Hurricanes, Response, and Community Health Resilience

Abstract

Natural and human-made disasters, including earthquakes, floods, cyber-security threats, and antimicrobial resistance, collectively continue to strain local economies and affect communities worldwide in a multiplicity of ways, demanding international response and posing ongoing logistical hurdles (Nicogossian & Stabile, 2015). Natural disasters can strike anywhere and do not discriminate between developed and developing countries, though affluence certainly eases the always arduous recovery process. Geographic location and proximity to natural resources and products supporting major commercial nodes are major challenges facing many communities is the aftermath of disasters, with dire implications for human health. Hurricanes and tropical storms regularly affect coastal regions during specific months of the year. The population of coastal regions is steadily increasing, and expanding urbanization usually brings geographic and ecological changes. Two-thirds of annual coastal disasters are associated with extreme weather events, such as tornadoes, destructive wind, and flooding, and these are part of a “trend that is expected to continue into the future … due to climate change and sea level rise” (Newmann, Vafeidis, Zimmermann, & Nicholls, 2015). Such disasters are attributable in part to the documented contribution of human activities (Nicogossian, Stabile, Kloiber, & Septimus, 2017). The severe impacts of multiple hurricanes that devastated and flooded Florida, Caribbean islands, the Gulf Coast of Texas and Mexico, and Puerto Rico, in 2017 are unfortunate reminders of the severe and worsening challenges facing coastal communities. While there has been marked improvement in disaster response, including early warnings and large-scale evacuations, community recovery is still problematic. The aftermath of such disasters can result in unnecessary loss of life and astronomical costs. Flooding, infections, mold, and exposure to environmental and industrial hazards continue to hamper recovery. Natural or human-made disasters can overwhelm the ability of communities and even governments to care for those affected. Socioeconomic disparities and post-traumatic stress disorders demand continuous attention (Nicogossian et al., 2012). Frail elderly people are particularly vulnerable during hurricanes (McCann, 2015). Evidence that the poor, children, elderly, and those afflicted with chronic health disorders are at a higher risk for morbidity and mortality is mounting. Since 2001, disease-surveillance, provision of public health services (vaccines, antibiotics), ability to deliver care in the event of mass casualties (surge capacity) and community resiliency have all become essential elements of preparedness. In the United States, health-care readiness is part of homeland security preparedness, and is not viewed as an extension of daily emergency response. Disaster response and resilience requires continuous training and the ability to respond with measured and appropriate surge capacity. Standards of care, interoperability, and coordination of response to disasters have been developed, adopted and continue to be improved upon (Gostin & Hanfling, 2009; Gostin et al., 2010; Hanfling & Llewellyn, 2014). Planning and building resilience in coastal regions should address all of the above four areas of interest, in addition to long-term community support and better engineering of human settlements. The goals of health-care facility preparedness should encompass planning and training, not only for medical and emergency response personnel, but for the community. Availability of military resources and rapid deployment are also essential to ensure survival, rescue, and humanitarian assistance. The 2017 hurricane season enhanced the urgency of addressing human activities’ contributions to climate change and coastal vulnerabilities. We are still trying to develop better predictive models of such interactions based on evidence to guide mitigating strategies (Adger, Hughes, Folke, Carpenter, & Rockström, 2005; Janssen & Ostrom, 2006; Rose & Shu-Yi, 2005). Adequate research funding is a must to address disaster mitigation strategies and develop reliable warning systems. We do encourage the submission of manuscripts addressing policies and practices for disaster mitigation and community health resilience. Finally, we would like to offer special thanks to our Editorial Board members, contributors, and readership, and wish you all a happy and prosperous 2018.