Flood inundation and isolation differentially impact access to dialysis care.

Objective: To assess the impacts of flooding on access to dialysis care and compare current and future risk from flood inundation and isolation.
Design: A cross-sectional study. Maps were generated in ArcGIS using the 100-year flood plain, transportation networks, and dialysis center locations, showing spatial flood risks for dialysis center locations in the State of Delaware.
Main Outcome Measure: Number of roads, intersections, and dialysis centers closed due to flood inundation or isolation and population expected to be impacted.
Results: Six dialysis facilities would be flooded in a flooding event, and three additional facilities would be isolated. The spatial distribution of dialysis care access is inequitable across the state and among socially vulnerable groups.
Conclusions: Mapping the impact of flooding on access to dialysis center care in Delaware is important for identifying geographic areas and socially vulnerable populations at high risk for dialysis service disruptions in flooding events.