COVID-19 outcomes impacted more by Hurricane Harvey-related economic and mental health stressors

A study by Rice University, the University of Notre Dame and the Environmental Defense Fund shows the economic and mental health consequences on victims of Hurricane Harvey and COVID-19 were cumulative. The results appear in Environmental Research.

The result springs from separate surveys on the impact of Harvey and COVID-19, led by Katherine Ensor, the Noah G. Harding Professor of Statistics at Rice; Marie Lynn Miranda, director of the Children's Environmental Health Initiative at Notre Dame and former Rice provost; and Elena Craft, senior director for climate and health at the Environmental Defense Fund.

The study originated with 2018's Texas Flood Registry (TFR), a first-of-its-kind registry to track the short and long-term health and housing impacts of a hurricane through online survey data. As COVID-19 came into play, the researchers realized the tools that support the TFR could be used to track the impact of the pandemic and assess whether multiple exposures magnify preexisting harms.

"We've already looked at how prior exposure to Hurricane Harvey and other flooding events affect economic and mental health outcomes," said Rashida Callender, a research associate at Rice and lead author on the project. "We know prior exposure to natural disasters of short duration such as a flood can reduce resilience, but there's never been a study that looked at prior flooding exposure and how that affects outcomes during a longer-term, nonweather-related disaster such as a pandemic."

The new study built upon technical infrastructure from the existing TFR to launch the national COVID-19 Registry in April 2020. Its purpose is to track experiences during the pandemic, including health, behavior and economic changes.

The analysis incorporates answers from approximately 3,000 participants returned questionnaires to both the TFR and COVID-19 registries.

"Something that stood out was a clear distinction between the impact of acute effects and secondary stressors," Callender said.

The team concluded the following:

• COVID-19 outcomes were impacted more by Hurricane Harvey-related economic and mental health stressors than by acute home flooding and damage.
• People who lost income during Harvey were four times more likely to lose income during COVID-19.
• People who experienced Hurricane Harvey as a "severe impact event" were five times more likely to have severe anxiety during COVID-19 compared to those whose experience with Harvey was not a meaningful impact event.

But Callender pointed out the sample group who returned surveys is not representative of the general population.

"In general, our study population has been a majority non-Hispanic white, female population, many of whom have a college degree or higher," she said. "For us, it suggests that in the general population, the impacts could potentially be greater. We did find that non-Hispanic Black and Hispanic respondents were more than twice as likely to report having difficulty paying rent or bills during the pandemic, consistent with other studies documenting disproportionate impacts of COVID-19."

The registries are hosted by the Kinder Institute Urban Data Platform (UDP). The UDP is a secure computing platform and data repository hosting 282 datasets about the greater Houston area.

Ensor said the Kinder Institute's support made the study possible. "The UDP is a tremendous resource for our community, and I am proud to have played a leading role in its creation," she said.

With both climate change accelerating the frequency and intensity of natural disasters and COVID-19 becoming endemic, the question remains how to handle the next disaster and who will be more heavily affected.

Callender said tracking the long-term aftermath of exposure to prior disasters can underscore the importance of identifying higher-risk people and communities when developing response efforts and intervention programs.