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J Public Health Management Practice, 2016, 00(00), 1–8
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On October 29, 2012, Hurricane Sandy made landfall in Brigantine, New Jersey, ravaging the mid-Atlantic region of the United States. Hurricane Sandy was the second costliest cyclone in US record-keeping history, after Hurricane Katrina of 2005, and the largest named storm on record in the Atlantic Ocean. Of the 147 deaths directly attributed to Hurricane Sandy, nearly half (n = 72) occurred in the mid-Atlantic andNortheastern United States.1 In addition to resulting in direct mortality, Hurricane Sandy had devastating impacts on the mid-Atlantic region’s health care systems, particularly hospitals.2,3 In New York City alone, to ensure safety and continuity ofmedical care, approximately 6300 patients were evacuated from 37 health care facilities.4 In Hurricane Sandy’s aftermath, researchers and news media questioned why hospitals that were literally adjacent and had ostensibly similar risk profiles made differing decisions about evacuation and shelter-in-place (ie, stay on-site until danger passes).