Unveiling Vulnerability and Inequality in Disrupted Access to Dialysis Centers During Urban Flooding

TL;DR

This study analyzes how urban flooding, specifically Hurricane Harvey, disrupted access to dialysis centers, revealing inequalities and persistent impacts on vulnerable communities using mobility data and spatiotemporal analysis.

Contribution

It provides a detailed analysis of access disruptions and inequalities in dialysis care during flooding, highlighting the importance of facility size and location in resilience.

Findings

Flooding reduces access redundancy and visit frequency.

Disruptions last over a month post-flood.

Vulnerable communities face more severe access disruptions.

Abstract

Despite the criticality of dialysis facilities, limited knowledge exists regarding the extent and inequality of disrupted access caused by weather events. This study uses mobility data in the context of the 2017 Hurricane Harvey in Harris County to examine the impact of flooding on access to dialysis centers. We examined access dimensions using multiple static and dynamic metrics. By analyzing fluctuations in dynamic metrics during the flood event, we derived spatiotemporal patterns of access disruptions and inequity in mobility from CBGs to dialysis centers. The results show that: (1) the extent of dependence of CBGs on dialysis centers varies; (2) flooding significantly reduces access redundancy and frequency of dialysis center visits; access disruptions persist for more than one month after the flood event; (3) CBGs with a greater minority percentage and lower household income were more likely to experience more extensive access disruptions; (4) high-income CBGs more quickly revert to their pre-disaster levels; (5) larger dialysis centers located in non-flooded areas are critical to absorbing the unmet demand from disrupted facilities; these larger facilities contribute to the absorptive capacity of the network of dialysis facilities in the region.