Health Disparities and Climate Change: The Intersection of Three Disaster Events on Vulnerable Communities in Houston, Texas

Vested Interest Theory as a Framework for Understanding Anthropogenic Climate Change Risk Perceptions

Climate change due to anthropogenic activities is contributing to the systematic warming of Earth. A warming planet represents an existential threat to humanity, contributing to the increased frequency and magnitude of multiple natural hazards. The UN's Intergovernmental Panel on Climate Change (IPCC) notes that time is running out to create meaningful change to avert climate-related consequences. This research posits Vested Interest Theory (VIT) as a potentially useful framework for assessing attitudes and risk perceptions associated with anthropogenic climate change (ACC). Vested Interest Theory mediates the attitude-behavior relationship where highly vested individuals are more likely to behave in attitudinally-consistent ways. Vestedness is conceptualized as five distinct and observable variables: salience, certainty, immediacy, self-efficacy, and response-efficacy. To test VIT's efficacy in this context, a survey was conducted with participants crowdsourced from Amazon's Mechanical Turk platform (N = 1053). Participants responded to items designed to measure their individual vestedness in ACC consequences, risk perceptions, and behavioral intentions. This initial investigation shows that VIT's constituent variables predict consequential amounts of observed variance in critical variables including risk perception, perceived event severity, and behavioral intentions related to ACC hazard mitigation. The results support the use of VIT as a framework for understanding attitude-behavior relationships associated with ACC mitigation. Based on these findings, we argue that VIT can also serve as a valuable message design framework to motivate ACC-related mitigation actions.

Social vulnerabilities among immigrants and refugees in emergencies and disasters: a systematic review

Background

Due to cultural, economic, and societal factors, immigrants and refugees are pivotal groups in dealing with social vulnerability in disasters. Ignoring or inadequate attention to those groups in preparing for and responding to disasters and health emergencies could decrease the effectiveness of efforts. This article aims to identify the most basic social vulnerabilities among immigrants and refugees and provide effective solutions to alleviate or eliminate these vulnerabilities.

Methods

This systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The main keywords include Social Vulnerabilities, Immigrants, Refugees, and Disasters. All articles published up to February 2023 were reviewed regardless of language and location. A total of 575 articles were extracted from SCOPUS, Web of Science, ScienceDirect, ProQuest, PubMed, EMBASE, and PsycINFO databases, and finally, 14 articles were selected for full-text analysis. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to evaluate the quality of the selected articles.

Results

Fourteen articles including 4 qualitative and 10 quantitative articles were selected and analyzed in this review. The findings showed: 1. According to the consensus of the studies, the most vulnerable people who need urgent care during an epidemic due to their special conditions are immigrants and refugees; 2. In most countries, no database provides reliable, up-to-date, and accurate statistics about these people; 3. Refugees usually hesitate to express their vulnerability and receive services due to the fear of deportation; and 4. The main challenges faced by refugees are socio-economic problems such as language problems, lack of emotional and social support, and living in crowded places.

Conclusion

Considering the prevalence of migration among countries, it is essential to identify the social problems and vulnerabilities of immigrants and provide effective solutions to cope with their challenges, especially during crises and emergencies.

Systematic review registration

https://clinicaltrials.gov/, identifier CRD42022371345.

Climate and environmental changes exacerbate health disparities in pregnant people and their offspring. How can we protect women and their babies?

BACKGROUND

The effects of climate and environmental changes (CEC) are being felt globally and will worsen over the next decade unless significant changes are made on a global level. Climate change is having serious consequences for health, particularly for vulnerable women and their offspring and less resilient individuals in communities with socioeconomic inequalities. To protect human health from CEC effects, efforts need to be directed toward building resilience strategies. Building political and economic power, as well as directly addressing CEC-related challenges, are critical components of climate resilience. Effective communication and tailored methods to engage women in preventive strategies are also necessary to ameliorate the deleterious effects of CEC on women's health. Furthermore, women from marginalized communities face more CEC-associated challenges.

CONCLUSIONS

Therefore, effective policies and programs targeting these at-risk populations-are crucial to improve the overall state of global health. In closing, it is time to increase awareness of the effects of CECs on women's health and their transgenerational effects in order to ensure that all people, regardless of race, ethnicity, education and income are protected from the detrimental effects of CECs.

Dietary quality and cardiometabolic indicators in the USA: A comparison of the Planetary Health Diet Index, Healthy Eating Index-2015, and Dietary Approaches to Stop Hypertension

BACKGROUND

The Planetary Health Diet Index (PHDI) measures adherence to the sustainable dietary guidance proposed by the EAT-Lancet Commission on Food, Planet, Health. To justify incorporating sustainable dietary guidance such as the PHDI in the US, the index needs to be compared to health-focused dietary recommendations already in use. The objectives of this study were to compare the how the Planetary Health Diet Index (PHDI), the Healthy Eating Index-2015 (HEI-2015) and Dietary Approaches to Stop Hypertension (DASH) relate to cardiometabolic risk factors.

METHODS AND FINDINGS

Participants from the National Health and Nutrition Examination Survey (2015-2018) were assigned a score for each dietary index. We examined disparities in dietary quality for each index. We used linear and logistic regression to assess the association of standardized dietary index values with waist circumference, blood pressure, HDL-C, fasting plasma glucose (FPG) and triglycerides (TG). We also dichotomized the cardiometabolic indicators using the cutoffs for the Metabolic Syndrome and used logistic regression to assess the relationship of the standardized dietary index values with binary cardiometabolic risk factors. We observed diet quality disparities for populations that were Black, Hispanic, low-income, and low-education. Higher diet quality was associated with improved continuous and binary cardiometabolic risk factors, although higher PHDI was not associated with high FPG and was the only index associated with lower TG. These patterns remained consistent in sensitivity analyses.

CONCLUSIONS

Sustainability-focused dietary recommendations such as the PHDI have similar cross-sectional associations with cardiometabolic risk as HEI-2015 or DASH. Health-focused dietary guidelines such as the forthcoming 2025-2030 Dietary Guidelines for Americans can consider the environmental impact of diet and still promote cardiometabolic health.

Mapping social vulnerability indicators to understand the health impacts of climate change: a scoping review

The need to assess and measure how social vulnerability influences the health impacts of climate change has resulted in a rapidly growing body of research literature. To date, there has been no overarching, systematic examination of where this evidence is concentrated and what inferences can be made. This scoping review provides an overview of studies published between 2012 and 2022 on social vulnerability to the negative health effects of climate change. Of the 2115 studies identified from four bibliographic databases (Scopus, Web of Science, PubMed, and CAB Direct), 230 that considered indicators of social vulnerability to climate change impacts on health outcomes were selected for review. Frequency and thematic analyses were conducted to establish the scope of the social vulnerability indicators, climate change impacts, and health conditions studied, and the substantive themes and findings of this research. 113 indicators of social vulnerability covering 15 themes were identified, with a small set of indicators receiving most of the research attention, including age, sex, ethnicity, education, income, poverty, unemployment, access to green and blue spaces, access to health services, social isolation, and population density. The results reveal an undertheorisation and few indicators that conceptualise and operationalise social vulnerability beyond individual sociodemographic characteristics by identifying structural and institutional dimensions of vulnerability, and a preponderance of social vulnerability research in high-income countries. This Review highlights the need for future research, data infrastructure, and policy attention to address structural, institutional, and sociopolitical conditions, which will better support climate resilience and adaptation planning.

Coping With Disasters and Pandemics Through Experience and Community: How African American Older Adults Navigate Disaster Planning, Response, and Recovery

OBJECTIVE

Studies have reported that minorities are disproportionately impacted by the COVID-19 pandemic. Few studies have elucidated the lived experiences of African American older adults, and the resiliency displayed in combatting the COVID-19 pandemic and other disasters.

METHODS

This study used 4 recorded focus groups with 26 African American older adults who have spent most of their lives living in Houston, Texas to assess safety, economic, and health concerns related to the pandemic and similarities or differences with other types of disasters that are specific to Houston/ the Gulf Region of Texas, such as Hurricane Harvey.

RESULTS

Key themes emerged from the thematic analysis: 1) previous disasters provided important coping and preparation skills, although each occurrence was still a major stressor, 2) while telehealth was a significant benefit, regular health maintenance and chronic disease management were not completed during the COVID-19 pandemic, 3) information from the federal and state authorities were inconsistent and spurred fear and anxiety, 4) participants experienced few to no disruptions to their income but were heavily called on to support family members, and 5) participants experienced anxiety and isolation, but many used existing social connections to cope.

CONCLUSIONS

These findings demonstrate how African American older adults navigate disaster response and recovery through experience and community. Providing unambiguous information to older adults could prove useful in preparing for future disaster events and coping with disasters.

Optimizing Disaster Preparedness Planning for Minority Older Adults: One Size Does Not Fit All

By 2050, one in five Americans will be 65 years and older. The growing proportion of older adults in the U.S. population has implications for many aspects of health including disaster preparedness. This study assessed correlates of disaster preparedness among community-dwelling minority older adults and explored unique differences for African American and Hispanic older adults. An electronic survey was disseminated to older minority adults 55+, between November 2020 and January 2021 (n = 522). An empirical framework was used to contextualize 12 disaster-related activities into survival an0000000d planning actions. Multivariate logistic regression models were stratified by race/ethnicity to examine the correlates of survival and planning actions in African American and Hispanic older adults, separately. We found that approximately 6 in 10 older minority adults did not perceive themselves to be disaster prepared. Medicare coverage was positively associated with survival and planning actions. Income level and prior experience with disaster were related to survival actions in the African American population. In conclusion, recognizing the gaps in disaster-preparedness in elderly minority communities can inform culturally sensitive interventions to improve disaster preparedness and recovery.

Economic and mental health impacts of multiple adverse events: Hurricane Harvey, other flooding events, and the COVID-19 pandemic

OBJECTIVES

To assess the economic and mental health impacts of COVID-19 in the presence of previous exposure to flooding events.

METHODS

Starting in April 2018, the Texas Flood Registry (TFR) invited residents to complete an online survey regarding their experiences with Hurricane Harvey and subsequent flooding events. Starting in April 2020, participants nationwide were invited to complete a brief online survey on their experiences during the pandemic. This study includes participants in the TFR (N = 20,754) and the COVID-19 Registry (N = 8568) through October 2020 (joint N = 2929). Logistic regression and generalized estimating equations were used to examine the relationship between exposure to flooding events and the economic and mental health impacts of COVID-19.

RESULTS

Among COVID-19 registrants, 21% experienced moderate to severe anxiety during the pandemic, and 7% and 12% of households had difficulty paying rent and bills, respectively. Approximately 17% of Black and 15% of Hispanic households had difficulty paying rent, compared to 5% of non-Hispanic white households. The odds of COVID-19 income loss are 1.20 (1.02, 1.40) times higher for those who previously had storm-related home damage compared to those who did not and 3.84 (3.25-4.55) times higher for those who experienced Harvey income loss compared to those who did not. For registrants for whom Harvey was a severe impact event, the odds of having more severe anxiety during the pandemic are 5.14 (4.02, 6.58) times higher than among registrants for whom Harvey was a no meaningful impact event.

CONCLUSIONS

Multiple crises can jointly and cumulatively shape health and wellbeing outcomes. This knowledge can help craft emergency preparation and intervention programs.

Emergency food distribution efforts in New Orleans, LA after Hurricane Ida

Background

The provision of food aid after a natural disaster is necessary to prevent hunger, particularly in low-resourced and low-income communities. Little is known about the operational challenges associated with ensuring equitable distribution of emergency food resources to communities in need following a disaster. To address this gap, this study assessed emergency food distribution efforts in New Orleans, LA during the 2 weeks following Hurricane Ida's landfall on August 29, 2021.

Methods

Information on free food distribution events was gathered from online sources. A list of distribution sites was generated that included data on operational logistics (e.g., address, days of operation, hours of operation, etc.), food offerings (e.g., prepared meals, groceries, etc.), and socio-demographic characteristics of the surrounding community. Geospatial mapping and bivariate analyses were used to analyze the site data.

Results

Seventy-four distribution sites operated in the 2 weeks after Hurricane Ida. Approximately 47.3% were located in census tracts with >80% Black residents, and 39.2% were in tracts with >30% poverty. A large proportion of sites offered prepared meals (86.2%) and only operated 1 day (36.5%). Tracts with >80% Black residents had more sites that operated only 1 day (p = 0.04). Tracts with >30% poverty had more sites that started distributing food resources 7-15 days after the hurricane (p = 0.02).

Conclusions

Most low-income and low-resourced communities in New Orleans had access to emergency food resources; however, several limitations in operations were identified that may have influenced access. Future initiatives to prevent hunger after a natural disaster in New Orleans, and elsewhere, should improve operational logistics for food aid.

Engaging the Houston Community in Research: An Early Case Study of a Community Engagement Core in the University of Houston's HEALTH Center for Addictions Research and Cancer Prevention

Objective

The National Institute on Minority Health and Health Disparities-funded U54 Research Center at the University of Houston addresses disparate racial/ethnic health outcomes related to cancer and substance abuse. Of its 4 cores, the Community Engagement Core involves the impacted community in affiliated research. Strategies include implementing community advisory boards, assisting with study design and execution, maintaining a social media presence, and publishing health-related videos for the community. We examine the early effectiveness of these strategies.

Methods

Data collection included surveying investigators and community advisory board members and monitoring traffic to videos and social media posts.

Results

On a Likert scale survey of investigators (4 = "agree" and 5 = "strongly agree"), the mean rating for a prompt expressing satisfaction with services received was 4.67 (SD = 0.52; N = 6). On a Likert scale survey of community advisory board members, the mean rating for a prompt expressing belief that feedback was taken seriously was 5.00 (SD = 0.00; N = 9).

Conclusions

The Community Engagement Core is building trusting relationships between researchers and community members. We discuss lessons learned that may inform both our growth and others' efforts to implement community-engaged research.

Social connectedness, mindfulness, and coping as protective factors during the COVID-19 pandemic

The COVID-19 pandemic has had an unprecedented psychological impact, revealing immense emotional disturbances among the general population. This study examined the extent to which social connectedness, dispositional mindfulness, and coping moderate symptoms of anxiety and depression in 1242 adults under the same government-issued COVID-19 stay-at-home mandate. Participants completed measures of anxiety, depression, dispositional mindfulness, social connectedness, and coping, and regression analyses were used to examine associations and interaction effects. Results indicated that social connectedness and dispositional mindfulness were associated with reduced symptoms. For individuals living with a partner, decreased mindfulness and avoidant coping were associated with anxious symptoms. In households with children, overutilization of approach coping served to increase symptoms of depression. Results indicate the importance of considering social connectedness, mindfulness, and coping in counseling to enhance factors serving to protect clients during a public health crisis. Implications for professional counselors and areas of future research are discussed.