Compounding Effects of Social Vulnerability and Recurring Natural Disasters on Mental and Physical Health

Abstract

Objective: This study evaluated the relationships between the occurrence of recent and recurring natural disasters on the incidence of acute and chronic health outcomes at the census tract level in 500 cities across the United States between 2001 and 2015. Methods: Using the Centers for Disease Control and Prevention (CDC) 500 cities data set, the CDC Social Vulnerability Index, and the US Small Business Administration (SBA) Disaster Loan Database, we modeled the incidence of self-reported, poor mental and physical health, or a clinical diagnosis of high blood pressure or asthma in census tracts (N = 27 204 tracts in 500 cities) that had experienced recent or recurring natural disasters while controlling for social and environmental risk factors. Results: Communities that experienced a natural disaster in the previous 5 years compared to those that had not had a higher incidence of poor mental health (RR: 1.02, 95% CI: 1.01-1.02), poor physical health (RR: 1.03, 95% CI: 1.02-1.04), high blood pressure (RR: 1.04, 95% CI: 1.02-1.05), and asthma (RR: 1.01, 95% CI: 1.01-1.02). The incidence of these poor health outcomes increased 1-2% with each additional year that a community experienced a disaster. Conclusions: Prevention and preparedness plans that work to build resilience in communities before disasters should focus on closing the gap in environmental and social determinants that have been linked with disproportionate health burdens and slow recovery post-disaster.

Public health implications of multiple disaster exposures

“…However, we found an emerging body of literature on the inequitable effects of multiple disaster exposures on physical health, mental health, and recovery processes at the community level. Hahn and colleagues 128 found that communities in the USA that had medium or high ratings on the Centers for Disease Control and Prevention Social Vulnerability Index (built from data on poverty levels, employment, educational attainment, and more) had the highest incidences of self-reported poor mental health, poor physical health, asthma, and high blood pressure after exposure to multiple disasters. Morgan and colleagues 121 found uneven trajectories of wellbeing and quality-of-life scores in the aftermath of the 2010 and 2011 Christchurch earthquakes in New Zealand.…”

“…82 Physical health 16 articles focused on physical health after multiple disasters. 75,76,79,80,[122][123][124][125][126][127][128][129][130][131][132][133] One study, which looked at 500 com munities across the USA, found that those who had experienced recurring disasters had increased incidences of asthma, high blood pressure, and self-reported poor mental health and poor physical health. Moreover, the incidence of all such outcomes increased with each additional year in which a community experienced a disaster.…”

“…Moreover, the incidence of all such outcomes increased with each additional year in which a community experienced a disaster. 128 After Hurricane Katrina and the Deepwater Horizon oil spill in the Gulf Coast of the USA, one study (focused primarily on mental health) found that people exposed to both of these disasters had more physical health symptoms than did populations exposed to only one of the disasters, 41 suggesting a cumulative effect. These studies highlight that exposure to multiple disasters can be associated with poorer self-rated health or increased physical health symptoms than exposure to one disaster.…”

Social vulnerability indicators to the Health Impacts of Climate Change: A Scoping Review

“…Multiple social vulnerability indices include race or ethnicity based indicators for social vulnerability which have been found to be good predictors of susceptibility to heat (21,22,26,32,37,44,46,58,72,95,98,111,116,119,(158)(159)(160)(161)(162)(163)(164). This is attributed to the history of structural disadvantage and discrimination faced by minority communities (111,112).…”

What's new in critical illness and injury science? The effect of concomitant natural and manmade disasters on chronic disease exacerbations: COVID-19, armed conflicts, refugee crises and research needs

“…[ 2 ] Postdisaster increases in mental and behavioral health comorbidities, obesity, hypertension, atrial fibrillation, cardio-cerebrovascular disease, respiratory problems, diabetes, gastrointestinal diseases, chronic kidney disease, eye disease, arthritis, and others have been observed. [ 2 3 18 19 20 21 ]…”