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About SALENDO.

Despite a large and growing body of literature on racial and ethnic disparities in substance use, inequities persist. These entrenched differences are reflected in the context of natural disasters—a growing, looming threat to health.

Experiencing a natural disaster is associated with increased PSTD, depression, and anxiety symptomatology. After a disaster, people are more likely to lack access to substance use services and medications for opioid use disorder.

 

In most studies that consider demographic factors, racial inequities in results are evident. Studies conducted after Hurricanes Maria, Katrina, and Sandy found that Black/Latinx people have increased experiences of depression and PTSD, substance use, and overdose.

 

While these are important studies to begin to elucidate disparities in the impact of natural disasters on substance use outcomes, it is necessary to shift away from individual vulnerabilities to identify structural level drivers. Structural racism  may provide a better lens for examining community-level inequity.

 

Structural racism is defined as:

“the totality of ways in which societies foster [racial] discrimination, via mutually reinforcing [inequitable] systems…that in turn re-enforce discriminatory beliefs, values, and distributions of resources” (Bailey et al., 2017).

 

In this vein, some studies have utilized place-based research to understand how community-level factors shape outcomes. For instance, studies have found that post-Hurricane Katrina predictors of mental health-related hospitalization included poor socio- economic status, that residents in four predominantly Black Houston communities had higher burdens of comorbidities post-Hurricane Harvey. These studies hint at the importance of considering structural racism, but the explicit linkage between structural racism, behavioral health,  and natural disaster remains unexplored.

Investigator Team

Primary Investigator:

Co-Investigator:

Co-Investigator:

Lauren Brinkley-Rubinstein

Carmen Gutierrez (UNC-CH)

Erin McCauley (UCSF)

Hurricane Harvey FEMA Map: Texas

In the Contribution of Structural Racism to the Long-Term Effects of Natural Disaster on Behavioral Health Outcomes (SALENDO) Study, we will interrogate the interconnection of structural racism,  natural disaster exposure and risk, and behavioral health and the degree to which the impact of natural disasters on behavioral health outcomes is modified by level of structural racism.

 

This area of research is urgent. Over the last 50 years, the number of natural disasters has increased fivefold. From 1970 to 2019, weather, climate, and water hazards accounted for 50% of all disasters, 45% of all deaths, and 74% of all reported economic losses. There is significant variability relevant to the impact of natural disasters including which communities are most vulnerable. Via this project, we will be among the first to interrogate the degree to which measures of structural racism modify impacts of natural disasters and will identify key action items to enact change. This is especially important as climate events (increasing natural disasters, wildfires, floods, extreme temperatures), continue to escalate and wreak havoc across the country. ​

Hurricane Harvey FEMA Map: Louisiana

Why Texas & Louisiana?

Within the US, Southern states are the most vulnerable to these disasters and in 2017, for the first time ever, the Southern US experienced three Category 4 or greater hurricanes in the span of just two months, which hit parts of Texas , Florida, and Louisiana. Yet, the South United States also has the lowest preparedness levels, in relation to other states.

 

Therefore, it is important to understand what factors might exacerbate the impact of natural disasters, especially in states that are disproportionately at risk. In the US, Southern coastal regions are especially vulnerable to natural disasters and are also places where the number of Black and Latinx residents is particularly large, and the legacy of racism is distinctly observable.

 

Along these lines, Texas and Louisiana represent important states for the proposed study for several reasons:

  1. ​both states experienced significant devastation from Hurricane Harvey in 2017.

  2. they are states where the absolute and relative number of Black and Latinx populations are among the highest in the nation.

  3. each state ranks among the highest in the nation in terms of their rates of incarceration and in prevalence of behavioral health needs

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