Public Health Consequences of Hurricane Harvey Continue to Unfold

Monday, February 5, 2018

Just over five months have elapsed since Hurricane Harvey battered the Texas Coast, dropping more than 50 inches of rain on parts of the Houston area. The storm’s devastation was swift, killing 88 people and displacing many thousands. Yet, Harvey’s full impacts continue to unfold. Beyond imposing huge material losses, the storm has taken a significant toll on the health of those in its wake. It may be wise to understand storm events like Harvey not only as short-term physical disruptors, but as public health crises that will likely unfold over many years, long after media attention and political will to respond may have cooled.

The Near-Term Consequences

Extreme storm events like Harvey expose impacted communities to a litany of health threats almost immediately.

After Harvey, many residents lacked access to critical services like clean water and medication.  (DoD)For those unable to evacuate, remaining at home may entail a lack of access to adequate and safe food and water or an inability to obtain necessary medication. Those experiencing power outages may also be made vulnerable to weather. Many enduring Harvey’s wrath in the late Texas summer experienced heat stress.

Flood waters often disturb local wildlife, forcing populations out of their native habitat and into contact with humans. Snakebites, for example, occur with greater incidence during flooding. During Harvey, enormous mounds of venomous fire ants were spotted floating through flood waters, much to the fascination and chagrin of those evacuating.

Large storm events also often present ideal conditions for bacteria to incubate and proliferate, exposing humans to infectious disease. Inundated sewer systems may overflow, mixing waste into rising waters. Moreover, as flood waters sit in homes, the tepid, warm conditions are particularly amenable to the growth of bacteria.

In Houston, the high density of Superfund sites, chemical plants, and natural gas and oil refineries presented further concerns. As rain and wind battered the region, leakages of toxic waste into the water running through streets and filling homes became a primary concern. On August 25, EPA reported that 13 of the 34 federal Superfund sites in Harvey’s path had been impacted by flooding.

And the list goes on.

Long-Term Health Implications

For the intensity and volume of immediate health threats produced by storms like Harvey, some of the most insidious impacts may only be emerging now, many months out.

Of particular concern is the growth of mold. The impacts of extreme storm events are destructive to most life, but mold thrives in the wet conditions presented by flooding. Excess moisture and standing water provide ideal conditions for these fungi to proliferate in homes and other buildings. In structures where standing water has accumulated, mold begins to grow relatively quickly—even within only a few days. The Centers for Disease Control and Prevention (CDC) advises cleaning out and drying flooded buildings within 48 hours of water exposure. Of course, most families evacuated during Harvey were not able to return this quickly. Those returning to their homes after weeks of displacement may unknowingly have entered spaces endangering their health.

The most common varieties of indoor mold—Cladosporium, Penicillium, Alternaria, and Aspergillus—induce a range of reactions from humans. These may include wheezing, skin and eye irritation, and shortness of breath. Certain individuals may find themselves more sensitive to the impacts of mold—including those with asthma, young children, or people with a weakened immune system. Allergy sufferers, in particular, may find the months and years after storms to be particularly taxing.

These risks endanger many, but those most heavily engaged in demolition and rebuilding may be at particular risk. In the months after Harvey, construction workers were in short supply in the Texas Gulf Coast region. Those available often found themselves working long days to try and keep pace with widespread need and likely experienced high exposure to potentially harmful mold growth.

Rebuilding and Remediating Long-Term Risks

Hurricane Harvey will continues to threaten public health long after floodwaters have subsided (Wikimedia Commons).The rebuilding process in Houston has begun, though much work remains and thousands of families are still in temporary housing. In October, Texas Governor Greg Abbott submitted a request for additional federal aid for rebuilding public infrastructure in the Texas Gulf Coast after Harvey. This request totaled $61 billion in federal appropriations beyond allocations by the Federal Emergency Management Administration (FEMA) and the U.S. Department of Housing and Urban Development (HUD) for individual housing assistance.

In late December, the U.S. House of Representatives approved an aid package totaling $81 billion to be allocated among California, Puerto Rico, and Texas—all recovering from their own disasters in a particularly tumultuous year. Only a fraction of these federal appropriations—far less than the requested $61 billion—will be given to Texas. Moreover, these appropriations are designated primarily for public works, leaving many wondering what may happen to impaired housing in the Gulf Coast that has yet to receive aid.

Who Most Bears the Health Burdens of Natural Disasters?

Natural disasters like Hurricane Harvey dispense destruction indiscriminately. Yet, in the weeks, months, and years that follow Harvey and similar events, certain individuals and communities are likely to bear a greater share of the burden of destruction than others.

Low-income communities, oftentimes communities of color, may be less resilient to the impacts of flooding and heavy rains from the outset. Builders and homeowners in higher-income neighborhoods may be more able to invest in the weather-proofing design elements that spared some structures from the greatest impacts of flooding and rains. Lower-income communities may also risk higher exposure to leaked toxic waste, given their proximity to Superfund sites, natural gas and oil refineries, and chemical plants.

Moreover, after the rains have ceased, low-income communities are also less likely to have the resources to move or rebuild in the face of destruction.

In the Texas Gulf Coast, undocumented community members may also share unique concerns as they attempt to recover. Without documentation, these individuals generally have less access to public aid critical to rebuilding. Undocumented renters may also have less confidence that a landlord will remediate impaired housing than those renters with the security of documentation.

There is also evidence to suggest that the chronic stressors unique to these communities may leave them more vulnerable to the wide range of near- and long-term health consequences that emerge after storms like Harvey.

A Need to Build Resilience

The full extent of Hurricane Harvey’s public health impacts and the success of efforts to rebuild will likely not become clear for many years. As the world moves toward a future in which a changing climate makes the occurrence of storm events like this one increasingly likely, however, policymakers should keep a careful eye on how these processes unfold. Given the difficulty of rebuilding communities from the ground up after disaster strikes, it will be critical to plan for resilience before the next storm strikes.

To learn about some of the climate resilience work ELI is doing, visit https://www.eli.org/climate-energy/strengthen-capacity-adapt-climate-change.