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.
Most disaster studies rely on convenience sampling and ‘after‐only’ designs to assess impacts. This paper, focusing on Hurricane Harvey (2017) and leveraging a pre‐/post‐event sample of Greater Houston households (n=71) in the United States, establishes baselines for disaster preparedness and home structure flood hazard mitigation, explores household‐level ramifications, and examines how preparedness and mitigation relate to health effects, event exposures, and recovery. Between 70 and 80 per cent of participants instituted preparedness measures. Mitigation actions varied: six per cent had interior drainage systems and 83 per cent had elevated indoor heating/cooling components. Sixty per cent reported home damage. One‐half highlighted allergies and two‐thirds indicated some level of post‐traumatic stress (PTS). Three‐quarters worried about family members/friends. The results of generalised linear models revealed that greater pre‐ event mitigation was associated with fewer physical health problems and adverse experiences, lower PTS, and faster recovery. The study design exposed the broad benefits of home structure flood hazard mitigation for households after Harvey.
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