Secondary surge capacity: a framework for understanding long-term access to primary care for medically vulnerable populations in disaster recovery

Am J Public Health. 2012 Dec;102(12):e24-32. doi: 10.2105/AJPH.2012.301027. Epub 2012 Oct 18.


Disasters create a secondary surge in casualties because of the sudden increased need for long-term health care. Surging demands for medical care after a disaster place excess strain on an overtaxed health care system operating at maximum or reduced capacity. We have applied a health services use model to identify areas of vulnerability that perpetuate health disparities for at-risk populations seeking care after a disaster. We have proposed a framework to understand the role of the medical system in modifying the health impact of the secondary surge on vulnerable populations. Baseline assessment of existing needs and the anticipation of ballooning chronic health care needs following the acute response for at-risk populations are overlooked vulnerability gaps in national surge capacity plans.

MeSH terms

  • Disaster Medicine / organization & administration*
  • Health Services Accessibility / organization & administration*
  • Health Services Needs and Demand
  • Health Status Disparities
  • Healthcare Disparities
  • Humans
  • Primary Health Care / organization & administration*
  • Primary Health Care / statistics & numerical data
  • Surge Capacity / organization & administration*
  • United States
  • Vulnerable Populations