Health risks of natural hazards and resilience resources: Evidence from a U.S. nationwide longitudinal study

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Soc Sci Med. 2021 Jun 8;281:114110. doi: 10.1016/j.socscimed.2021.114110. Online ahead of print.

ABSTRACT

BACKGROUND: Although natural disasters can threaten health and well-being, some people show greater resilience to their effects than others. Identifying the characteristics related to resilience has important implications for reducing the health risks in the aftermath of a disaster.

OBJECTIVE: Using the Conservation of Resources Theory as a framework, we study the role of resources in moderating the adverse effects of natural disasters on people’s health and coping behaviors.

METHOD: We match 20,658 unique individuals aged 50 or older from the 2012-2016 waves of the Health and Retirement Study to the county-level annual natural hazard data provided by the Federal Emergency Management Agency. Using individual-fixed effect models, we first model whether the experience of natural disasters can predict people’s health and coping behaviors. We then explore heterogeneity in such effects by interacting individual- and county-level resilience resources with the number of natural disasters.

RESULTS: The results show that with increased exposure to natural disasters, older adults are more likely to experience difficulties performing instrumental daily activities. They also tend to have fewer overnight hospital stays, higher out-of-pocket medical expenses, and increased alcohol dependency. However, older adults with certain socio-economic characteristics ‒ white, higher education, higher income, and homeownership ‒ are better able than others to mitigate any adverse health effects of natural disasters. One significant community-level resource is a robust healthcare capacity in a county with a high ratio of healthcare practitioners, where older adults are more likely to seek hospital care and have lower alcohol dependency.

CONCLUSIONS: Health resilience can be improved by strengthening community-level healthcare capacity, with a particular focus on residents with lower socio-economic resources. Failing to address healthcare provision inequalities may exacerbate health disparities.

PMID:34139633 | DOI:10.1016/j.socscimed.2021.114110