Assessing the Flood Vulnerability of Opioid Treatment Facilities in Houston, Texas: A Case Study of Hurricane Harvey

Abstract

Background: Hurricanes are associated with disruption in access to medical services, especially for socially vulnerable populations. This study aimed to (1) estimate the proportion of opioid treatment program (OTP) facilities in Harris County, Texas, and (2) estimate the proportion of OTP facilities flooded during Hurricane Harvey in the county. Methods: The spatial locations of OTP facilities in Harris County were geocoded using ArcGIS Online®. The Federal Emergency Management Agency's Flood Insurance Rate Map was overlaid to assess the flood risk of each OTP facility. Hurricane Harvey's inundation map was also superimposed to estimate the proportion of OTP facilities flooded after the hurricane. For OTPs not inundated by the hurricane, we assessed their accessibility by creating a 1 km buffer radius within each facility and examining the inundation status of the area. Results: There were 14 OTP facilities in Harris County, serving a total of 2947 opioid-dependent patients. Seven percent of the facilities were in a high-risk flood zone and 93% were in areas of low-to-moderate flood risk. Hurricane Harvey inundated 7.1% of the facilities. However, of the 92.9% facilities not inundated by the hurricane, 61.5% were within a kilometer of an inundation area. Conclusions: Hurricane Harvey inundated 7.1% of OTP facilities in Harris County, Texas. Of the facilities not inundated, 100% were at low-to-moderate risk of flooding, and 61.5% were within a kilometer of an inundation area. Public health measures must be taken to enhance the resilience of OTP facilities in the county during disasters.