{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:41:24Z","timestamp":1792604484376,"version":"4.5.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>Environmental determinants significantly impact the health of individuals and populations contributing to increased rates of traumatic injuries, higher cancer incidence, and disruptions in access to healthcare systems and surgical services. Additionally, the healthcare industry contributes significantly to climate change, negatively impacting the earth\u2019s environment in both developed and developing nations. Natural disasters such as hurricanes and wildfires cause destruction of hospitals, clinics, pharmacies, and even supply chain facilities, hindering patient access to surgical care. These impacts were recently evidenced by the recent hurricanes Helene and Milton, which struck the Southeast US, hindering access and delivery of surgical care. Damage to infrastructure caused by hurricanes can compromise emergency response efforts, limiting access to essential services, and interrupting healthcare delivery. The increase in traumatic injuries because of natural disasters, coupled with damage to infrastructure, places an additional strain on healthcare systems\u2019 ability to provide essential and critical care. While the direct immediate effects of natural disasters and other environmental determinants can be substantial, a decrease in regular and consistent access to healthcare can lead to a long-term decline in community health. Continuous evaluation of cultural and environmental factors that impact the health care system\u2019s capacity to provide care is necessary to inform interventions to improve the health system\u2019s ability to adapt to provide continued access to care and serve the surgical community.<\/jats:p>","DOI":"10.1177\/00031348251323708","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T02:05:56Z","timestamp":1742436356000},"page":"690-695","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of Environmental Determinants of Health on Access to Surgical Care"],"prefix":"10.1177","volume":"91","author":[{"given":"Temisan","family":"Blagogee","sequence":"first","affiliation":[{"name":"Morehouse School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenaye","family":"Burrows","sequence":"additional","affiliation":[{"name":"Morehouse School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"Gopaul","sequence":"additional","affiliation":[{"name":"Morehouse School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6196-440X","authenticated-orcid":false,"given":"Shaneeta","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Meharry Medical College, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.27889"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02438-w"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30448-4"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-41888-1"},{"key":"e_1_3_3_6_2","unstructured":"Scientists A. 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Baxter facility damage after hurricane in North Carolina 2024. https:\/\/www.ama-assn.org\/delivering-care\/public-health\/iv-shortage-update-baxter-facility-damage-after-hurricane-north. accessed on 7 November 2024."},{"key":"e_1_3_3_23_2","unstructured":"Baxter announces expiration dating extensions for certain products related to IV solutions disruption. https:\/\/www.aha.org\/2024-10-28-baxter-announces-expiration-dating-extensions-certain-products-related-iv-solutions-disruption#:\u223c:text=As-part-of-its-efforts to-Sept.-30%2C-2024 (accessed on 7 November 2024)."},{"key":"e_1_3_3_24_2","unstructured":"American Kidney Fund activates disaster relief program to support dialysis and post-transplant patients affected by Hurricane Helene. https:\/\/www.kidneyfund.org\/article\/american-kidney-fund-activates-disaster-relief-program-supportdialysis-and-post-transplant-patients-10 (accessed on 7 November 2024)."},{"key":"e_1_3_3_25_2","unstructured":"Climate change key driver of catastrophic impacts of Hurricane Helene that devastated both coastal and inland communities \u2013 world weather attribution. https:\/\/www.worldweatherattribution.org\/climate-change-key-driver-of-catastrophic-impacts-of-hurricane-helene-that-devastated-oth-coastal-and-inland-communities\/ (accessed on 7 November 2024)."},{"key":"e_1_3_3_26_2","unstructured":"Hurricane Helene storm related fatalities. https:\/\/www.ncdhhs.gov\/assistance\/hurricane-helene-recovery-resources\/hurricane-helene-storm-related-fatalities (accessed on 7 November 2024)."},{"key":"e_1_3_3_27_2","unstructured":"Legoas M. 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