The impact of climate change and natural disasters on vulnerable populations: A systematic review of literature

To shed light on how the public health community can promote the recovery of Hurricane Katrina victims and protect people in future disasters, we examined the experiences of evacuees housed in Houston area shelters 2 weeks after the hurricane. A survey was conducted September 10 through 12, 2005, with 680 randomly selected respondents who were evacuated to Houston from the Gulf Coast as a result of Hurricane Katrina. Interviews were conducted in Red Cross shelters in the greater Houston area. Many evacuees suffered physical and emotional stress during the storm and its aftermath, including going without adequate food and water. In comparison with New Orleans and Louisiana residents overall, disproportionate numbers of this group were African American, had low incomes, and had no health insurance coverage. Many had chronic health conditions and relied heavily on the New Orleans public hospital system, which was destroyed in the storm. Our results highlight the need for better plans for emergency communication and evacuation of low-income and disabled citizens in future disasters and shed light on choices facing policymakers in planning for the long-term health care needs of vulnerable populations.

Previous studies in the aftermath of natural disasters have demonstrated relationships between four dimensions of displacement - geographic distance from the predisaster community, type of postdisaster housing, number of postdisaster moves, and time spent in temporary housing - and adverse psychological outcomes. However, to date no study has explored how these dimensions operate in tandem. The literature is further limited by a reliance on postdisaster data. We addressed these limitations in a study of low-income parents, predominantly non-Hispanic Black single mothers, who survived Hurricane Katrina and who completed pre and postdisaster assessments (N = 392). Using latent profile analysis, we demonstrated three profiles of displacement experiences within the sample: (1) returned, characterized by return to a predisaster community; (2) relocated, characterized by relocation to a new community, and (3) unstably housed, characterized by long periods in temporary housing and multiple moves. Using regression analyses, we assessed the relationship between displacement profiles and three mental health outcomes (general psychological distress, posttraumatic stress, and perceived stress), controlling for predisaster characteristics and mental health indices and hurricane-related experiences. Relative to participants in the returned profile, those in the relocated profile had significantly higher general psychological distress and perceived stress, and those in the unstably housed profile had significantly higher perceived stress. Based on these results, we suggest interventions and policies that reduce postdisaster housing instability and prioritize mental health services in communities receiving evacuees.

Examination of social capital and its relationship to disaster preparedness has grown in prominence partially due to world-wide need to effectively respond to terrorist attacks, viral epidemics, or natural disasters. Recent studies suggested that social capital may be related to a community's ability to plan for and respond to such disasters. Few studies, however, have examined social capital constructs among low income populations living in disaster prone areas and accounted for the influence of social capital at the individual and community level. We examined social capital as measured by perceived fairness, perceived civic trust, perceived reciprocity and group membership. We undertook a multistage random cluster survey in three coastal counties in Texas (U.S.) noted for their high levels of poverty. Individuals from 3088 households provided data on social capital, socioeconomic and demographic characteristics, and self-reported level of preparedness for a hurricane. We used multivariable logistic regression to test potential associations between social capital measures and disaster preparedness. After adjusting for age, gender, marital status, ethnicity, education, employment, household income, acculturation, self-reported health, special needs persons in household, household size, and distance to the shore we found a higher prevalence of preparedness among individuals who reported the highest perception of fairness [AOR = 3.12, 95% CI: (1.86, 5.21)] compared to those individuals who reported lowest perceptions of fairness. We also found a higher prevalence of preparedness [AOR = 2.06; 95% CI: (1.17, 3.62)] among individuals who reported highest perceptions of trust compared to individuals who reported lowest perceptions of trust. Perceived reciprocity and group membership were not associated with preparedness. These results extend previous findings on social capital and disaster preparedness and further characterize social capital's presence among a low income population living in a hurricane prone area. Copyright © 2013 Elsevier Ltd. All rights reserved.