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Epidemiology & Population Hlth


Respond to
 two colleagues in one or more of the following ways:

· Ask a probing question, substantiated with additional background information, evidence, or research.

· Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

· Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

· Validate an idea with your own experience and additional research.

· Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

· Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.


Lucretia Dennise Sanders

Week 11 Initial Post:


Briefly describe your selected recent natural disaster

The natural disaster that comes to mind is the Hawaii fires. In August 2023, a devastating series of wildfires erupted in the U.S. state of Hawaii, causing significant destruction and prompting widespread evacuations. The fires were particularly severe on the island of Maui, where strong winds exacerbated the spread, making it difficult for firefighters to contain the blaze. The fires led to tragic losses, including multiple fatalities and the destruction of hundreds of homes and structures. Entire communities were affected, with Lahaina being one of the hardest hit. The rapid spread of the fires, fueled by dry conditions and high winds, overwhelmed local emergency services and prompted state and federal authorities to step in to assist with firefighting efforts and disaster relief. The event marked one of the most severe natural disasters in Hawaii’s recent history (Rowan et al., 2023).

Discuss the health consequences of the disaster at the population level

The devastating wildfires that swept through Hawaii in August 2023 had dire health consequences for the population, with a broad range of impacts that extended well beyond immediate physical injuries. One major concern was the significant air pollution caused by pervasive smoke and ash, which dramatically reduced air quality across affected areas. This pollution not only posed immediate respiratory risks but also increased the risk of developing long-term respiratory conditions such as asthma and chronic obstructive pulmonary disease (Holliday et al., 2024). The extensive air pollution is particularly alarming as it could lead to a long-term increase in respiratory health issues among the populace.

In addition to respiratory risks, the wildfires led to widespread destruction of homes and critical infrastructure, resulting in significant displacement of communities. This upheaval exacerbated mental health issues, with many residents experiencing anxiety, depression, and post-traumatic stress disorder (PTSD) due to the traumatic events and ongoing uncertainty. The situation was further complicated by disruptions to local healthcare services; damage to facilities and the displacement of healthcare workers hindered access to both routine and emergency medical care. This disruption made it difficult for people to manage chronic conditions and access necessary medical treatments, increasing the overall health burden on the community. The cumulative effect of these challenges underscores the need for disaster response plans that comprehensively address the immediate and lasting health impacts on affected populations. (Holliday et al., 2024)

Explain how the concepts of population health and epidemiology discussed in this course were or could have been used to assess health outcomes after this disaster

The principles of population health and epidemiology are vital for evaluating the health impacts of the wildfires in Hawaii, as they provide essential methods for understanding and addressing the broad health consequences on affected communities. By utilizing these concepts, epidemiologists can systematically gather and analyze health data to track increases in respiratory illnesses, mental health issues, and other health outcomes attributable to the disaster. This involves comparing health statistics from before and after the wildfires to clearly define the scope and scale of health impacts. Such analysis not only helps in pinpointing the most affected populations but also aids in determining the effectiveness of deployed health interventions. Furthermore, ongoing epidemiological surveillance post-disaster can inform future preparedness efforts, ensuring that health systems are better equipped to mitigate the long-term effects of such events and improve community health resilience against future crises (Finlay et al., 2012).

Describe the specific leadership roles that nurses have in mitigating negative health outcomes following disasters

Following disasters such as the wildfires in Hawaii, nurses assume critical leadership roles that are crucial in reducing adverse health outcomes. They are typically among the first responders, providing essential care and conducting health assessments to prioritize and address the urgent needs of disaster victims. Nurses are instrumental in managing triage operations, delivering acute care, and offering ongoing support as communities recover. Additionally, their roles often extend to coordinating efforts between various health services and emergency response teams to ensure efficient use of resources and cohesive care delivery. Nurses leverage their knowledge of public health to educate affected populations on preventative measures, help manage chronic diseases under challenging conditions, and provide mental health support. They also spearhead initiatives to restore healthcare services and adapt public health strategies to the altered landscape, thus playing a pivotal role in both immediate disaster response and long-term community resilience. (Holliday et al., 2024)


Finlay, S. E., Moffat, A., Gazzard, R., Baker, D., & Murray, V. (2012). Health impacts of wildfires. PLoS Currents, 4, e4f959951cce2c. 

to an external site.

Holliday, R., Krishnamurti, L. S., Jordan, S. E., Sia, M. A., Brenner, L. A., & Monteith, L. L. (2024). The Health and Social Impacts of the Maui Wildfires: Post-Disaster Care from a Sociocultural Lens. Hawai’i journal of health & social welfare, 83(3), 85–87.

Rowan, L. R., Lee, E. A., & Riddle, A. A. (2023, August 14). August 2023 wildfires in Hawaii – CRS Reports. Congressional Research Service. 

to an external site.


Andrea Nicole Gibson

Andrea Nicole Gibson


Infectious Disease and Natural Disaster

Briefly describe your selected recent natural disaster.

Hurricane Maria (Sept 20, 2017) landed on Puerto Rico as a devastating Category 5 storm, resulting in a death count of over 4600 people (Guerra, 2022). The infrastructure of the island was demolished, leaving residents without telecommunications, utilities and healthcare systems for nearly a year afterward. With winds of up to 175 mph, it was the largest hurricane to have hit Puerto Rico since 1928 and the costliest in Puerto Rican history, causing estimated damages of $100 billion (Guerra, 2022).

Discuss the health consequences of the disaster at the population level.

One component of the island’s infrastructure that was largely affected was the Puerto Rican Electric Power Authority. Because of the economic downturn from the storm, the Authority was left with only three options to recover and restore services: 1) increase the electricity rates, which were already high, 2) stop paying bondholders, or 3) abandon the maintenance of its plants. They chose the third option, and once relief efforts came [from the United States], the U.S. Army Corps of Engineers’ head of power grid restoration observed that there were elements that had not been replaced in years leaving Puerto Rico lacking both power plants, and reconstruction of the grid itself (Guerra, 2022).

The water services of the island were already questionable prior to the hurricane, with the Environmental Protection Agency [in 2016] declaring Dorado (a northern municipality of Puerto Rico) a “Superfund site” – meaning, Puerto Rico’s systems of pipes had registered more drinking water violations than any other state or territory in the United States – and this is where 70% of the island’s residents obtained their drinking water. This devastating finding was only magnified because of the hurricane.

Finally, access to healthcare was considerably affected, as between 2014 and 2016, more than 1400 doctors canceled their medical licenses issued in Puerto Rico. All of these are concerning public health issues by themselves, but with the addition of lack of access to insulin, the prolonged consumption of processed foods, the drinking of tainted water, and the lack of electricity that followed Hurricane Maria, it is not surprising that these pre-existing conditions increased the hurricane’s adverse effects and hindered recovery (Guerra, 2022).

Explain how the concepts of population health and epidemiology discussed in this course were or could have been used to assess health outcomes after this disaster.

Puerto Rico has a high prevalence of non communicable diseases such as hypertension, diabetes, and kidney disease – with kidney disease leading the statistical prevalence at 31% (Andrade et al., 2022). Prior to Hurricane Maria, these statistics were not favorable for this lush island nation, with 16% of the residents being diagnosed with diabetes and over 40% with hypertension (Guerra, 2022). Using the epidemiology concepts of population health discussed in this course, combined with the devastating effects from Hurricane Maria, it is not difficult to understand how access to healthcare was further impeded by inaccessible roadways due to debris, landslides, flooding, and collapsed bridges. This physical barrier to healthcare was further compounded by limited telecommunication services to locate available facilities and clinicians to coordinate care. Fuel shortages added to the complexity of attempts at relief efforts, as emergent transport of patients was significantly compromised – leading to the deaths of dialysis patients who literally could not get to their dialysis centers [if the centers were even viable for use].

To gain greater insight into the impact this mighty storm had on the residents of Puerto Rico [for epidemiological research], I cannot think of a more informative adjunct research tool than direct interviews of those who survived the storm. Descriptive statistics using quantitative data are absolutely beneficial, but in my opinion, do not give complete context. Qualitative data help to explain the “why” behind the “what”.  Qualitative research can be used to address important questions of relevance to epidemiology and enrich our understanding of contingent causal processes that explain variation in the distribution of health-related outcomes (Bannister-Tyrell and Meigari, 2020).

Explain how the concepts of population health and epidemiology discussed in this course were or could have been used to mitigate negative health effects following this disaster

Qualitative research can help lend insight into understanding why certain demographics were negatively impacted. Similarly, the same qualitative research methods can be utilized to brainstorm improvement strategies for access to healthcare and methods to improve outcomes. A question as simple as “how can we help?” can give rise to a world of opportunity and hope for anyone who is searching for healthcare assistance.

 Describe the specific leadership roles that nurses have in mitigating negative health outcomes following disasters. 

The ability to care for and protect the nation’s most vulnerable citizens depends substantially on the preparedness of the nursing workforce. Nurses provide education, community engagement, and health promotion and implement interventions to safeguard the public health (Al Harthi et al., 2020). It is essential for the nurse [in a disaster situation] to remember ethical principles surrounding patient confidentiality and privacy. In disaster emergency situations, critical decisions must be made when resources are scarce – these decisions may be perceived as unjust, and when the consequences of difficult decisions may erode public trust, result in moral injury to staff, and cause community division. 


Al Harthi, M., Al Thobaity, A., Al Ahmari, W., & Almalki, M. (2020). Challenges for Nurses in Disaster Management: A Scoping Review. 
Risk management and healthcare policy
13, 2627–2634.

Andrade, E. L., Cordova, A., Schagen, C. R., Jula, M., Rodriguez-Diaz, C. E., Rivera, M. I., & Santos-Burgoa, C. (2022). The impact of Hurricane Maria on individuals living with non-communicable disease in Puerto Rico: the experience of 10 communities. 
BMC public health
22(1), 2083.

Bannister, M., & Meigari, L. (2020). Qualitative research in epidemiology: theoretical and methodological perspectives. 
Annals of Epidemiology, (49), 27-35.

Guerra Velázquez G. R. (2022). Hurricane María and Public Health in Puerto Rico: Lessons Learned to Increase Resiliency and Prepare for Future Disasters. 
Annals of global health
88(1), 82.

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