People impacted by disasters may have adverse non-communicable disease health effects associated with the disaster. This research examined the independent and joint impacts of federally declared disasters on the diagnosis of hypertension (HTN), diabetes (DM), anxiety, and medication changes 6 months before and after a disaster. Patients seen in zip codes that received a federal disaster declaration for Hurricanes Gustave or Ike in 2008 and who had electronic health records captured by MarketScan^® were analyzed. The analysis included patients seen 6 months before or after Hurricanes Gustav and Ike in 2008 and who were diagnosed with HTN, DM, or anxiety. There was a statistically significant association between post-disaster and diagnosis of hypertension, X² (1, n = 19,328) = 3.985, p = 0.04. There was no association post-disaster and diabetes X² (1, n = 19,328) = 0.778, p = 0.378 or anxiety, X² (1, n = 19,328) = 0.017, p = 0.898. The research showed that there was a change in the diagnosis of HTN after a disaster. Changes in HTN are an additional important consideration for clinicians in disaster-prone areas. Data about non-communicable diseases help healthcare disaster planners to include primary care needs and providers in the plans to prevent the long-term health impacts of disasters and expedite recovery efforts.

Caregivers of wounded, ill, or disabled military servicemembers and Veterans play an essential yet underrecognized role in health care delivery. A new cohort of younger spouses, parents, and peers has emerged after the wars in Iraq and Afghanistan, assuming complex clinical, coordination, and advocacy responsibilities while facing substantial health, emotional, and financial risk. This column highlights the role of Nurse Practitioners in recognizing caregivers as secondary patients and advancing caregiver health as integral to patient-centered care. As Nurse Practitioners, we are educated to look beyond diagnoses to the broader context in which health and healing occur. As a Fellow of the American Association of Nurse Practitioners, I believe one of the most pressing—and persistently overlooked—contexts in care today are the health and well-being of caregivers of the wounded, ill, injured, or disabled military servicemembers and Veterans. After the wars in Iraq and Afghanistan, a new cohort of caregivers has emerged. These individuals are central to recovery, rehabilitation, and long-term outcomes for those who have served. Yet caregiver health is too often assumed rather than assessed, and caregiving capacity is taken for granted rather than intentionally supported.