Natural Disasters Can Affect Our Health

A natural disaster is defined as a sudden and terrible event in nature that usually results in serious damage and many deaths.⁸ Each region in the United States experiences some type of natural disaster, such as flooding, hurricanes, tornadoes, wildfires, droughts, volcanic eruptions, winter storms, or earthquakes. Recently, there have been several natural disasters in the United States: wildfires in California burned entire neighborhoods, while hurricanes Dorian, Harvey, Irma, and Maria struck The Bahamas and the East Coast, Texas, Florida, and Puerto Rico, respectively, leaving behind major wind and water destruction, as well as significant loss of life.

Each disaster or emergency comes with its own health risks. Downed trees from a tornado can lead to power outages; flooding from a hurricane can lead to people drowning or becoming stranded in their homes or has the potential to spread infectious diseases.⁶ Anyone can be affected by a natural disaster, but certain populations may be especially vulnerable to the negative health consequences they bring.

Communities whose health is most likely to be negatively affected by disasters include⁴:

• People with sensory impairment, mobility challenges, and mental health conditions¹
• People dependent on medical devices and/or medications to survive¹
• People living in poverty² (who may not have the financial resources to leave in advance of an emergency or who might live in poor housing conditions)
• Individuals living in rural areas who are hard to reach and often isolated from services
• Children, the elderly, and pregnant women²
• Racial and ethnic minority groups⁴
• Women⁴ (women are often responsible for taking care of family members and are more likely to be unemployed and/or underpaid)
• People with little or no English language proficiency⁴

Because these communities are at an increased risk for negative consequences related to natural disasters, building the capacity of the community to prepare and respond to these situations is key to ensuring that the most vulnerable members are safe. Community Health Workers (CHWs) are community members who possess an intimate understanding of their community’s social networks, strengths, health needs, and vulnerable groups. Because of their unique position in the community, CHWs play an important role in disaster preparedness and relief.

What is the Role of a CHW Before, During, and After a Disaster?

CHWs can help people prepare for a disaster before it even happens; they build community resilience to be prepared to face a disaster. Because CHWs are trusted members of the communities they serve, they know how to connect with those who may experience more harm from a natural disaster. They also provide culturally appropriate information in the language the community speaks and presented in a way that people in the community understand. This can help minimize or even prevent health emergencies during and after a natural disaster. For example, CHWs can educate residents in a rural community on how to prepare an emergency kit or safety plan in the event of road closures or power outages.

During a disaster, CHWs can be very important in responding to people in crisis. CHWs know the vulnerable groups in their communities. The Centers for Disease Control and Prevention states, “One barrier faced by emergency managers trying to communicate and work with at-risk groups is distrust of the government. Working with existing, trusted sources in your community can help overcome this mistrust. People are more likely to listen and react when the message comes from a trusted source they view as credible.”⁴ Because CHWs are members of the community they serve, they can help identify higher risk groups and help ensure the community not only has access to information on the natural disaster, but that this information is also presented in a way that the community will understand and be able to act upon.

After a disaster has passed, there are lasting health consequences that can be seen in a community. Following hurricane Maria, many areas on the island of Puerto Rico were left without power, clean drinking water, or access to medical services for months. This contributed to many illnesses and deaths throughout the island.³ CHWs are invested in their communities and can help the community return to a sense of normalcy after a disaster occurs. They can accomplish this in many ways, including:

• Offering first aid, immunizations, and other primary health services, and serving as a first responder⁷
• Providing emotional support to the community (for example, helping people communicate with their families and addressing community trauma)
• Surveying community needs after a disaster³
• Reaching rural and isolated communities⁵
• Connecting community members with the relief and health services they need

CHWs are critical to disaster preparedness and response. Because CHWs know the communities they serve and have access to the most vulnerable groups, they can provide outreach and education about disaster preparedness and serve as a key part of an emergency response. MHP Salud’s “Including Outreach Workers and Community Health Workers in Health Center Emergency Preparedness and Management” tip sheet can be useful for Community Health Centers looking to utilize their CHWs for emergency preparedness.

References

1. Vulnerable Populations – National Center for Disaster Preparedness. Retrieved October 11, 2019, from https://ncdp.columbia.edu/research/vulnerable-populations/
2. Vulnerable groups. (2012, August 24). Retrieved October 11, 2019, from https://www.who.int/environmental_health_emergencies/vulnerable_groups/en/.
3. Kishore, Nishant, et. Al. “Mortality in Puerto Rico after Hurricane Maria.” New England Journal of Medicine, vol. 379, no.2, Dec. 2018, pp. 162-170., doi:10.1056/nejmsa1803972.
4. Centers for Disease Control and Prevention (CDC). Planning for an Emergency: Strategies for Identifying and Engaging At-Risk Groups. A guidance document for Emergency Managers: First edition. Atlanta (GA): CDC; 2015. https://www.cdc.gov/nceh/hsb/disaster/atriskguidance.pdf
   https://emergency.cdc.gov/workbook/pdf/ph_workbookFINAL.pdf (pg. 27 CHW specific info)
   
5. Centers for Disease Control and Prevention (CDC). Public Health Workbook – To Define, Locate, and Reach Special, Vulnerable, and At-risk Populations in an Emergency. Atlanta (GA): CDC; 2010. https://emergency.cdc.gov/workbook/pdf/ph_workbookFINAL.pdf
6. Flooding and communicable diseases fact sheet. (2012, April 13). Retrieved October 11, 2019, from https://www.who.int/hac/techguidance/ems/flood_cds/en/.
7. Community health workers – the first response in emergencies. (2014, June 10). Retrieved October 11, 2019, from https://www.who.int/features/2010/community_health_workers/en/.
8. Natural Disaster. [n.d]. Merriam-Webster Online. In Merriam-Webster. Retrieved October 11, 2019, from https://www.merriam-webster.com/dictionary/natural%20disaster