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

Public Health Relevance

Castro, EM / Jim, H NARRATIVE Studies evaluating the effects of natural disasters on cancer outcomes and disparities are scarce, and to the study team?s knowledge; none have examined the impact of exposure to multiple disasters, particularly in ethnic minority groups. The proposed supplement will complement the parent R21 grant by expanding recruitment, exploring the impact of three disasters (Hurricane Maria, earthquakes and COVID-19) on changes in stress biomarkers, and by examining the impact of these three disasters on multilevel factors relevant to cancer health outcomes. By supplementing the parent grant?s scope to include the 2020 earthquakes and COVID-19 pandemic, the study team will increase the understanding of the effects of multiple disaster stressors in cancer health outcomes. OMB No. 0925-0001/0002 (Rev. 01/18 Approved Through 03/31/2020) Page Continuation Format Page

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Exploratory/Developmental Grants (R21)
Project #
3R21MD013674-02S1
Application #
10172476
Study Section
Program Officer
Alvidrez, Jennifer L
Project Start
2018-09-17
Project End
2021-05-31
Budget Start
2020-06-01
Budget End
2021-05-31
Support Year
2
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Ponce School of Medicine
Department
Type
DUNS #
105742043
City
Ponce
State
PR
Country
United States
Zip Code
00732