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Quantifying inequities in US federal response to hurricane disaster in Texas and Florida compared with Puerto Rico
  1. Charley E Willison1,
  2. Phillip M Singer2,
  3. Melissa S Creary1,
  4. Scott L. Greer1
  1. 1 Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
  2. 2 Department of Political Science, University of Utah, Salt Lake City, Utah, USA
  1. Correspondence to Dr Scott L. Greer; slgreer{at}umich.edu

Abstract

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.

  • public health

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Footnotes

  • Handling editor Seye Abimbola

  • Contributors CW, the guarantor, affirms that this manuscript is an honest, accurate and transparent account of the study being reported that no important aspects of the study have been omitted and that any discrepancies from the study as planned have been explained. All authors jointly conceptualised the study. CW and PS conducted the research. CW wrote the article. CW and PS conducted the research. All authors reviewed and amended the final draft. All authors jointly conceptualised the study. All authors reviewed and amended the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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