Rural Designations and Geographic Access to Tertiary Healthcare in Idaho

This paper examines the geographic accessibility of tertiary health services for the rural population of Idaho. Utilizing the two most commonly used rurality definitions, we determined the spatial distribution of the rural and urban residents in Idaho. The distance to each of the tertiary healthcare facility was calculated using Geographic Information Systems (GIS). Our analysis showed a large disparity between rural and urban geographic access to tertiary healthcare and revealed that there are significant variations in the disparity depending on the rural definition used. Thus there is a need to deploy strategies to enhance rural access and to construct rurality measures that capture the local heterogeneity, given that rurality designations impact the interpretation of access problems, and the funding eligibility for healthcare programs

Children’s Health after the Oil Spill: A Four-State Study Findings from the Gulf Coast Population Impact (GCPI) Project

In 2012, with funding from the Baton Rouge Area Foundation, the National Center for Disaster Preparedness (NCDP) at Columbia University, in partnership with the Children’s Health Fund, launched a four-state study in order (1) to identify communities of children in the coastal areas of Louisiana, Mississippi, Alabama and Florida who were adversely impacted by the Deepwater Horizon oil spill, (2) to explore the prevalence of physical and mental health effects among these children, and (3) to conduct a preliminary assessment of the health services available to these children and the potential for targeted interventions or health system enhancements. We identified fifteen communities with higher numbers of BP compensation claims submitted by individuals and by businesses, and which also had higher rates of oil washing up on their shores based upon monitoring data collected by the National Oceanic and Atmospheric Administration. Over a span of four and a half months, a field team of six interviewers and two field coordinators completed 1,437 face-to-face household surveys. The parents whom we interviewed reported considerable exposure to the oil spill as well as a number of physical and mental health problems among their children. Over half of the parents interviewed in these highly-impacted communities reported that their children had some type of oil spill-related exposure, whether it was through physical, environmental, or economic factors. One in every five parents said their children had direct contact with the oil; one in four reported smelling strong oil-related odors; and two of every five said their household had lost income or a job since the oil spill. A little over 40% of parents in these high-impact communities reported some type of health effect experienced by their children since the oil spill. 18.1% of the parents said their children had experienced breathing problems after the oil spill, 14.8% noted skin problems, 16.0% reported visual problems and 21.6% mentioned emotional or behavioral problems since the oil spill. In October 2012 our research team traveled to four communities to interview local officials and leaders and conduct in-depth parent focus groups. We selected the four communities based on the household data, where parents had reported significant health effects. Across the four communities, the team heard of significant issues related to children’s health and well-being

Families Coping With Financial Loss Following the Deepwater Horizon Oil Spill

Objective: This study examines family strategies for coping and adaptation to social disruption from the 2010 Deepwater Horizon oil spill (DHOS) in south Louisiana. Background: The DHOS is a technological disaster of unprecedented scale and ongoing impact, including the socioeconomic disruption of families. Method: Using data from focus groups, grounded‐theory methods informed a thematic analysis of spill‐related economic loss and coping mechanisms among families in the spill‐affected region. Results: Key findings were as follows: (a) long‐term economic impacts persisted but were nuanced and differed across places; (b) for families living in multistressor environments, concerns about the DHOS spilled over into other aspects of social functioning and became enmeshed with perceptions of other environmental stressors; and (c) economic exposure after the DHOS affected families differently based on social position and community social structure. Conclusion: This study contributes to existing knowledge on technological disaster and family resilience in the face of environmental shocks and stressors, underscoring the utility of the conservation of resources model of stress in this area of research. Implications: This research offers information about family‐level response to oil spill impacts and may be of interest to policymakers and practitioners who work to support resilience in disaster contexts

Deepwater Horizon Oil Spill Exposure, Industry Sector, and Child Health

The historic 2010 BP Deepwater Horizon Oil Spill (DHOS) led to public distress regarding potential impacts on children in nearby Gulf Coast communities. Using a community-based South Louisiana panel study of households with children, we examined the effect of fishing industry employment on changes in a subjective measure of general child health and whether economic and physical DHOS exposures played a mediating role. Fishing industry employment had a negative effect on child health compared to other industries. Economic exposure and physical exposure both mediated the effects of the fishing industry on child health, with economic exposure mediating a larger share (49.3%) of the relationship compared to physical exposure (40.5%). The importance of economic oil spill exposure in these findings highlights the significance of social determinants of health at the intersection of disasters and child vulnerability

The Hurricane Sandy Place Report: Evacuation Decisions, Housing Issues and Sense of Community

Hurricane Sandy was one of the largest storms on record, sweeping through the eastern seaboard of the United States with a massive diameter twice the size of Hurricane Katrina. Although wind speeds did not match those of Katrina, the combination of high tide at landfall and the lunar phase resulted in exceptionally high storm surges. Catastrophic storms such as Hurricane Sandy can have devastating effects on many aspects of human life and the environment, undermining economic activity, crippling critical infrastructure, and disrupting hundreds of thousands of lives for weeks, months, or even years. The Sandy Child and Family Health (S-CAFH) Study was designed to describe and analyze the impacts of the storm on the residents of New Jersey, identifying those needs which emerged and those which are still pressing. The research team – a partnership of faculty and research staff from Rutgers University, New York University, Columbia University, and Colorado State University – randomly selected and surveyed 1,000 residents of New Jersey’s “Disaster Footprint,” representing the experiences of 1 million New Jersey residents living in or near those coastal areas of the state most directly exposed to the storm. The primary focus of this Briefing Report, the first in a series of four thematic reports, is to document the storm’s impact on PLACE in New Jersey residents’ lives, with a particular emphasis on Sandy’s effect on people’s homes and housing decisions

The Hurricane Sandy Person Report: Disaster Exposure, Health Impacts, Economic Burden, and Social Well-Being

The impact a disaster has on the health of a population can be described as having a “dose-response” relationship: the larger the “dose” of the disaster, the greater the health impact or “response” among those individuals and communities exposed. This PERSON Briefing Report describes the impact of Hurricane Sandy (the dose) on the health and well-being of adults and children exposed to the storm (the response). Data for the report are drawn from the baseline survey of the Sandy Child and Family Health (S-CAFH) Study, an observational cohort study of nearly 1,000 randomly-selected New Jersey residents who were living in areas of the state exposed to the storm in 2012. Participants in the study represent over 1 million people living in Sandy’s “Disaster Footprint,” the hurricane-exposed portions of the state. This report describes and examines several critical aspects of individual health and well-being that may be associated with the storm, including: 1. Physical health of adults; 2. Psychological and emotional health of adults; 3. Social and economic health of adults; 4. Health and well-being of children; and 5. The association between disaster exposure and individual outcomes

Diverting the tourists:A spatial decision-support system for tourism planning on a developing island

Mauritius is a small island (1865 km2) in the Indian Ocean. Tourism is the third largest economic sector of the country, after manufacturing and agriculture. A limitation of space and the island's vulnerable ecosystem warrants a rational approach to tourism development. The main problems so far have been to manipulate and integrate all the factors affecting tourism planning and to match spatial data with their relevant attributes. A Spatial Decision Support System (SDSS) for sustainable tourism planning is therefore proposed. The proposed SDSS design would include a GIS as its core component. A first GIS model has already been constructed with available data. Supporting decision-making in a spatial context is implicit in the use of GIS. However the analytical capability of the GIS has to be enhanced to solve semi-structured problems, where subjective judgements come into play. The second part of the paper deals with the choice, implementation and customisation of a relevant model to develop a specialised SDSS. Different types of models and techniques are discussed, in particular a comparison of compensatory and non-compensatory approaches to multicriteria evaluation (MCE). It is concluded that compensatory multicriteria evaluation techniques increase the scope of the present GIS model as a decision-support tool. This approach gives the user or decision-maker the flexibility to change the importance of each criterion depending on relevant objectives

Gulf Coast parents speak: children’s health in the aftermath of the Deepwater Horizon oil spill

This paper examines the physical and mental health of children following the Deepwater Horizon oil spill (DHOS). A multi-stage sampling design was used to select households for inclusion in the study. Data were obtained from parental interviews (n = 720) in the harder-hit areas of Louisiana in the US Gulf Coast. Three out of five parents reported that their child had experienced physical health symptoms and nearly one third reported that their child had mental health issues since the oil spill. Both direct physical exposure and indirect economic exposure were found to be predictors of physical and mental health issues among the children. Our findings contribute to bridge the research gap on the impacts of the direct and indirect exposures of the DHOS on the health of children. The study underscores the importance of understanding the health and recovery trajectories of children and youth exposed to disasters. Knowledge gained from this study together with the emerging literature on the effect of the oil spill disaster on children can contribute towards more evidence-based public health policies and enhance the recovery of children and their families in the aftermath of disasters

Online community discourse during the Deepwater Horizon oil spill: an analysis of Twitter interactions

Following the Deepwater Horizon oil spill on April 20, 2010, information was widely broadcast through social media platforms such as Twitter. This study aimed to gain insights into the content and flow of the tweets that had shaped the conversation related to the oil spill within the first 4 months of the rig explosion and to understand how these online interactions may have contributed to disaster response and resilience. A set of tweets (n = 876,298) was identified and processed to yield 736,324 clean tweets. The study used a mixed-methods approach, including human coding, machine learning and social network analysis to examine the online discourse. Visualizations were used to present the patterns and connections within the dataset into a more readable and interpretable format. Our analysis revealed that popular themes such as environmental and economic concerns, clean-up and volunteering, health impacts and frustration towards BP had contributed to the shaping of the discourse. The Twitter users included seekers and providers of information and resources. Another group of users, local volunteers and digital activists, functioned as boundary spanners by facilitating information flow between the seekers and the providers. Additionally, Twitter had been used for risk communication and the dissemination of factual health information. The online communication and coordination efforts may have contributed to the mitigation of the impacts of the oil spill. Our findings suggest that social media empowered community-based users, affording access to power brokers, reliable information, the formation of online networks and social capital and potentially contributed to their resilience