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. 2020 Jul/Aug;135(4):511-523.
doi: 10.1177/0033354920930133. Epub 2020 Jun 15.

Disparities in Health Effects and Access to Health Care Among Houston Area Residents After Hurricane Harvey

Aaron B Flores  1   2 , Timothy W Collins  1   2 , Sara E Grineski  2   3 , Jayajit Chakraborty  4
Affiliations

Disparities in Health Effects and Access to Health Care Among Houston Area Residents After Hurricane Harvey

Aaron B Flores et al. Public Health Rep. 2020 Jul/Aug.

Abstract

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.

Keywords: Hurricane Harvey; disaster; flooding; health disparities.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Counties of the Houston–The Woodlands–Sugar Land, Texas, metropolitan statistical area, 2017. Data source: The flooded area is based on the Hurricane Harvey Inundation Footprint from the Federal Emergency Management Agency Region 6.
Figure 2
Figure 2
Data collection process for a post–Hurricane Harvey survey in the Houston–The Woodlands–Sugar Land, Texas, metropolitan statistical area (ie, Houston MSA), 2017.
See this image and copyright information in PMC

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