Abstract
Rural older adults, particularly those with Chronic Obstructive Pulmonary Disease (COPD), face significant risks to medical care during power outages caused by natural disasters. This cross-sectional study surveyed 222 Iowan adults aged 45-80 between March and May 2024 to assess disaster preparedness for power outages. Nearly nine in 10 participants experienced recent outages, yet 42% maintained a specific medical care plan for such events. Those with COPD exhibited moderately greater levels of preparedness, including higher rates of saving extra medication and establishing emergency communication plans. They were also twice as likely to have a care plan or emergency medication. Despite these gains, comprehensive preparedness remained low. The study highlights that recurrent disasters, such as windstorms and wildfire smoke, expose critical gaps in medical and emergency planning in rural communities. These results underscore the urgent need for tailored, disease-specific strategies and educational interventions to strengthen disaster resilience among rural populations.