Miller School’s Global Institute Helps Reimagine Disaster-Ready Primary Care with Gulf Futures Challenge Win
University of Miami Miller School of Medicine researchers are defining the future of disaster‑ready primary care through the Gulf Futures Challenge.
As climate-related disasters grow more frequent and more severe, the question of how communities prepare and recover has taken on new urgency.
With the Global Institute for Community Health and Development’s win in the Gulf Futures Challenge, the University of Miami Miller School of Medicine is helping lead a research-driven effort to strengthen primary care systems along the Gulf Coast, with the goal of protecting health both during disasters and long after headlines fade.
Reimagining Primary Care for a Changing Climate
The National Academies of Sciences, Engineering, and Medicine’s Gulf Research Program has awarded $20 million to the Gulf Hub initiative, through the Gulf Futures Challenge. The Miller School is contributing expertise and research to this regional initiative to transform community health centers into Learning Resilience Hubs: energy-independent, climate adaptive health care facilities that stay operational before, during and after disruptions and disasters.
“Fundamentally, it’s a pretty simple idea,” said Elizabeth Greig, M.D. ‘10, assistant professor of medicine at the Miller School and civil and architectural engineering at UM, and co-director of the Global Institute. “We want to harden primary care facilities so they stay powered on through disasters and able to deliver community-based primary care and extended services both in disaster and as part of disaster preparedness.”
The work builds on concepts developed by the Miller School and focuses on federally qualified health centers serving high-risk, medically underserved populations in areas prone to climate hazards such as hurricanes and flooding.
“The idea is that on blue-sky days, the hubs are making their communities healthier,” Dr. Greig said. “And on gray-sky days, they’re staying open, serving as a disaster responding agency and maintaining continuous primary care within their communities.”
Keeping Community Health Centers Powered and Connected
While the clinics will be located along the Gulf Coast, the Miller School plays a critical advisory and research role. In recent years, Dr. Greig has worked with UM engineering faculty members Esber Andiroglu, Ph.D., and Murat Erkoc, Ph.D., the Florida Association of Community Health Centers (FACHC) and Andrew MacCalla and the Collective Energy Company™ to find the most effective ways to strengthen primary care facilities before disasters strike.
The introduction of solar power is one key element in their work plan, backup generators and electrical storage, another. Primary care clinics need to keep the lights on, even when the power grids they rely upon are inoperable.
That seems obvious, but Florida’s reality hadn’t truly acknowledged it.
“In 2022, we set out to gain a better understanding of where health centers were statewide with emergency power,” said Gianna Van Winkle, FACHC’s director of emergency management programs. “We found at that time only about 40% of health center sites had an emergency power backup source.”
The project pairs health systems research with infrastructure investments. Clinics will be retrofitted with solar panels and redundant energy systems through partners like Collective Energy, allowing them to stay operational during power outages while also reducing long-term energy costs.
Equally important are system-level changes that protect continuity of care, especially displaced patients. Unifying different medical records systems across the hubs will give providers access to up-to-date health information for patients who may have to seek care at multiple sites.
“If patients have to move between one facility and another, their records go with them,” Dr. Greig said.
Shoring up these deficits would go a long way toward not only weathering the storm but dealing with its aftermath.
Why Disaster Health Impacts Last Long After the Storm
The Gulf Futures Challenge funding supports five years of work, but Dr. Greig emphasized the long-term impact. Infrastructure upgrades will outlast the grant, and the research aims to answer questions that have gone largely unaddressed in disaster preparedness.
“We know that, when there’s a disaster, people have higher morbidity and mortality long after the event,” Dr. Greig said. “But there is this huge gap in knowledge between the event and why people die or decline from the event years out.”
Data from Hurricane Sandy and Hurricane Maria show increases in cardiovascular events, strokes and other causes of death long after recovery efforts end. The reasons remain unclear.
“It may not be all about the interruption in care,” Dr. Greig said, noting that chronic stress, displacement and incomplete recovery may compound health risks.
For Dr. Greig, national recognition reinforces the urgency of reframing disaster response to center community health.
“Getting this kind of recognition from the National Academies highlights the importance of putting community-based health care at the center of holistic resilience,” she said.
More from the Global Institute
Students, teachers and counselors met to discussed mental health possibilities in the island chain that was devastated by Hurricane Dorian.
The Miller School’s Global Medical Sciences program will provide specialized training for aspiring and current health care professionals.
The disaster response program is contributing to this year’s initial Continuing Promise voyage to train Grenada first responders.
Medically complex families gathered at the Christine E. Lynn Rehab Center for answers questions about safety during emergencies.
Tags: disaster response, Dr. Elizabeth Greig, Global Institute for Community Health and Development, primary care