Pharmacy Deserts and Pharmacies’ Roles Post-Extreme Weather and Climate Events in the United States: A Scoping Review

Abstract

Background: The effects of climate change are seen with a rise of extreme weather and climate events (EWCEs) which lead to the closures of many healthcare facilities, such as community pharmacies. Pharmacists in community pharmacies are seen as the most accessible healthcare professional to the public and are responsible for the continued delivery of care to patients. However, amid closures due to EWCEs and the emergence of pharmacy deserts, there is decreased access to pharmacies and a disruption of care. Objective: It is important to address the preparedness and accessibility of pharmacies post-EWCEs to guide future research and policy. Additionally, to tackle health disparities that arise due to pharmacy deserts, the populations most affected by a decreased access to pharmacies should be identified. We conducted a scoping review to assess the preparedness and accessibility of pharmacies post-EWCEs and to identify populations most affected by pharmacy deserts. Methods: We searched PubMed, Embase, and Web of Science from January 1, 2012 to September 30, 2022 and included all English-language, peer-reviewed primary literature that examined the preparedness and accessibility of community pharmacies in the United States post-EWCEs and addressed disparities within pharmacy deserts. Studies meeting these criteria were screened of their titles and abstracts by the first author and discrepancies were resolved with co-authors. We used Covidence for data extraction. Results: A total of 472 studies were identified (196 duplicates removed) and after screening, 53 studies were assessed for eligibility. The results of included publications (N = 26) showed that pharmacists and pharmacies are not equipped with the necessary emergency protocols which could lead to decreased access of pharmacies in the wake of EWCEs. Pharmacy deserts disproportionately affect residents living in rural, lower income, and Black/African American and Hispanic/Latino neighborhoods. The lack of preparedness of pharmacies post-EWCEs could worsen medication access. Conclusion: This scoping review addresses challenges impacting pharmacies and patients post-EWCEs and within pharmacy deserts. In times of increased need, these challenges implicate the well-being of communities affected by EWCEs by breaking the continuum of care and access to medications. Here we offer suggestions for future research and directions for policy change.

Locations and characteristics of pharmacy deserts in the United States: a geospatial study

“…The COVID-19 pandemic is the most recent example of the importance of pharmacy infrastructure—not only for testing, vaccinations, and treatment access to mitigate health and economic consequences of the pandemic but to enable continuity of care for peoples’ prescription medications. 7 In climate-related and natural disasters, pharmacists remain trusted health providers who are perceived as responsible for the continuity of medication supply chains by both patients and other health care providers, 37 , 38 and may be well suited to take on roles such as triaging evacuees, assessing vaccination needs, and providing over-the-counter and prescription medications. 39 People living in pharmacy desert communities may be left behind in accessing important emergency services.…”

The Cost of Medications at a Student-Run Free Clinic in New Haven, Connecticut, 2021–2023

“…Amity is more affluent than the neighborhoods in which our patients live, with a median income of $81,809 in 2021 ( 16 ). Neighborhoods in New Haven such as Fair Haven and the Hill may be “pharmacy deserts” — areas with inadequate access to retail pharmacies that disproportionately affect low-income people ( 17 – 19 ).…”

Pulmonary vascular disease, environmental pollution, and climate change

“…Wildfires, hurricanes and floods have been shown to prevent access to health care, 114 all the while aggravating chronic respiratory disease. 115 , 116 , 117 For example, patients and health care workers affected by wildfires 118 , 119 and hurricanes reported disrupted access to doctor consultations, medication, 120 or life‐saving treatments 114 ; in some studies, this was associated with increased mortality. 121 Although these challenges are not specific to PVD—the disruption to health care access due to extreme weather events, extreme temperatures and migrations affects everyone—PH patients require a complex network of care, 15 which could prove harder to provide as the effects of climate change increase.…”