When natural hazards lead to disasters, they can affect people in many ways, including damaging their housing and negatively impacting their livelihoods. Each year, millions of people are injured or killed as a result of disasters. They can also force people out of their homes: In 2020, 30.7 million new internal displacements linked with disasters, mostly storms or floods, were recorded throughout the world. Between 2010 and 2020, disaster displacements were recorded in 198 countries and territories, making the issue truly global. Such displacement can have severe and long-lasting consequences on physical and mental health, often similar to those of conflict-related displacement. Psychosocial trauma and the deterioration of living standards and housing conditions often alter displaced people’s well-being and their ability to maintain healthy lives or obtain treatment and care. People with disabilities or long-term illnesses are particularly vulnerable in displacement, as are children and older people. Depression and anxiety, malnutrition, communicable diseases, and lack of access to sexual and reproductive health are among the most frequent issues for internally displaced people. The health consequences of displacement linked with disasters vary depending on affected people’s pre-existing conditions and sociodemographic characteristics, the duration and severity of their displacement, and the type of support they are able to access. In cases of mass and protracted displacement, the health of people in communities of refuge and the health systems in the areas of origin and refuge can also be affected, with repercussions on the broader society. Although some of these impacts are relatively frequent and should be systematically considered by national and local governments, humanitarian organizations, and aid providers, each situation requires tailored approaches. Information on the health impacts of displacement remains limited, but the body of knowledge is growing as awareness increases on the scale of current and future displacement crises linked with disasters in a changing climate.
Displacement, Natural Hazards, and Health Consequences
Hurricanes and Health
Caleb Dresser, Satchit Balsari, and Jennifer Leaning
Hurricanes, also referred to as tropical cyclones or typhoons, are powerful storms that originate over warm ocean waters. Throughout history, these storms have had lasting impacts on societies around the world. High winds, rain, storm surges, and floods affect lives, land, and livelihoods and have a variety of effects on human health. The direct health impacts of hurricanes include drowning due to flooding and trauma resulting from storm surges, blown debris, and structural collapse. Systems for detection, forecasting, early warning, and communications can give populations time to make preparations before hurricane landfall. Evacuation, shelter use, and other preparedness efforts have reduced mortality from hurricanes in many parts of Asia and the Americas. Engineered defenses such as sea walls, flood barriers, and raised structures provide added protection in some settings. While effective in the medium term, such approaches are costly and require dedicated resources, and therefore they have not been implemented in many at-risk sites around the world. Indirect health impacts of hurricanes arise from damage to housing, electricity, water, and transportation infrastructure, and from effects on social supports, economies, and healthcare systems. Indirect health impacts can include infectious diseases, carbon monoxide poisoning, trauma sustained during cleanup, mental health effects, exacerbations of chronic disease, and increases in all-cause mortality. Indirect and long-term health consequences are poorly understood because dedicated study of specific impacts has occurred in only a handful of settings, and, given the diverse array of societies and geographies affected by hurricanes, it is unclear how generalizable the results of these studies may be. Policy makers face three interlinked challenges in protecting human health from hurricanes. First, climate change is leading to increased hazards in many locations by altering hurricane dynamics and contributing to sea-level rise. Second, patterns of intensifying coastal settlement and development are expected to increase population exposure. Third, unequal patterns of exposure and impact on specific populations will continue to raise issues of climate and environmental injustice. Situationally appropriate strategies to protect health from future storms will vary widely, as they must both address the locally relevant manifestations of hurricane hazards and adapt to the cultural and economic context of the affected population. In some areas, inexorable ocean encroachment may lead to consideration of managed retreat from high-risk coastlines; in others, the presence of very large coastal urban populations that cannot feasibly evacuate may lead to design and use of vertical shelters for temporary protection during storms. New ideas and programs are urgently needed in many settings to address hazards associated with extreme rainfall, rising seas on floodplains and low-lying islands, landslide risk in areas undergoing rapid deforestation, and structurally unsound housing in some urban settings. Policies to reduce greenhouse gas emissions will help reduce long-term risk from hurricanes and sea-level rise. Without concrete actions to address both hurricane hazards and population vulnerabiliy, the 21st century may be marked by increasingly dangerous hurricanes affecting growing coastal populations that will be left with few viable options for seeking safety.
Psychological Strategies and Challenges in Disaster Recovery
This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Natural Hazard Science. Please check back later for the full article. Natural disasters have increased dramatically in the twenty-first century. An estimated 217 million people are affected by natural disasters each year. Recent disasters, both nationally and globally, provide insight into how the degree of destruction and number of fatalities can negatively affect survivors. Cultural, political, and geographic factors may increase risk of trauma and negative mental health outcomes. Understanding these risks is critical to helping survivors recover in the aftermath of disasters. Different disasters pose different risks, and some communities are chronically affected. How to support these communities psychologically in the face of ongoing threats of destruction is an important question. Recent years have also seen major advances in technology that provide new and innovative ways to manage disasters. Technological strategies can be harnessed to better serve the interests of disaster-affected communities. For example, warning times for disasters have increased because of better instrumentation and the ability to send messages sooner to communities that may be in the path of a disaster. These increased warning times may allow for psychological preparation before a disaster that can support positive mental health outcomes in recovery. Demands for evidence-based mental health interventions require an understanding of best practices in disaster response, challenges to past relief efforts, and the strategies and factors that can enhance effective future efforts.
Resilient Health Structures and Services
This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Natural Hazard Science. Please check back later for the full article. Interest in health care resilience started in the mid-1940s, and it took approximately 2 decades for researchers to pick up the topic and realize its importance. By the early 2000s, the body of knowledge reached a level of maturity, with details of international case studies about the performance of health facilities and systems faced with multiple hazards, guidance, and regulations able to lead to secure the minimum level of resilience of health systems. However, the failure of health systems to respond effectively to COVID-19 indicates that preparedness was not adequate and that there is a gap between this body of knowledge and practice. This gap is driven by many factors but mostly by the “Lost in Translation (LiT)” effect. This effect happens when the application of guidelines is done in a mechanical, “paper filing” method without understanding their goal and the knowledge behind them. There are countless contributors to the LiT effect, such as appropriate knowledge of disaster resilience; an individual’s workload, motivation, and capability to acquire new knowledge; as well as the difference between agendas and organizational priorities. Some of these have been investigated, with the conclusion that more work is needed to generate knowledge to translate strategic evidence at operational levels. This will enhance the further learning of professionals and enable them to develop adequate plans. The way disaster resilience is approached is one of the key issues of health care vulnerability. Health systems are struggling with the large number of day-to-day challenges. Disaster resilience falls low on decision makers’ lists of priorities, specifically when risks are moderate or low, due to being viewed as a burden instead of an obligation, a moral and legal requirement. The analogy of the human body can help us understand how health care facilities’ internal systems, specifically the immune system, operate. Immunity is integrated throughout the body; it detects and manages most external hazards such as bacteria and viruses without affecting daily activities. The immunity of the human body is comparable to the resilience of health care facilities and health systems and perhaps should be operating in a similar way. Resilience needs to be embedded in the daily routine of health systems and facilities operations. To facilitate this integration and reduce the LiT effect, the functionality of health care facilities needs to be simplified in a way that allows more structured approaches to be developed. This functionality depends on six internal interconnected components, namely the building of integrity, lifeline systems, equipment, supplies, workforce, and management that regulates the way all these operate. Externally, it depends on interdependent components such as suppliers and infrastructure (e.g., transportation, power, water, Internet, and gas networks). Failure of one of these could cause direct or indirect failure of the continuity of health care service. Each of these components plays a unique role in the system, similarly to pieces of a jigsaw needing to be assembled in a specific way to provide a clear picture; clarity is affected when one piece is missing. Advanced and smart technologies might play a role in dealing with this compounded complexity; however, there are many questions to be answered before this technology is applied, among them the ethics and ownership of used and generated data.
Safe Water Adaptability for Water Scarcity in Coastal Areas of Bangladesh
Mohammad Golam Kibria and Md Anwarul Abedin
Water scarcity is a significant global concern affecting every continent. The problem of accessing safe water mainly occurs due to climate change, the increasing global population, and urbanization. The safe water crisis is more distressing in climate hot spots such as coastal areas, areas of low rainfall, and urban areas. Being a developing country, Bangladesh is experiencing the problem of water crisis in both coastal and urban areas. Safe water adaptability can be an integrative approach to mitigate water scarcity in these areas. Adaptability measures include monitoring surface and groundwater resources, using natural and artificial water storage, and providing technical training to the local community for safe water management, which can contribute to combat the safe water crisis across the globe. Safe water adaptability measures can be classified into four different dimensions (i.e., socioeconomic, institutional, physicochemical, and environmental) known as SIPE, which is based on some primary and secondary indicators. The SIPE approach measures the adaptability index by scoring the primary and secondary indicators and categorizes low to high adaptive community. Through the adaptability index, the capacity of the community and the gap between different levels of society can be measured, which can guide the review of existing policy and provide recommendations for a safe water adaptability action plan. This new approach will offer information and guidelines for the government, policymakers, and researchers to combat water scarcity problems. Although the proposed approach is applicable in the context of Bangladesh, this strategy can also be used for any parts of the globe by customizing the secondary indicators and considering the types of local problems to provide safe water for the community. The SIPE approach can be initiated at a micro level to become an integral part of national policies related to safe water access, especially for drinking and irrigation purposes.
The Impact of Moisture and Temperature on Human Health in Heat Waves
Michael Wehner, Federico Castillo, and Dáithí Stone
Extremely high air temperatures are uncomfortable for everyone. For some segments of the population, they can be deadly. Both the physical and societal aspects of intense heat waves in a changing climate warrant close study. The large-scale meteorological patterns leading to such events lay the framework for understanding their underlying causal mechanisms, while several methods of quantifying the combination of heat and humidity can be used to determine when these patterns result in stressful conditions. We examine four historic heat waves as case studies to illustrate differences in the structure of heat waves and the variety of effects of extreme heat on humans, which are characterized in terms of demographic, geographic, and socioeconomic impacts, including mortality and economic ramifications. Weather station data and climate model projections for the future point to an increase in the frequency and intensity of extreme heat waves as the overall climate gets warmer. Changes in the radiative energy balance of the planet are the principal culprit behind this increase. Quantifying changes in the statistics of extreme heat waves allows for examination of changes in their potential contribution to human health risk. Large-scale mortality during heat waves always occurs within a context of other factors, including public health policy, rural and urban management and planning, and cultural practices. Consequently, the impacts of heat waves can be reduced, and may in many places be manageable into the future, through implementation of such measures as public health warning systems, effective land management, penetration of air conditioning, and increased monitoring of vulnerable or exposed individuals. Given the potential for severe impacts of the more intense heat waves that are virtually certain to occur in the warmer future, it is critical that both the physical and social sciences be considered together to enable society to adapt to these conditions.