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Children have been theorized as vulnerable to the health consequences of climate change, but data limitations have hampered prior studies of climate-related disasters in the United States. In this article, the author exploits the interruption of a health survey in Houston by Hurricane Harvey, linked to local flooding data (n = 1,123, ages 5–17 years). Multivariable models on a matched sample show that Harvey led to worse parent-reported health among children six to nine months later, particularly in flooded communities. Further evidence suggests that household life disruption and home damage were key mechanisms and that severe exposure correlated with larger health declines among immigrants, including Hispanic and Asian or other-race children and those younger than 10 years. Integrating these findings with life-course theory and climate science, the author argues that through disasters, climate change should be conceptualized as a risk factor for heath and intragenerational disparities within cohorts and for intergenerational inequalities as newer cohorts experience more extreme weather.

In this article, we describe, decompose, and examine correlates of the geography of ethnoracial inequalities in low birth weight (LBW) in the United States. Drawing on the population of singleton births to U.S.-born White, Black, Latinx, and Native American parents in the first decade of the twenty-first century (N = 28.2 million births), we calculate county-level LBW rates and rate ratios. Results demonstrate a stark racial hierarchy in which Black infants experience the most significant disadvantage, but we also document substantial local-level variation organized in what we call a regionalized patchwork of inequality, with high-disparity counties bordering low-disparity counties coupled with regional clustering. Examining the component parts of local disparities – the LBW rates for Whites and groups of color - we find strong evidence that spatial variation in ethnoracial LBW inequalities is driven by greater variation in infants of color's health across counties relative to Whites. Further, LBW rates for groups of color are only weakly to moderately correlated with Whites' LBW rates, indicating that the same contexts can produce racially divergent health outcomes. Examining contextual factors that predict LBW disparities, we find that more segregated, socioeconomically unequal, and urban counties have larger LBW disparities. We conclude by positing an approach to health disparities that conceptualizes ethnoracial differences in health as fundamentally relational and spatial phenomena produced by systems of White advantage.

Physical Health Symptoms and Hurricane Katrina. 2021.

with M Zacher, MC Arcaya, SR Lowe, J Rhodes, & MC Waters

American Journal of Public Health

Objectives. To examine how physical health symptoms developed and resolved in response to Hurricane Katrina.
Methods. We used data from a 2003 to 2018 study of young, low-income mothers who were living in New Orleans, Louisiana, when Hurricane Katrina struck in 2005 (n = 276). We fit logistic regressions to model the odds of first reporting or “developing” headaches or migraines, back problems, and digestive problems, and of experiencing remission or “recovery” from previously reported symptoms, across surveys.
Results. The prevalence of each symptom increased after Hurricane Katrina, but the odds of developing symptoms shortly before versus after the storm were comparable. The number of traumatic experiences endured during Hurricane Katrina increased the odds of developing back and digestive problems just after the hurricane. Headaches or migraines and back problems that developed shortly after Hurricane Katrina were more likely to resolve than those that developed just before the storm.
Conclusions. While traumatic experiences endured in disasters such as Hurricane Katrina appear to prompt the development of new physical symptoms, disaster-induced symptoms may be less likely to persist or become chronic than those emerging for other reasons

Mitigating Health Disparities after Natural Disasters. 2020.

with MC Arcaya, SR Lowe, M Zacher, J Rhodes, & MC Waters

Health Affairs

Climate change exacerbates the severity of natural disasters, which disproportionately affect vulnerable populations. Mitigating disasters’ health consequences is critical to promoting health equity, but few studies have isolated the short- and long-term effects of disasters on vulnerable groups. We filled this gap by conducting a fifteen-year (2003–2018) prospective study of low-income, predominantly Black parents who experienced Hurricane Katrina: the Resilience in Survivors of Katrina (RISK) Project. Here we describe this project and synthesize lessons from work that has resulted from it. Our findings can guide policy makers, service providers, and health officials in disaster planning and response. We synthesize them into an organizational schema of five priorities: Primary efforts should be aimed at preventing exposure to trauma through investments in climate resilience and by eliminating impediments to evacuation, health care policies should promote uninterrupted and expanded access to care, social services should integrate and strive to reduce the administrative burden on survivors, programs should aid survivors in forging or strengthening connections to their communities, and policy makers should fund targeted long-term services for highly affected survivors.

Lessons from Hurricane Katrina for Predicting the Indirect Health Consequences of the COVID-19 Pandemic. 2020.

with M Zacher & SR Lowe

Proceedings of the National Academy of Sciences

Beyond their immediate effects on mortality, disasters have widespread, indirect impacts on mental and physical well-being by exposing survivors to stress and potential trauma. Identifying the disaster-related stressors that predict health adversity will help officials prepare for the coronavirus disease 2019 (COVID-19) pandemic. Using data from a prospective study of young, low-income mothers who survived Hurricane Katrina, we find that bereavement, fearing for loved ones’ well-being, and lacking access to medical care and medications predict adverse mental and physical health 1 y postdisaster, and some effects persist 12 y later. Adjusting for preexisting health and socioeconomic conditions attenuates, but does not eliminate, these associations. The findings, while drawn from a demographically unique sample, suggest that, to mitigate the indirect effects of COVID-19, lapses in medical care and medication use must be minimized, and public health resources should be directed to those with preexisting medical conditions, their social networks, and the bereaved.

Natural hazards and disasters distress populations and inflict damage on the built environment, but existing studies yield mixed results regarding their lasting demographic implications. I leverage variation across three decades of block group exposure to an exogenous and acute natural hazard—severe tornadoes—to focus conceptually on social vulnerability and to empirically assess local net demographic change. Using matching techniques and a difference-in-difference estimator, I find that severe tornadoes result in no net change in local population size but lead to compositional changes, whereby affected neighborhoods become more white and socioeconomically advantaged. Moderation models show that the effects are exacerbated for wealthier communities and that a federal disaster declaration does not mitigate the effects. I interpret the empirical findings as evidence of a displacement process by which economically disadvantaged residents are forcibly mobile, and economically advantaged and white locals rebuild rather than relocate. To make sense of demographic change after natural hazards, I advance an unequal replacement of social vulnerability framework that considers hazard attributes, geographic scale, and impacted local context. I conclude that the natural environment is consequential for the socio-spatial organization of communities and that a disaster declaration has little impact on mitigating this driver of neighborhood inequality.

The Social Consequences of Disasters. 2020.

with MC Arcaya & MC Waters

Annual Review of Sociology

We review the findings from the last decade of research on the effects of disasters, concentrating on three important themes: the differences between the recovery of places vs. people, the need to differentiate between short and long term recovery trajectories, and the changing role of government and how it has exacerbated inequality in recovery and engendered feedback loops that create greater vulnerability. We reflect the focus of the majority of sociological studies on disasters by concentrating our review on studies in the United States, but we also include studies on disasters throughout the world if they contribute to our empirical and theoretical understanding of disasters and their impacts. We end with a discussion of the inevitability of more severe disasters as climate change progresses and call on social scientists to develop new concepts and to use new methods to study these developments.

Twelve Years Later. 2019.

with SR Lowe, MC Arcaya, S Johnson, J Rhodes, & MC Waters

Social Science & Medicine

In August 2005, Hurricane Katrina caused unprecedented damage, widespread population displacement, and exposed Gulf Coast residents to traumatic events. The hurricane's adverse impact on survivors' mental health was apparent shortly after the storm and persisted, but no study has examined the long-term effects now that more than a decade has transpired. Using new data from a panel study of low-income mothers interviewed once before Hurricane Katrina and now three times after, we document changes in mental health, and estimate the sociodemographic and hurricane-related factors associated with long-term trajectories of mental health. We find that post-traumatic stress symptoms (PTSS) declined at each of the three post-Katrina follow-ups, but 12 years after the hurricane, one in six still had symptoms indicative of probable post-traumatic stress disorder. The rate of non-specific psychological distress (PD) remained consistently higher in all three follow-ups, compared to the pre-disaster period. In full covariate-adjusted models, no sociodemographic variables predicted long-run combinations of PTSS and PD. However, 12 years later, exposure to hurricane-related traumatic events and pre-disaster PD significantly predicted co-occurring PTSS and PD. Hurricane-related housing damage predicted PTSS in earlier follow-ups, but no longer predicted PTSS in the long-term. Furthermore, hurricane related traumatic events significantly differentiated the risk of having persistent PTSS, relative to recovering from PTSS. The results suggest that there is still a non-negligible group of survivors with continued need for recovery resources and that exposure to traumatic events is a primary predictor of adverse mental health more than a decade post-disaster.