capacity? Factors influencing efficiency of disaster rescue. Disaster Med Pub Health Prep 12(2):176–183
Gawande A (2013) Why Boston’s Hospitals Were Ready. The New Yorker. Available at https://www.newyorker.com/news/news-desk/why-bostons-hospitals-were-ready. Accessed 17 Apr, 2022
Hoffman A, Fagan H, Casas-Melley A, Wei J, Hebra A (2018) Hurricane irma impact on the inpatient population at a tertiary children’s hospital in Florida. Am Surg 84(9):1395–1400
Intergovernmental Panel on Climate Change (IPCC) (2013) Summary for Policymakers. Climate change 2013: the physical science basis. In: Stocker TF, Dahe Q, Plattner G-K, Tignor M, Allen SK, Boschung J, Nauels A, Xia Y, Bex V, Midgley PM (eds) Contribution of Working Group I to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge, Cambridge University Press
Kaiser Family Foundation (2022) Hospitals by ownership type. https://www.kff.org/other/state-indicator/hospitals-by-ownership/?currentTimeframe=0&selectedRows=%7B%22states%22:%7B%22florida%22:%7B%7D%7D%7D&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
Jaspen B (2022) Hospital mergers just keep getting bigger. Forbes. https://www.forbes.com/sites/brucejapsen/2022/01/17/hospital-mergers-just-keep-getting-bigger/?sh=4a9ca9d575be
Kapucu N, Özerdem A, Sadiq AA (2022) Managing emergencies and crises: global perspectives. Jones & Bartlett Learning
Kreibich H, M€uller M, Thieken AH, and Bruno Merz (2007) Flood Precaution of Companies and their ability to cope with the Flood in August 2002 in Saxony, Germany. Water Resour Res 43(3). https://doi.org/10.1029/2005WR004691
National Conference of State Legislatures (2022) States modernizing certificate of need laws. https://www.ncsl.org/research/health/states-modernizing-certificate-of-need-laws.aspx
Pant R, Thacker S, Hall JW, Alderson D, Barr S (2018) Critical infrastructure impact assessment due to flood exposure. J Flood Risk Manag 11(1):22–33
Pourghasemi HR, Amiri M, Edalat M, Ahrari AH, Panahi M, Sadhasivam N, Lee S (2020) Assessment of urban infrastructures exposed to flood using susceptibility map and Google Earth Engine. IEEE J Sel Top Appl Earth Obs Remote Sens 14:1923–1937
Powell T, Hanfling D, Gostin LO (2012) Emergency preparedness and public health: the lessons of Hurricane Sandy. JAMA 308(24):2569–2570
Rattanakanlaya K, Sukonthasarn A, Wangsrikhun S, Chanprasit C (2022) Improving flood disaster preparedness of hospitals in Central Thailand: hospital personnel perspectives. J Clin Nurs 31(7–8):1073–1081
Rodríguez H, Aguirre BE (2006) Hurricane Katrina and the healthcare infrastructure: a focus on disaster preparedness, response, and resiliency. Front Health Serv Manag 23(1):13
Sadiq A-A, Noonan D (2015) Local capacity and resilience to flooding: community responsiveness to the community ratings System Program incentives. Nat Hazards 78(2):1412–1428
Sexton C (2021) Florida drops fight to regulate specialized health-care services. Sun Sentinel. https://www.sun-sentinel.com/news/politics/fl-ne-nsf-florida-drops-proposed-hospital-regulations-20210618-vnsvnxzr7zhg3hld7jayj2d2qu-story.html
Simpson K (2022) STORM act: new federal funding for resilience. Parks and Recreation Magazine. Available at https://www.nrpa.org/parks-recreation-magazine/2022/may/storm-act-new-federal-funding-for-resilience/
Tyler J (2022) Exploring the predictors of and the relationship between evidence cultures and flood risk management performance [Doctoral dissertation]. Electronic Theses and Dissertations. https://stars.library.ucf.edu/etd2020/1105
Walker DM, Mora AM, Hogan TH, Diana ML, McAlearney AS (2018) Assessing trends in hospital system structures from 2008 to 2015. Med Care 56(10):831–839
Yazdani M, Mojtahedi M, Loosemore M, Sanderson D (2022) A modelling framework to design an evacuation support system for healthcare infrastructures in response to major flood events. Prog Disaster Sci 13:100218
Acknowledgements
This article is based on research funded by the US National Science Foundation (NSF) Grant No. 1838421. We appreciate First Street Foundation for providing some of the data used in this study. The findings and opinions are those of the authors and do not necessarily represent the NSF or First Street Foundation.
Funding
US National Science Foundation (NSF) Grant No. 1838421, Abdul-Akeem Sadiq.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no relevant financial or non-financial interests to disclose.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Sun, P., Entress, R., Tyler, J. et al. Critical public infrastructure underwater: the flood hazard profile of Florida hospitals. Nat Hazards 117, 473–489 (2023). https://doi.org/10.1007/s11069-023-05869-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11069-023-05869-3