Hurricanes: A Public Health Issue

By: Imani Brooks

September is National Preparedness Month. At the start of this month, Hurricane Dorian demonstrated the serious need to learn about how hurricanes are in fact a public health issue. 

Hurricane season runs from June 1 to November 30. Hurricane Dorian hit the Atlantic and Caribbean regions as a Category 5 storm. The Bahamas were hit the heaviest, with the current death toll at least 50 and 1,300 people still missing. As Dorian headed north, governors of states along the US East Coast declared states of emergencies.

This kind of natural disaster poses threats beyond physical destruction to impact community and individual health. Preparedness is crucial and can counteract the devastating impact of hurricane conditions. The most common lesson learned from hurricanes is that it is important to have an emergency preparation plan for medication, food and water before and after the hurricane hits.

Floodwater is a common source of public health problems following hurricanes.

Preparation for hurricanes, and any natural disaster, must occur on an individual and community level to produce a helpful understanding of local risks and resources for possible victims. Preparation and response agencies, including the Federal Emergency Management Agency (FEMA) and their state level counterparts, the National Guard, the U.S. Department of State, and USAID, are critical resources for local and state communities. Concerning hurricanes, public health actions can and should include any of the following:

• “Assessing the public health/medical needs of the affected communities
• Maintaining public health surveillance to detect an increase in disaster-related illnesses and injuries
• Ensuring that proper and sufficient medical care personnel and supplies are availabe
• Helping coordinate patient movement
• Monitoring the safety and security of medicines, blood products and services, and food
• Addressing important environmental issues such as vector control and solid and hazardous waster management
• Providing needed mental health and substance abuse care
• Working to help identify and respectfully handle the remains of those lost.”

Floodwater is a common source of public health problems following hurricanes. Unfortunately, it is an ideal source for transmission of bacteria. Bacteria in floodwaters makes recovering property and belongings dangerous as homes are more likely to mold. Further this can create mold in homes, which, according to the Institute for Global Health and Infectious Diseases at University of North Carolina, Chapel Hill, are particularly dangerous for the elderly and people with weak immune systems.

In trying to evacuate, wading through dirty water becomes even more dangerous if power lines are in the water as well as bacteria. Additionally, the combination of unsafe water and losing electricity can make food inedible food, which may lead to E. coli outbreaks. Furthermore, heavy rainfall forms pools of water attract mosquitoes, creating opportunities to transmit diseases.

Thankfully, there are some preventative measures for the above issues from floodwater. Making sure to have and use bug repellent and increasing a household’s stock of clean water are good preventative measures to ensure clean drinking sources and food. Advisories regarding boiling or filtering water can prevent water borne diseases and infections as well.

Another side of public health issues from hurricanes is mental health. During Hurricane Katrina, about 10% of the effected population had post-traumatic stress disorder (PTSD) and depression. In addition to the initial trauma from hurricanes, stress impedes a person’s health the longer she is displaced and recovering.

Grief from loss; disruptions in health care services; exacerbation of pre-existing issues; uncertainty about daily regiments like work, schooling; and other stressors related to evacuation, devastation, and rebuilding can also negatively impact mental health. When people with preexisting or emerging mental health concerns relocate to shelters, they often have a difficult time locating and accessing support and rehabilitative resources. And recovery is rarely quick. Survivors can experience guilt and/or trauma that stays with them long after the physical damage of a hurricane is fixed.

As was the case with Hurricane Harvey, social media can be a good source of information to increase preparedness. But the public health and preparedness conversation must continue before, during, and after a disaster to lower the health risks in the future. Programs that enable collaboration and better capacities across state territorial, local, and tribal public health agencies will improve daily responsiveness and disaster-related responsiveness.

In response to Hurricane Harvey and Maria, the University of North Carolina Chapel Hill encouraged community development projects that focus on flood resilience, social and community cohesion, equity, history and culture, and quality of life. Knowing the areas for focus is important, but the people and organizations behind efforts have yet to be critically analyzed and critiqued even with more and more evidence of failing procedures and resource allocation. Jeanne S. Ringel, a public health researcher and author at RAND Corporation, has published a toolkit for state and local planning for public health emergencies that can be applied to hurricane disasters as well. Speaking to an audience of state and local agencies, Ringel’s toolkit includes strategies, practices and resources for specific vulnerabilities amongst special needs populations. Interestingly, a few of her strategies emphasize including community members in emergency preparedness preparation to best meet the needs of the community.[1]

References

1. Ringel, J., Chandra, A., Williams, M., Ricci, K., Felton, A., Adamson, D., . . . Huang, M. (2009). SUMMARY. In Enhancing Public Health Emergency Preparedness for Special Needs Populations: A Toolkit for State and Local Planning and Response(pp. 5-9). RAND Corporation. Retrieved from http://www.jstor.org/stable/10.7249/tr681dhhs.4