Quantifying inequities in US federal response to hurricane disaster in Texas and Florida compared with Puerto Rico
Quantifying inequities in US federal response to hurricane disaster in Texas and Florida compared with Puerto Rico
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DOI：
10.1136/bmjgh-2018-001191
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发表时间：
2019-02-01
影响因子：
8.1
通讯作者：
Greer, Scott L.
中科院分区：
文献类型：
--
作者：
Willison, Charley E.;Singer, Phillip M.;Greer, Scott L.
如果不同社区的灾害应对措施的效力不同，卫生公平就会受到影响。本文旨在通过回顾性分析，评估和描述联邦对2017年飓风哈维、厄玛和玛丽亚的灾害响应变化，并与风暴损害的需求和严重程度进行比较。我们对每个飓风的分析范围从登陆到登陆后的6个月。为了检验不同飓风灾害反应的差异，我们将重点放在联邦支出、联邦资源分配以及直接和间接的风暴死亡人数上。联邦开支估算来自国会拨款和联邦紧急事务管理局（FEMA）的记录。资源估计来自联邦应急管理局的文件和新闻发布。死亡率统计来自美国国家海洋和大气管理局（NOAA）的报告、各自的人口统计办公室和新闻文章。损失估计来自NOAA的报告。在每种情况下，我们都会根据联邦应急管理局的时间日志比较风暴后关键时间点的响应和严重程度。我们的研究结果显示，与飓风玛丽亚对波多黎各的影响相比，联邦政府在德克萨斯州和佛罗里达州对飓风哈维和厄玛的联邦资金和人员配备方面的反应规模更大，速度也更快。与德克萨斯州和佛罗里达州相比，波多黎各的反应变化与风暴的严重程度和登陆后的需求不相称。假设灾害应对措施至少应与风暴的严重程度和人口的需要相称，但波多黎各收到的应对措施不足，令人对健康差距扩大和不良健康后果增加感到关切。
If disaster responses vary in their effectiveness across communities, health equity is affected. This paper aims to evaluate and describe variation in the federal disaster responses to 2017 Hurricanes Harvey, Irma and Maria, compared with the need and severity of storm damage through a retrospective analysis. Our analysis spans from landfall to 6 months after landfall for each hurricane. To examine differences in disaster responses across the hurricanes, we focus on measures of federal spending, federal resources distributed and direct and indirect storm-mortality counts. Federal spending estimates come from congressional appropriations and Federal Emergency Management Agency (FEMA) records. Resource estimates come from FEMA documents and news releases. Mortality counts come from National Oceanic and Atmospheric Administration (NOAA) reports, respective vital statistics offices and news articles. Damage estimates came from NOAA reports. In each case, we compare the responses and the severity at critical time points after the storm based on FEMA time logs. Our results show that the federal government responded on a larger scale and much more quickly across measures of federal money and staffing to Hurricanes Harvey and Irma in Texas and Florida, compared with Hurricane Maria in Puerto Rico. The variation in the responses was not commensurate with storm severity and need after landfall in the case of Puerto Rico compared with Texas and Florida. Assuming that disaster responses should be at least commensurate to the degree of storm severity and need of the population, the insufficient response received by Puerto Rico raises concern for growth in health disparities and increases in adverse health outcomes.