Post-Hurricane Cancer Care: Patient Needs after Hurricane Maria

PROJECT Summary: Studies evaluating the effects of natural disasters on cancer outcomes and disparities are scarce, and to thestudy team's knowledge; none have examined the impact of exposure to multiple disasters, particularly in ethnicminority groups. Currently, the team is expanding assessments to include the impact of COVID-19 and theearthquakes' secondary hazards (social isolation, unemployment, healthcare services disruption, structuraldamage) on stress biomarkers and changes in multilevel determinants of health. The proposed supplement willcomplement the scope of the parent R21 (1R21MD013674) by: 1) expanding recruitment to include additionalcancer patients (+75) and controls (+75) who were exposed to Maria, the 2020 earthquakes, and the COVID-19pandemic; 2) identifying patients' unmet psychological and medical needs resulting from the aftermath of the2020 earthquakes and the COVID-19 pandemic, and; 3) examining the impact of Maria, the earthquakes, andthe COVID-19 pandemic on multilevel factors relevant to health outcomes. The proposed supplement projectwill shift current research paradigms in health outcomes after natural disasters by exploring the physiologicaleffects of extreme stressors on biological processes known to affect cancer progression and comorbidconditions, including inflammation and stress hormones. By expanding the parent grant's scope to include the2020 earthquakes and COVID-19 pandemic, the study team will increase the understanding of the effects ofmultiple disaster stressors.