Student Name

Vulnerable Populations and Natural Disasters

What is a vulnerable population?
Vulnerable populations include patients who are racial or ethnic minorities, children, elderly, socioeconomically disadvantaged, underinsured or those with certain medical conditions.
Vulnerability is the degree to which a population, individual or organization is unable to anticipate, cope with, resist and recover from the impacts of disasters. Environmental health in emergencies and disasters: a practical guide. (WHO, 2002)

https://www.ncbi.nlm.nih.gov/pubmed/23385323
http://www.who.int/environmental_health_emergencies/vulnerable_groups/en/
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Who is vulnerable?
In general, vulnerability is greater among people at age extremes (young and old), with low incomes, members of minority populations, and those with special health or medical needs.
Social vulnerability is partially a product of social inequalities—those social factors and forces that create the susceptibility of various groups to harm, and in turn affect their ability to respond, and bounce back (resilience) after the disaster.

Who is Vulnerable During Hurricanes: 6 Things to Know

http://understandingkatrina.ssrc.org/Cutter/

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Socio-economic status
Those of lower socio-economic standing tend to live in more polluted, less secure, and high-risk environments. It has been suggested that their environment receives less protection than other regions, creating a vicious cycle of ever-increasing risk. Independent of location and environment, structurally poor quality housing often is a proxy for poverty and ethnic minorities, and is more likely to collapse during a disaster.
The socio-economic disparities that contributed to this suffering are not always acknowledged or considered. Disaster planning should emphasize those at greater risk, and understand that many “risks” are societal; not physiological.

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.176.2958&rep=rep1&type=pdf
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evacuations
Evacuation not only requires a method of transportation, but involves the risk of missing work, the cost of food, and a place to stay.

Costs of evacuations include hotels, food, transportation, missed work days, ect. Which can reach thousands of dollars and may not be feasible for those who are poor.
The mandatory evacuation above was issued the day after my family was RESCUED and hundreds of homes around us had FEET of water in them already. People with no family or those without phones or internet who did not know about evacuations were at extreme risk during this time.
“Anyone who chooses to not heed this directive cannont expect to be rescued and should write their social security numbers in permanent marker on their arm so their bodies can be identified. The loss of life and property is certain. GET OUT OR DIE!“ These people who live along the river, many have been there for generations and were being evacuated immediately, many with no funds prepared nor places to go.
https://pdfs.semanticscholar.org/4b89/a3f37f6994577f22b6e51cbd1c0cc68deaa6
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Recovery
Those without resources are more likely to end up in shelters and remain in them. Home repairs require money. Public housing units and rental units tend to be repaired more slowly. The poor and ethnic minorities are less likely to have insurance, and also more likely to lose their jobs. Work for-pay programs may split families, with one going “where the work is” leaving the spouse to fend until their return. Even as the recovery phase evolves, the lower paying jobs and underground economy often is affected disproportionately.

Thousands and thousands of people did not have insurance on their homes and so many were already in poverty
About 80% were not insured
Many people will now have a mortgage as well as a loan to repair their home and will be upside down on their home- lead to poverty
Many people are living in travel trailers, which are not adequate for whole families to live in, living on the second story of their home that did not flood, tents and even in homes with non insulation, flooring or electricity or in homes with numerous other families or in portable buildings.
Many of these living situations are not adequate for living. Many people do not have a way in their home to wash clothes and the laundromat is miles from them. Many people do not have a kitchen adequate for cooking (or any kitchen at all). Some people are without heat or electricity or in structures without adequate insulation. These are al features of a healthy home.

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Effects
Affects peoples work ability
Affects health
Affects the built environment
Affected many schools
Has affected roadways
County will not clear ditches, homes are flooding all over again

Many people have missed work due to hurricane itself, working on home, work place being flooded, ect.
Has lead to chronic stress in many people. Many have expressed their complete and total exhaustion from the recovery and have expressed they have come down with more illnesses since the storm.
Harvey destroyed many homes, schools, churches, businesses, roadways, bridges, ect
Destroyed many schools. Destroyed 2/6 of Vidor schools, one elementary in portable buildings, middle school divided into junior high and high school
LCM- destroyed al but 2 schools. Had to divide students between 2 remaining schools and a church. Kids only went half days.
Has affected their education this year significantly- missed month of school, many had to attend counseling sessions
Many roadways have to be redone due to the rushing water
Homes and roads flooding again due to county not having funds to rent or buy equipment to properly clear ditches
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Health effects
Short Term
Deaths from storm
Health issues immediately after or during storm
Various dangers while evacuations or performing rescues
Dangers while cleaning up from storm
Lack of clean water
Long Term
PTSD
Lack of adequate housing or housing features can have consequences
Recovery can last months and years leading to extreme stress

During Harvey Beaumont, TX water plant went under water and for several days the residents had no access to water and were also trapped in their homes.
People who suffer from heart conditions will be experiencing extreme addition stress and could lead to health issues
During rescues and evacuations there are many dangers. Those who are poor may not be able to evacuate and will have to be rescued or face dangers such as structural collapse, fire danger, ect. Rescuers face many dangers such as electrocution, drowning, ect.
Dangers while cleaning up from the storm include bacteria, tetanus, ect- low income may not be able to access proper equipment to clean up, or shots to protect themselves
PDST is rampant after major disasters in which you were rescued
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Orange County, tx
Approximately 26,000 homes affected
Housing units, July 1, 2016: 36,755
Median household income, 2012-2016: $51,443
Per capita income in past 12 months, 2012-2016: $26,611
Persons in poverty: 14.0%

How are people assisted?
FEMA has spent about $1.5 billion
$597 million has gone to local governments that have requested help rebuilding infrastructure like roads, bridges and levees.
The FEMA-administered National Flood Insurance Program, which enrolls homeowners who live in flood-prone areas that private insurance won’t cover, has paid out more than $8.2 billion in claims for Texans.
The federal agency could not say how much money had gone to pay for hotel rooms for Texas residents displaced by Harvey. At Texas’ request, federal administrators extended the hotel program until March 12 for many families.
Other Sources
In November, the U.S. Department of Housing and Urban Development announced Texas would receive just over $5 billion for long-term rebuilding efforts.
So far, the SBA has approved $3.1 billion in low-interest loans to homeowners and renters in Texas.
The Texas Health and Human Services Commission has spent more than $1.1 billion on Harvey relief, most of which came from the USDA’s food assistance program, according to state budget officials. The Texas
Workforce Commission has spent more than $20.6 million using federal funds for disaster unemployment benefits.

https://www.texastribune.org/2018/01/30/how-much-has-been-raised-harvey-relief-and-hows-it-being-spent/
This is how people are assisted after Harvey, but is how people are assisted after every storm.
USDA has also offer free school lunches to many school districts that were majorly affected and to families who are displaced- as talked about in the previous chapter children’s nutrition is extremely important and this is greatly helping ensure proper nutrition and taking this costs of families already having to pay for so much
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Conclusion
Disasters will happen. To lessen their impacts in the future, we need to reduce our social vulnerability and increase disaster resilience with improvements in the social conditions and living standards in our cities. We need to build (and rebuild) damaged housing and infrastructure in harmony with nature and design cities to be resilient to environmental threats even if it means smaller, more livable places, and fewer profits for land and urban developers and a smaller tax base for the city. Disasters are income neutral and color-blind. Their impacts, however, are not.

http://understandingkatrina.ssrc.org/Cutter/

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References
https://www.ncbi.nlm.nih.gov/pubmed/23385323

Who is Vulnerable During Hurricanes: 6 Things to Know

http://understandingkatrina.ssrc.org/Cutter/

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.176.2958&rep=rep1&type=pdf
https://pdfs.semanticscholar.org/4b89/a3f37f6994577f22b6e51cbd1c0cc68deaa6
https://www.texastribune.org/2018/01/30/how-much-has-been-raised-harvey-relief-and-hows-it-being-spent/

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The Built Environment and Public Health

Chapter 11: Mental health, stressors, and health care environments

Learning objectives
Describe the role of the developing field of sociology in the early twentieth century in understanding how cities might affect mental health
Discuss the association between immigration and health
Define biophilia
Compare the relative health impacts of urban versus rural living
Assess the contribution of density to health
Describe the concept of defensible space
Define evidence-based design
Identify the potential impacts of gentrification on health

Beginnings
Immigration and urbanization was believed to be a contributing factor to the breakdown in mental health and social order
The Chicago School of Sociology
Studied tenement districts
Helped define the impact of immigration to cities on mental health
Helped establish sociology as a profession
Anomie
The dislocation of people from traditional environments
Disestablished social norms
Thought to contribute to urban social problems

Immigration today
Acculturation
Immigrants adapt to their new country
Lose health practices and beliefs from their prior country
This may expose immigrants to new risks
Discrimination
Acculturation less of a factor in a globalized world
It is the influence of discrimination that leads to adverse health outcomes

Healthy immigrant effect
The Latino paradox
Mexicans in the US who were born in Mexico have better health outcomes and lower mortality than predicted by other factors
Their children are less likely to have these health advantages.

Latino Immigrants in the US: Key Health Indicators
< 5 Years in US Obesity Currently Smoking Diabetes Hypertension Cardiovascular Disease 16.100000000000001 15.3 6.9 13.4 3.5 5 or More Years in US Obesity Currently Smoking Diabetes Hypertension Cardiovascular Disease 22 13.8 7.5 19.8 5.4 Source: CDC Age Adjusted Percent Biophilia The hypothesis that people have an innate attraction to or need for nature Some evidence to support this Roger Ulrich’s hospital view studies Other studies which measure biological responses to pictures of open space Some evidence that children with ADHD are more attentive after nature walks Which is healthier, rule or urban living? Urban areas: Social problems appear to cluster in cities, related to clustering of unwanted land uses Lack of open space, higher pollution levels Rural areas Social isolation Tend to have higher rates of poverty Difficulty accessing hospitals and food sources Urban residents walk more, rural residents less. Density and health 1960s studies on rats appeared to demonstrate that high population densities lead to a breakdown of social order and “behavioral sinks” Reevaluation of these studies found that it was not overcrowding but withholding of food that led to behavioral problems Little evidence that high density communities in other countries foster social and mental problems Many of the most problematic communities in the US have lower densities than areas with less crime Defensible space Areas that are most unsafe feeling tend to be those where no one is watching or where no one seems to be in control of them Areas that are private or semi-private tend to be better maintained and have fewer crime issues Architectural modifications to promote defensible space: Private entries Private yards Windows on streets Stressors and allostatic load Continued exposure to stressors can lead to increased risk of morbidity and mortality The allostatic load represents the amount of stressors that have been affecting an individual over time A way to quantify cumulative risk and the constant day-to-day exposure Noise exposure and health Exposures to high noise environments can lead to health problems Example: stimulates the nervous system and creates a distress-like response Health facilities design Based upon the work of Ulrich and others Uses medical outcomes to assess the built environment Also being used to assess educational outcomes