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Flores AB, Sullivan JA, Yu Y, Friedrich HK. Health Disparities in the Aftermath of Flood Events: A Review of Physical and Mental Health Outcomes with Methodological Considerations in the USA. Curr Environ Health Rep 2024; 11:238-254. [PMID: 38605256 DOI: 10.1007/s40572-024-00446-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE OF REVIEW This review applies an environmental justice perspective to synthesize knowledge of flood-related health disparities across demographic groups in the USA. The primary aim is to examine differential impacts on physical and mental health outcomes while also assessing methodological considerations such as flood exposure metrics, baseline health metrics, and community engagement. RECENT FINDINGS In our review (n = 27), 65% and 72% of studies identified racial, ethnic, or socio-economic disparities in physical and mental health outcomes post-flooding, respectively. The majority of racial/ethnic disparities were based on Black race, while most socio-economic disparities were based on lower household income. Forty-two percent of studies lacked flood exposure metrics, but often identified disparities. Common flood exposure metrics included self-reported flooding, flood risk models, and satellite-based observations. Seventy percent of studies lacked baseline health measurements or suitable alternatives, and only 19% incorporated community engagement into their research design. The literature consistently finds that both physical and mental health burdens following flooding are unequally shared across racial, ethnic, and socio-economic groups. These findings emphasize the need for disaster risk reduction policies that address underlying vulnerabilities to flooding, unequal exposure to flooding, and progressive funding for recovery efforts. Findings also underscore the importance of methodological enhancements to facilitate precise assessments of flood exposure and health outcomes.
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Affiliation(s)
- Aaron B Flores
- School of Geographical Sciences & Urban Planning, Arizona State University, Lattie F. Coor Hall, 975 S Myrtle Ave, Tempe, AZ, 85281, USA.
- Urban Climate Research Center, Arizona State University, Tempe, AZ, USA.
| | - Jonathan A Sullivan
- School of Geography, Development & Environment, University of Arizona, Tucson, AZ, 85721, USA
| | - Yilei Yu
- School of Geographical Sciences & Urban Planning, Arizona State University, Lattie F. Coor Hall, 975 S Myrtle Ave, Tempe, AZ, 85281, USA
| | - Hannah K Friedrich
- School of Geography, Development & Environment, University of Arizona, Tucson, AZ, 85721, USA
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Stein PJS, Stein MA, Groce N, Kett M, Akyeampong EK, Alford WP, Chakraborty J, Daniels-Mayes S, Eriksen SH, Fracht A, Gallegos L, Grech S, Gurung P, Hans A, Harpur P, Jodoin S, Lord JE, Macanawai SS, McClain-Nhlapo CV, Mezmur BD, Moore RJ, Muñoz Y, Patel V, Pham PN, Quinn G, Sadlier SA, Shachar C, Smith MS, Van Susteren L. Advancing disability-inclusive climate research and action, climate justice, and climate-resilient development. Lancet Planet Health 2024; 8:e242-e255. [PMID: 38580426 DOI: 10.1016/s2542-5196(24)00024-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/30/2023] [Accepted: 02/14/2024] [Indexed: 04/07/2024]
Abstract
Globally, more than 1 billion people with disabilities are disproportionately and differentially at risk from the climate crisis. Yet there is a notable absence of climate policy, programming, and research at the intersection of disability and climate change. Advancing climate justice urgently requires accelerated disability-inclusive climate action. We present pivotal research recommendations and guidance to advance disability-inclusive climate research and responses identified by a global interdisciplinary group of experts in disability, climate change, sustainable development, public health, environmental justice, humanitarianism, gender, Indigeneity, mental health, law, and planetary health. Climate-resilient development is a framework for enabling universal sustainable development. Advancing inclusive climate-resilient development requires a disability human rights approach that deepens understanding of how societal choices and actions-characterised by meaningful participation, inclusion, knowledge diversity in decision making, and co-design by and with people with disabilities and their representative organisations-build collective climate resilience benefiting disability communities and society at large while advancing planetary health.
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Affiliation(s)
- Penelope J S Stein
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Michael Ashley Stein
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA.
| | - Nora Groce
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; International Disability Research Centre, University College London, London, UK
| | - Maria Kett
- International Disability Research Centre, University College London, London, UK
| | - Emmanuel K Akyeampong
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Department of African and African American Studies, Harvard University, Cambridge, MA, USA
| | - Willliam P Alford
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Jayajit Chakraborty
- Bren School of Environmental Science and Management, University of California-Santa Barbara, Santa Barbara, CA, USA
| | | | - Siri H Eriksen
- Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - Anne Fracht
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Luis Gallegos
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; The United Nations Institute for Training and Research, Quito, Ecuador
| | - Shaun Grech
- Community Based Inclusive Development Initiative, CBM, Bensheim, Germany
| | - Pratima Gurung
- National Indigenous Disabled Women Association Nepal, Kusunti, Nepal
| | - Asha Hans
- School of Women's Studies, Utkal University, Bhubaneswar, India
| | - Paul Harpur
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; TC Beirne School of Law, University of Queensland, Brisbane, QLD, Australia
| | | | - Janet E Lord
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Center for International and Comparative Law, University of Baltimore, Baltimore, MD, USA
| | | | | | | | - Rhonda J Moore
- All of US Research Program, National Institutes of Health, Washington, DC, USA
| | | | - Vikram Patel
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Department of Global Health and Social Medicine, Harvard Medical School, Cambridge, MA, USA
| | - Phuong N Pham
- Harvard Humanitarian Initiative, Cambridge, MA, USA; Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Gerard Quinn
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Faculty of Law, University of Galway, Galway, Ireland
| | | | - Carmel Shachar
- Health Law and Policy Clinic at the Center for Health Law and Policy Innovation, Harvard Law School, Cambridge, MA, USA
| | - Matthew S Smith
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Lise Van Susteren
- Department of Psychiatry and Behavorial Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Lindsay S, Hsu S, Ragunathan S, Lindsay J. The impact of climate change related extreme weather events on people with pre-existing disabilities and chronic conditions: a scoping review. Disabil Rehabil 2023; 45:4338-4358. [PMID: 36426560 DOI: 10.1080/09638288.2022.2150328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/16/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE People with disabilities experience a disproportionate impact of extreme weather events and there is a critical need to better understand the impact that climate change has for them. Most previous reviews focus on the risk of acquiring a new disability or injury after a climate-related event and not the impact on people with pre-existing disabilities or chronic conditions, which is the purpose of this study. METHODS We conducted a scoping review while searching seven international databases that identified 45 studies meeting our inclusion criteria. RESULTS The studies included in our review involved 2 337 199 participants with pre-existing disabilities and chronic conditions across 13 countries over a 20-year period. The findings demonstrated the following trends: (1) the impact on physical and mental health; (2) the impact on education and work; (3) barriers to accessing health and community services (i.e., lack of access to services, lack of knowledge about people with disabilities, communication challenges, lack of adequate housing); and (4) coping strategies (i.e., social supports and connecting to resources) and resilience. CONCLUSIONS Our findings highlight the critical need for rehabilitation clinicians and other service providers to explore opportunities to support their clients in preparing for climate-related emergencies.
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Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Shaelynn Hsu
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Sharmigaa Ragunathan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - John Lindsay
- Department of Geography, Environment & Geomatics, University of Guelph, Guelph, Canada
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Li Y, Buendia J, Sears S, Ibrahimovic M, Bertero H, Wiseman R, Bhakta N. Impact of Hurricane Harvey on Inpatient Asthma Hospitalization Visits Within Southeast Texas, 2016-2019. J Occup Environ Med 2023; 65:924-930. [PMID: 37488772 DOI: 10.1097/jom.0000000000002928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
OBJECTIVE The aim of the study is to estimate inpatient asthma hospital visit rates among impacted Texans in Public Health Region 6/5S during the year of and after Hurricane Harvey. METHODS Asthma inpatient hospitalization discharges were collected from the Texas Health Care Information Collection database (2016-2019). RESULTS Females (age-adjusted rates [AARs] = 4.8-5.0) and Black Texans (AARs = 5.0-8.1) experienced significantly higher AARs compared with males and White Texans during the year of and after Harvey. During the year of Hurricane Harvey, females were 1.49 times as likely to have an inpatient asthma visit compared with males, while Black Texans were 2.78 times as likely to have an inpatient asthma hospitalization compared with White Texans. CONCLUSIONS Findings from this study may assist public health professionals and local officials to allocate future resources to the most impacted subgroups as well as establish effective processes to mitigate consequences.
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Affiliation(s)
- Yiyao Li
- From the Health Promotion and Chronic Disease Prevention Section, Department of State Health Services, Austin, Texas
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Chakraborty J, Collins TW, Grineski SE. Disability and subsidized housing residency: The adverse impacts of Winter Storm Uri in metropolitan Texas. Disabil Health J 2023; 16:101403. [PMID: 36473824 DOI: 10.1016/j.dhjo.2022.101403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/19/2022] [Accepted: 11/06/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND While natural disasters have been found to affect both disabled and subsidized rental housing residents negatively and disproportionately, previous studies have not examined if adverse disaster impacts experienced by disabled individuals in subsidized housing developments differ from those living in other housing. OBJECTIVE We focused on Winter Storm Uri in Texas, USA, which lasted from February 10-20, 2021. We sought to: (1) compare differences in adverse impacts suffered by households with and without disabled persons; and (2) examine how residency in US Department of Housing and Urban Development (HUD)-assisted rental housing influences the severity of impacts for households with disabled persons. METHODS We collected data from 790 randomly selected households in eight Texas metropolitan areas through a bilingual phone survey. Bivariate and multivariable statistical methods were utilized to compare adverse impacts suffered by households, based on both disability status and HUD-assisted housing residency. RESULTS Households with disabled persons were more severely impacted by Uri than households without disabled persons, in terms of service disruptions, colder temperatures, slower recovery, and adverse experiences that have important health implications. Households with disabled persons residing in HUD-assisted housing were more negatively impacted and suffered more adverse experiences than those living in other housing. CONCLUSIONS Residency in federally-assisted rental housing can worsen severity of adverse impacts and amplify disaster vulnerability for disabled individuals. These disparities based on disability and subsidized housing status emphasize the need for additional research to understand the impacts of disasters on disabled residents and formulate interventions that provide equitable protections.
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Affiliation(s)
- Jayajit Chakraborty
- Department of Sociology and Anthropology, University of Texas at El Paso; 500 West University Avenue, El Paso, TX, 79968, USA.
| | - Timothy W Collins
- Department of Geography, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA
| | - Sara E Grineski
- Department of Sociology, University of Utah; 380 S 1530 E, Rm. 301, Salt Lake City, UT, 84112, USA
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Bailie J, Matthews V, Bailie R, Villeneuve M, Longman J. Exposure to risk and experiences of river flooding for people with disability and carers in rural Australia: a cross-sectional survey. BMJ Open 2022; 12:e056210. [PMID: 35918120 PMCID: PMC9252212 DOI: 10.1136/bmjopen-2021-056210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES In this paper, we explore the exposure to risk and experiences of people with disability and carers during a flooding event and the subsequent mental health impacts. DESIGN A cross-sectional survey between September and November 2017. Binary logistic regression models were used to investigate associations between the mental health of people with disability and carers and their exposure to the flood. Inductive content analysis was used to analyse qualitative data. SETTING Flood-affected communities in the rural area of Northern Rivers, New South Wales, Australia, 6 months after river flooding in 2017. PARTICIPANTS People over 16 years and a resident in the Northern Rivers at the time of the flood were invited to participate. Using a purposive, snowballing sampling technique participants were drawn from a wide range of socioeconomic backgrounds and had experienced different degrees of flood exposure. RESULTS Of 2252 respondents, there were 164 people with disability and 91 carers. Both groups had increased odds of having their home flooded (people with a disability: OR 2.41 95% CI 1.71 to 3.39; carers: OR 1.76 95% CI 1.10 to 2.84). On evacuation, respondents reported inaccessible, conflicting and confusing information regarding flood warnings. Essential services such as healthcare and social services were disrupted (people with a disability: OR 3.98 95% CI 2.82 to 5.60; carers 2.17 95% CI 1.33 to 3.54) and access to safe and mould free housing post flood event was limited. After taking sociodemographic factors into account, respondents with a disability and carers had greater odds of probable post-traumatic stress disorder compared with other respondents (people with a disability: 3.32 95% CI 2.22 to 4.96; carers: 1.87 95% CI 1.10 to 3.19). CONCLUSION Our findings show the profound impact and systemic neglect experienced by people with disability and carers during and after the 2017 flood event in the Northern Rivers. As people with disability will take longer to recover, they will require longer-term tailored supports and purposeful inclusion in flood preparedness and recovery efforts.
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Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
- Centre for Disability Research and Policy, The University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Ross Bailie
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Michelle Villeneuve
- Centre for Disability Research and Policy, The University of Sydney, Sydney, New South Wales, Australia
| | - Jo Longman
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
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Carrel M, Clore GS, Kim S, Vaughan Sarrazin M, Tate E, Perencevich EN, Goto M. Health Care Utilization Among Texas Veterans Health Administration Enrollees Before and After Hurricane Harvey, 2016-2018. JAMA Netw Open 2021; 4:e2138535. [PMID: 34889944 PMCID: PMC8665372 DOI: 10.1001/jamanetworkopen.2021.38535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
IMPORTANCE Hurricanes and flooding can interrupt health care utilization. Understanding the magnitude and duration of interruptions, as well as how they vary according to hazard exposure, race, and income, are important for identifying populations in need of greater retention in care. OBJECTIVE To determine how the differential exposure to Hurricane Harvey in August 2017 is associated with changes in utilization of Veterans Health Administration health care. DESIGN, SETTING, AND PARTICIPANTS This is a retrospective cohort analysis of primary care practitioner (PCP) visits, emergency department visits, and inpatient admissions in the Veterans Health Administration among Texas veterans residing in counties impacted by Hurricane Harvey from 2016 to 2018. Data analysis was performed from September 2020 to May 2021. EXPOSURES Residential flooding after Hurricane Harvey. MAIN OUTCOMES AND MEASURES Interrupted time series analysis measured changes in health care utilization over time, stratified by residential flood exposure, race, and income. RESULTS Of the 99 858 patients in the cohort, 89 931 (90.06%) were male, and their median (range) age was 58 (21 to 102) years. Compared with veterans in nonflooded areas, veterans living in flooded areas were more likely to be Black (24 715 veterans [33.80%] vs 4237 veterans [15.85%]) and low-income (14 895 veterans [20.37%] vs 4853 veterans [18.15%]). Rates of PCP visits decreased by 49.78% (95% CI, -64.52% to -35.15%) for veterans in flooded areas and by 45.89% (95% CI, -61.93% to -29.91%) for veterans in nonflooded areas and did not rebound until more than 8 weeks after the hurricane. Rates of PCP visits in flooded areas remained lower than expected for 11 weeks among White veterans (-6.99%; 95% CI, -14.36% to 0.81%) and for 13 weeks among racial minority veterans (-7.22%; 95% CI, -14.11% to 0.30%). Low-income veterans, regardless of flood status, experienced greater suppression of PCP visits in the 8 weeks following the hurricane (-13.72%; 95% CI, -20.51% to -6.68%) compared with their wealthier counterparts (-9.63%; 95% CI, -16.74% to -2.26%). CONCLUSIONS AND RELEVANCE These findings suggest that flood disasters such as Hurricane Harvey may be associated with declines in health care utilization that differ according to flood status, race, and income strata. Patients most exposed to the disaster also had the greatest delay or nonreceipt of care.
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Affiliation(s)
- Margaret Carrel
- Department of Geographical and Sustainability Sciences, University of Iowa, Iowa City
| | - Gosia S. Clore
- Department of Internal Medicine, University of Iowa, Iowa City
- Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, Iowa
| | - Seungwon Kim
- Department of Geographical and Sustainability Sciences, University of Iowa, Iowa City
| | - Mary Vaughan Sarrazin
- Department of Internal Medicine, University of Iowa, Iowa City
- Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, Iowa
| | - Eric Tate
- Department of Geographical and Sustainability Sciences, University of Iowa, Iowa City
| | - Eli N. Perencevich
- Department of Internal Medicine, University of Iowa, Iowa City
- Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, Iowa
| | - Michihiko Goto
- Department of Internal Medicine, University of Iowa, Iowa City
- Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, Iowa
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Lieberman-Cribbin W, Liu B, Sheffield P, Schwartz R, Taioli E. Socioeconomic disparities in incidents at toxic sites during Hurricane Harvey. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:454-460. [PMID: 33875771 PMCID: PMC8992005 DOI: 10.1038/s41370-021-00324-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 03/26/2021] [Accepted: 03/26/2021] [Indexed: 05/20/2023]
Abstract
BACKGROUND Hurricane Harvey facilitated exposure to various toxic substances and floodwater throughout the greater Houston metropolitan area. Although disparities exist in this exposure and vulnerable populations can bear a disproportionate impact, no research has integrated disparities in exposure to toxic incidents following Hurricane Harvey. OBJECTIVE The objective of this study was to analyze the relationship between flooding, socioeconomic status (SES), and toxic site incidents. METHODS Data on toxic site locations, reported releases, and flood water depths during Hurricane Harvey in the greater Houston area were compiled from multiple sources. A multivariable logistic regression was performed to predict the odds of a toxic site release by flooding at the site, SES and racial composition of the census tract. RESULTS 83 out of 1403 toxic sites (5.9%) had reported releases during Hurricane Harvey. The proportion of toxic sites with reported incidents across increasing SES index quintiles were 8.35, 7.67, 5.14, 4.55, and 0.51, respectively. The odds of an incident were lower in the highest SES quintile areas (ORadj = 0.06, 95% CI: 0.01-0.42) compared to the lowest SES quintile. Flooding was similar at toxic sites with and without incidents, and was distributed similarly and highest at toxic sites located in lower SES quintiles. SIGNIFICANCE Despite similar flooding across toxic sites during Hurricane Harvey, areas with lower SES were more likely to have a toxic release during the storm, after accounting for number of toxic sites. Improving quality of maintenance, safety protocols, number of storm-resilient facilities may minimize this disproportionate exposure and its subsequent adverse outcomes among socioeconomically vulnerable populations.
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Affiliation(s)
- Wil Lieberman-Cribbin
- Department of Population Health Science and Policy and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Joint Center for Disaster Health, Trauma and Resilience, Great Neck, NY, USA
| | - Bian Liu
- Department of Population Health Science and Policy and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Joint Center for Disaster Health, Trauma and Resilience, Great Neck, NY, USA
| | - Perry Sheffield
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rebecca Schwartz
- Department of Population Health Science and Policy and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Joint Center for Disaster Health, Trauma and Resilience, Great Neck, NY, USA
- Department of Occupational Medicine, Epidemiology and Prevention, Zucker School of Medicine at Hofstra-Northwell, Great Neck, NY, USA
| | - Emanuela Taioli
- Department of Population Health Science and Policy and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Joint Center for Disaster Health, Trauma and Resilience, Great Neck, NY, USA.
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Rusca M, Messori G, Di Baldassarre G. Scenarios of Human Responses to Unprecedented Social-Environmental Extreme Events. EARTH'S FUTURE 2021; 9:e2020EF001911. [PMID: 33869652 PMCID: PMC8047902 DOI: 10.1029/2020ef001911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/25/2021] [Accepted: 02/16/2021] [Indexed: 06/01/2023]
Abstract
In a rapidly changing world, what is today an unprecedented extreme may soon become the norm. As a result, extreme-related disasters are expected to become more frequent and intense. This will have widespread socio-economic consequences and affect the ability of different societal groups to recover from and adapt to rapidly changing environmental conditions. Therefore, there is the need to decipher the relation between genesis of unprecedented events, accumulation and distribution of risk, and recovery trajectories across different societal groups. Here, we develop an analytical approach to unravel the complexity of future extremes and multiscalar societal responses-from households to national governments and from immediate impacts to longer term recovery. This requires creating new forms of knowledge that integrate analyses of the past-that is, structural causes and political processes of risk accumulation and differentiated recovery trajectories-with plausible scenarios of future environmental extremes grounded in the event-specific literature. We specifically seek to combine the physical characteristics of the extremes with examinations of how culture, politics, power, and policy visions shape societal responses to unprecedented events, and interpret the events as social-environmental extremes. This new approach, at the nexus between social and natural sciences, has the concrete advantage of providing an impact-focused vision of future social-environmental risks, beyond what is achievable within conventional disciplinary boundaries. In this paper, we focus on extreme flooding events and the societal responses they elicit. However, our approach is flexible and applicable to a wide range of extreme events. We see it as the first building block of a new field of research, allowing for novel and integrated theoretical explanations and forecasting of social-environmental extremes.
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Affiliation(s)
- Maria Rusca
- Department of Earth SciencesUppsala UniversityUppsalaSweden
- Centre of Natural Hazards and Disaster Science (CNDS)UppsalaSweden
| | - Gabriele Messori
- Department of Earth SciencesUppsala UniversityUppsalaSweden
- Centre of Natural Hazards and Disaster Science (CNDS)UppsalaSweden
- Department of MeteorologyStockholm UniversityStockholmSweden
- Bolin Centre for Climate ResearchStockholmSweden
| | - Giuliano Di Baldassarre
- Department of Earth SciencesUppsala UniversityUppsalaSweden
- Centre of Natural Hazards and Disaster Science (CNDS)UppsalaSweden
- Department of Integrated Water Systems and GovernanceIHE Delftthe Netherlands
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Discrimination and Bias in State Triage Protocols Toward Populations With Intellectual Disabilities During the COVID-19 Pandemic. Disaster Med Public Health Prep 2021; 16:1772-1774. [PMID: 33762036 PMCID: PMC8193195 DOI: 10.1017/dmp.2021.81] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Individuals with intellectual disabilities face discrimination on a daily basis. The coronavirus disease (COVID-19) pandemic has highlighted the systemic ableism that is embedded within American culture, particularly through health care bias and discrimination. In turn, this creates further marginalization during diagnosis, triage, and treatment of the novel coronavirus. Multiple states have filed complaints against state triage protocols that suggest an abled life is more worthy than a life with a disability. Although many of these protocols have been updated and replaced, generalized triage statements fail to address health care bias that is embedded within the American system. In addition to the existing solutions, proposed solutions to addressing health care bias include integrating social workers into the emergency management process and the overall disaster management field. To combat bias and ableism across the health care system, a social justice perspective that highlights discrimination, inequalities, and inequities in overall individual care must be adopted.
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Chakraborty J. Convergence of COVID-19 and chronic air pollution risks: Racial/ethnic and socioeconomic inequities in the U.S. ENVIRONMENTAL RESEARCH 2021; 193:110586. [PMID: 33309819 PMCID: PMC7728411 DOI: 10.1016/j.envres.2020.110586] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/17/2020] [Accepted: 12/02/2020] [Indexed: 05/07/2023]
Abstract
Recent research suggests greater COVID-19 prevalence in areas burdened with higher exposure to chronic air pollution, but previous studies have not examined if socially disadvantaged populations are more likely to reside in communities located at the convergence of both COVID-19 and air pollution health risks. This article presents a national scale U.S. study that investigates whether racial/ethnic minorities, socioeconomically deprived residents, and other vulnerable groups are significantly overrepresented in counties where significantly higher COVID-19 incidence spatially coincides with higher respiratory health risks from outdoor exposure to hazardous air pollutants (HAPs). COVID-19 data from the Johns Hopkins Center for Systems Science and Engineering database are linked to respiratory risk estimates from the U.S. Environmental Protection Agency's National Air Toxics Assessment and variables from the 2018 American Community Survey. Bivariate local measures of spatial association are implemented to identify county clusters representing relationships between COVID-19 incidence rate and respiratory risk from HAP exposure. Socio-demographic characteristics of these clusters are compared using bivariate statistical tests and multivariable generalized estimating equations. Counties where greater COVID-19 incidence coincides significantly with higher HAP respiratory risk contain disproportionately higher percentages of non-Hispanic Black, socioeconomically deprived, and uninsured residents than all other U.S. counties, after controlling for spatial clustering, population density, older age, and other contextual factors. These significant socio-demographic inequities represent an important starting point for more detailed investigations of places facing the double burden of elevated COVID-19 prevalence and air pollution exposure, and also emphasize the urgent need to develop mitigation strategies for addressing both COVID-19 and chronic air pollution in socially vulnerable communities.
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Affiliation(s)
- Jayajit Chakraborty
- Department of Sociology and Anthropology, University of Texas at El Paso; 500 West University Avenue, El Paso, TX 79968, USA.
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Limaye VS. Making the climate crisis personal through a focus on human health. CLIMATIC CHANGE 2021; 166:43. [PMID: 34155416 PMCID: PMC8210734 DOI: 10.1007/s10584-021-03107-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 04/20/2021] [Indexed: 05/19/2023]
Abstract
Climate change-driven health impacts are serious, widespread, and costly. Importantly, such damages are largely absent from policy debates around the costs of delay and inaction on this crisis. While climate change is a global problem, its impacts are localized and personal, and there is growing demand for specific information on how climate change affects human health in different places. Existing research indicates that climate-fueled health problems are growing, and that investments in reducing carbon pollution and improving community resilience could help to avoid tens to hundreds of billions of dollars in climate-sensitive health impacts across the USA each year, including those stemming from extreme heat, air pollution, hurricanes, and wildfires. Science that explores the underappreciated local health impacts and health-related costs of climate change can enhance advocacy by demonstrating the need to both address the root causes of climate change and enhance climate resilience in vulnerable communities. The climate crisis has historically been predominantly conceived as a global environmental challenge; examination of climate impacts on public health enables researchers to localize this urgent problem for members of the public and policymakers. In turn, approaches to climate science that focus on health can make dangerous climate impacts and the need for cost-effective solutions more salient and tangible.
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Flores AB, Collins TW, Grineski SE, Chakraborty J. Disparities in Health Effects and Access to Health Care Among Houston Area Residents After Hurricane Harvey. Public Health Rep 2020; 135:511-523. [PMID: 32539542 DOI: 10.1177/0033354920930133] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES Although research shows that public health is substantially affected during and after disasters, few studies have examined the health effects of Hurricane Harvey, which made landfall on the Texas coast in August 2017. We assessed disparities in physical health, mental health, and health care access after Hurricane Harvey among residents of the Houston-The Woodlands-Sugar Land, Texas, metropolitan statistical area (ie, Houston MSA). METHODS We used structured survey data collected through telephone and online surveys from a population-based random sample of Houston MSA residents (n = 403) collected from November 29, 2017, through January 6, 2018. We used descriptive statistics to describe the prevalence of physical health/mental health and health care access outcomes and multivariable generalized linear models to assess disparities (eg, based on race/ethnicity, socioeconomic status, disability) in health outcomes. RESULTS Physical health problems disproportionately affected persons who did not evacuate (odds ratio [OR] = 0.41; 95% confidence interval [CI], 0.19-0.87). Non-Hispanic black persons were more likely than non-Hispanic white persons to have posttraumatic stress (OR = 5.03; 95% CI, 1.90-13.10), as were persons in households that experienced job loss post-Harvey (vs did not experience job loss post-Harvey; OR = 2.89; 95% CI, 1.14-7.32) and older persons (OR = 1.04; 95% CI, 1.01-1.06). Health care access was constrained for persons whose households lost jobs post-Harvey (vs did not lose jobs post-Harvey; OR = 2.73; 95% CI, 1.29-5.78) and for persons with disabilities (vs without disabilities; OR = 3.19; 95% CI, 1.37-7.45). CONCLUSIONS Our findings underscore the need to plan for and ameliorate public health disparities resulting from climate change-related disasters, which are expected to occur with increased frequency and magnitude.
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Affiliation(s)
- Aaron B Flores
- 7060Department of Geography, University of Utah, Salt Lake City, UT, USA.,7060Center for Natural & Technological Hazards, University of Utah, Salt Lake City, UT, USA
| | - Timothy W Collins
- 7060Department of Geography, University of Utah, Salt Lake City, UT, USA.,7060Center for Natural & Technological Hazards, University of Utah, Salt Lake City, UT, USA
| | - Sara E Grineski
- 7060Center for Natural & Technological Hazards, University of Utah, Salt Lake City, UT, USA.,7060Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | - Jayajit Chakraborty
- 12337Department of Sociology & Anthropology, University of Texas at El Paso, El Paso, TX, USA
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Collins TW, Grineski SE, Chakraborty J, Flores AB. Environmental injustice and Hurricane Harvey: A household-level study of socially disparate flood exposures in Greater Houston, Texas, USA. ENVIRONMENTAL RESEARCH 2019; 179:108772. [PMID: 31593835 DOI: 10.1016/j.envres.2019.108772] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/20/2019] [Accepted: 09/22/2019] [Indexed: 06/10/2023]
Abstract
Environmental justice research on flooding has relied heavily on analyses of aggregated geographic areal units and assessing exposure to 'pre-flood' risks (e.g., residence in 100-year flood zones) rather than actual flood events. To address these limitations, we examined disproportionate exposure to flooding caused by Hurricane Harvey in 2017 in Greater Houston (Texas). Using primary survey data collected from 377 representative households before Harvey and spatial data on Harvey-induced inundation developed by the US Federal Emergency Management Agency, we found that the areal extent of flooding around residents' home sites was distributed inequitably with respect to race/ethnicity and socioeconomic status (SES). Hispanic, black and other racial/ethnic minority households experienced more extensive flooding than white households, and lower SES households faced more extensive flooding than higher SES households. Findings align with prior flood risk research in Greater Houston and provide cause for concern, as social inequities in flood exposure may have influenced social disparities in flood impacts and post-disaster needs. Since flood events in Greater Houston are expected to increase in frequency and magnitude due to climate change, socially disparate impacts are likely to become an increasingly salient public policy issue. Thus, proactive approaches for reducing flood risks and ameliorating disparities should be implemented.
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Affiliation(s)
- Timothy W Collins
- Department of Geography, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA.
| | - Sara E Grineski
- Department of Sociology, University of Utah; 380 S 1530 E, Rm. 301, Salt Lake City, UT, 84112, USA
| | - Jayajit Chakraborty
- Department of Sociology & Anthropology, University of Texas at El Paso; 500 West University Avenue, El Paso, TX, 79968, USA
| | - Aaron B Flores
- Department of Geography, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA
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