Authors: Balaji Ramesh*, Virginia Polytechnic Institute and State University, Meredith A Jagger, Independent Consultant, Benjamin F Zaitchik, Johns Hopkins University, Korine N Kolivras, Virginia Polytechnic Institute and State University, Samarth Swarup, University of Virginia, Lauren Deanes, Johns Hopkins University, Elaine Hallisey , Centers for Disease Control and Prevention, Danielle Sharpe, Centers for Disease Control and Prevention, Julia M Gohlke, Virginia Polytechnic Institute and State University
Topics: Hazards, Risks, and Disasters, Earth Science, United States
Keywords: Flooding and health, Earth Observation, CDC Social Vulnerability Index, Hurricane Harvey, Emergency department visit, controlled before-after analysis
Session Type: Virtual Paper
Start / End Time: 9:35 AM / 10:50 AM
Room: Virtual 41
Presentation File: No File Uploaded
The CDC Social Vulnerability Index (CDC SVI) measures sociodemographic factors that affect the ability of communities to prepare for, respond to, and recover from extreme weather events. Satellite observations and ground sensors can be used to measure the extent of flooding in affected areas. In this study, we analyzed emergency department (ED) visits in Texas during and following flooding caused by Hurricane Harvey in 2017. Census tracts were classified as flooded or non-flooded using inundation maps. A controlled before-after study design was used to estimate adjusted rate ratios of selected cause-specific ED visits for flooded census tracts compared to non-flooded census tracts during the period following landfall, accounting for differences in ED visits over a control period that includes visits in 2016 and 2018. Moderation of this relationship by social vulnerability, as measured by CDC SVI tertiles, was examined. Flooding was associated with a 35% (95% CI: 22%, 48%) increase in ED visits for insect bites, 39% (95% CI: 25%, 54%) increase for intestinal infectious diseases, 24% (95% CI: 17%, 31%) increase for pregnancy complications, 170% (95% CI: 60% - 354%) increase in hypothermia visits, and a 227% (95% CI: 34%, 698%) increase for CO poisoning. When an interaction term with CDC SVI was added to models, moderation was observed, with overall ED visits associated with flooding increasing in census tracts in higher CDC SVI tertiles. ED visits for hypothermia associated with flooding was 7 (95% CI: 1.6, 30.57) times higher in the most vulnerable versus least vulnerable tracts.