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Special Call 2: Strengthening Community Resilience in U.S. Territories

The following is a list of recently funded awards as part of a Special Call for Strengthening Community Resilience in U.S. Territories.

Multi-Hazard Planning for Access and Functional Needs in the U.S. Territories and Hawaii

Lilian Bui, University of Hawaii at Manoa
Jiwnath Ghimire, University of Hawaii at Manoa
Eric Yamashita, University of Hawaii at Manoa
Karl Kim, University of Hawaii at Manoa

Despite being a commonly used strategy to reduce exposure to hazards, sheltering poses a clear public health dilemma with regard to the global pandemic. This research proposes to investigate which agencies and sectors are responsible for multi-hazard shelter planning; what plans and strategies are in place for reaching those with access and functional needs; what resources exist to support planning efforts; and what education and training gaps exist to improve community resilience and public health equity in the U.S. island territories and Hawai'i.

The Public Health Implications of Abandoned Spaces in Post-Maria Puerto Rico

Luis Gallardo, University of Puerto Rico Río Piedras
David Carrasquillo, Hispanic Federation
Michelle Alvarado, Center for Habitat Reconstruction
Alison Chopel, Independent Researcher

Building abandonment contributes to increased health risks and is unevenly distributed, exacerbating geographic health inequities. Increased abandonment is a common consequence of natural hazards, and transforming abandoned properties is an effective resilience strategy. Yet little is known about effective practices for abandoned building transformation. This convergence study will address the gap by describing how Puerto Rico is fighting abandonment, the health, social and economic costs of abandoned properties, and the benefits of community-led building transformation processes. Findings will support improved practices across Puerto Rico and contribute to defining abatement efforts as a public health strategy in disaster mitigation, readiness, response and recovery.

Impact of Infrastructure Disruptions on Puerto Rican Household Capabilities, Health, and Well-Being

Susan Clark, University at Buffalo
Ralph Rivera-Gutirrez, University of Puerto Rico
Michael Shelly, University at Buffalo
Sara Peterson, Univerity at Buffalo
Andrea Rosario Zambrana, University of Puerto Rico

This research will empirically examine the impacts of infrastructure disruptions (e.g., power outages) in Puerto Rico on household capabilities, or the ability to fulfill basic needs (i.e., accessing food, drinking water, and medical services). Informed by ongoing community partnerships, scholars from the University at Buffalo and the University of Puerto Rico will conduct a representative survey across Puerto Rican households to identify the type and intensity of capability losses experienced from recent infrastructure disruptions on different household types. This project includes dissemination workshops in local communities that will discuss the implications of this research for infrastructure and public health planning.

Planning for Post-Disaster Needs of Women With Breast Cancer in Puerto Rico

Kevin Fagundo-Ojeda, University of Utah
Ivis Garcia Zambrana, University of Utah
Mabel Lassalle, Connecting Paths

Hurricane Maria, the 2020 earthquakes, and COVID-19 led to the collapse of the healthcare system in southwestern Puerto Rico. This interrupted cancer care for thousands of patients. Addressing the psychosocial needs of breast cancer patients leads to a better quality of life. There is a need to better understand the specific psychosocial needs of breast cancer patients in this region. Using surveys and interviews, this study will examine the psychosocial needs of breast cancer patients after concurrent and consecutive disasters, the services nonprofits employed to meet these needs, and how community partners could improve the delivery of these services.

The Public Health Implications of Social Vulnerability in the U.S. Virgin Islands

Greg Guannel, University of the Virgin Islands
Hilary Lohman, US Virgin Islands Department of Planning and Natural Resources
Joe Dwyer, University of the Virgin Islands

The USVI lacks a Social Vulnerability Index. As a result, it is not clear which communities are more at risk of adverse health impacts from natural disasters than others. This effort proposes to construct a social vulnerability index for the USVI using existing data and hazard risk proxies developed for the islands. Results will be used across institutions and agencies to guide the development of better policies, interventions and projects that will reduce the vulnerability of USVI communities.

Public Trust, Community Resilience, and Disaster Response in the U.S. Virgin Islands

Kenny Hendrickson, University of the Virgin Islands
Kula Francis, University of the Virgin Islands
Anna Clarke, University of the Virgin Islands

Public health disaster response requires a level of public trust for greater recovery efforts. This study examines the perceptions of public trust of public health disaster response within the US Virgin Islands (USVI). Data will be collected using a questionnaire consisting of modified versions of SCORE and Conjoint Community Resiliency Assessment Measure (CCRAM). This research evaluates the determinants of public trust as it relates to USVI governments’ public health response. The proposed research project also explores socio-demographic characteristics associated with USVI residents’ perceptions of public trust. Finally, this project explores the implications for public trust and community resilience.

Community-Based Organizations in Public Housing Resident Recovery in Puerto Rico

Sayma Khajehei, University of Utah
Elizabeth Rivera, Ponce Neighborhood Housing Services
Divya Chandrasekhar, University of Utah
Ivis Garcia Zambrana, University of Utah

Public housing residents depend on community-based organizations (CBOs) to provide critical housing, health and social services after disasters. However, CBOs may be limited in their ability to do so by impact from concurrent disaster events. This study explores the challenges and opportunities of engaging CBOs that serve public housing residents into public health and housing recovery efforts after concurrent disasters using the case of the 2020 Southwest Earthquakes and COVID-19 in Ponce, Puerto Rico. Study findings will help planners and policymakers better understand and engage CBOs in public housing recovery, and through that improve public health outcomes of these socially vulnerable residents.

Community First Aid Training: A Tool to Strengthen Community Resilience

Todd Miner, University of Colorado School of Medicine
Tayna Belyeu-Camacho, Mariana Islands College
Joan Flores, Mariana Islands College
Geri Rodgers, Mariana Islands College
Patrick George, Department of Fire and Emergency Medical Services, Commonwealth of the Northern Mariana Islands

Community resilience is a key part of reducing the impact of disasters. An overlooked aspect of building community resilience is first aid training for community laypeople and first responders. The study will address this gap in the literature by examining the effectiveness of a new course, Disaster Response Advanced First Aid, in terms of preparing community members for disaster-caused medical emergencies. Two classes of DRAFA will be delivered and evaluated on Saipan, part of the Commonwealth of the Northern Mariana Islands.

Social Capital, Community Health Resilience, and Compounding Hazards in Corcovada, Puerto Rico

Anaís Roque, Arizona State University
Enid Quintana, University of Puerto Rico
Sameer Shah, National Center for Atmospheric Research
Fernando Tormos-Aponte, University of Maryland, Baltimore County

Climate change increases the likelihood of contemporaneous extreme events. Compounding hazards create cascading impacts through interconnected food, energy, and water (FEW) systems, with significant implications for community health resilience. Using a community-based participatory research approach in Puerto Rico, we co-develop: i) an assessment protocol to understand the relationships between FEW insecurities, social capital, and community health resilience, ii) a process-oriented tool to support communities and health practitioners in coproducing context-specific assessments that enhance community preparedness to extreme events, and iii) a transdisciplinary framework explicating the roles of social capital in enhancing FEW security for positive public health outcomes.

Exploring Post-Disaster Transportation Barriers to Healthcare of Socially Vulnerable Puerto Rican Communities

Diana Ramirez-Rios, Rensselaer Polytechnic Institute
William A. Wallace, Rensselaer Polytechnic Institute
Jordan Kinsler, Rensselaer Polytechnic Institute
Norianne Martinez Viota, San Juan Bautista School of Medicine
Paola Mendez, University of Puerto Rico

This study explores the transportation-related healthcare access conditions that affect the social vulnerability of Puerto Rican communities. This effort includes the identification of key variables—such as transportation access conditions, infrastructure capacity, and medical capacities—that impact access to healthcare. Through an empirical analysis from publicly available data in Puerto Rico, the study aims at exploring how these factors affect social vulnerability. These findings will be complemented with data collected from in-depth interviews and focus groups. As a result, this research will provide public health and transportation strategies that improve the urgent healthcare needs following a natural disaster.

The Use of Disaster Information and Communication Technology Among At-Risk Populations in U.S. Virgin Islands

Nitin Roy, California State University, Sacramento
Nisha Clavier, University of Virgin Islands

The U.S. Virgin Islands are susceptible to different types of disasters: hurricanes and tropical storms, earthquakes, tsunamis, and more. Post-disaster community resilience can be greatly increased by utilizing available technologies: solar chargers, apps, websites, and more. Through interdisciplinary mixed-methods research, this study seeks to uncover the level of Information and Communication Technology (ICT) use and awareness that exists within at-risk populations and public health organizations on the island of St. Croix. Interviews will be conducted with leaders of public health organizations and residents of public housing communities will participate in surveys. Results will be used to inform public health agencies and the general community.

Special Call 1: Research in U.S. Territories

The following is a list of recently funded awards as part of a Special Call for Research in U.S. Territories.

Real-Time Tracking of Intraregional Immigration from the Caribbean to Puerto Rico After Extreme Events

Alejandro Arrieta, Florida International University
Shu-Ching Chen, Florida International University
Richard Olson, Florida International University
Juan Pablo Sarmiento, Florida International University

International migration is a major effect of extreme events, and it is particularly relevant to Puerto Rico as an important host territory in the Caribbean. The lack of real-time data to track international migration in the Caribbean when disasters occur can easily overload the capacity of health organizations and public health response. In this study we will develop, test and validate an innovative model that utilizes big internet-derived data to track post-event international migration. A public version of our model will be available to track immigration flows to Puerto Rico as a result of the aftermath of the COVID-19 pandemic.

Compound Hazards, Evacuations, and Mass Sheltering: Improving Practices for Public Health in the PRVI Region

Jennifer Collins, University of South Florida
Leslie Mass, Puerto Rico Science, Technology, and Research Trust
Janis Valmond, Caribbean Exploratory Research Center
Erik Ackerson, Virgin Islands Territorial Emergency Management Agency
Ernesto Morales, National Weather Service San Juan

Through interdisciplinary mixed-method research, this study aims to provide insight for evacuation preparation in Puerto Rico and the U.S. Virgin Islands (PRVI) for those who shelter at home, mass shelter, or evacuate elsewhere. Plans have to be tailored to accommodate new challenges (including pandemics), which are compounded to existing pressures (impacts from hurricanes, related landslides and flooding) that need to be addressed. Analysis compares results between PR and VI, informing planners in emergency management and public health. Researchers engage in PRVI territory-wide resident surveys examining their risks and vulnerabilities pre-hurricane as a baseline and post hurricane, providing analyses and trainings.

Hurricane Maria Mortality Study: Ascertaining the Excess Mortality and Associated Risk Factors Following Hurricane Maria in Puerto Rico

Kristen Cowan, University of North Carolina at Chapel Hill
Diego Zavala, Ponce Health Sciences University

In the year that followed Hurricane Maria in Puerto Rico the number of deaths from the hurricane was a point of disagreement as various studies utilizing models and surveys identified different mortality counts following the storm. There is a gap in literature on the number of deaths attributable to Hurricane Maria, particularly deaths indirectly caused by the hurricane or displacement. The Purpose of this study is to review death certificates to quantify excess deaths, to describe trends in deaths and to identify if there are geographical clusters of excess mortality from September 2017-March 2018 following Hurricane Maria in Puerto Rico.

Photovoice and Cultural Competence in Disaster Recovery

Monique Constance-Huggins, Winthrop University
Alexus Sharpe, Winthrop University

Culturally grounded work is critical in all types of service delivery, including disaster recovery. Yet, little attention is given to cultural competence of post disaster work and its impact on already distressed Caribbean communities. The proposed study fills the gap by exploring workers’ cultural competence using a unique social justice methodology—photovoice. The study has implications for improving the effectiveness of disaster work across a range of service areas. Should we remain committed to providing service that leads to sustainable change in the Caribbean region, then examining and responding to cultural competence must be critical components of our work.

Impact of Recovery on Economic Equality, Public Health, and Disaster Preparedness in Puerto Rico

Antonio Fernos, Inter American University of Puerto Rico
Alison Chopel, Independent Researcher
Laura Gorbea, Puerto Rico Public and Applied Social Sciences Workshop

The proposed study uses the convergent framework and mixed methods to examine dynamic relationships between natural disaster damages, emergency responses, recovery efforts, public health and hazard readiness in Puerto Rico. The research focuses on economic equality as we seek to improve understanding of both the causes and effects of poverty in the context of compound and cascading disasters. The transdisciplinary approach converges economics, applied anthropology and public health. Findings are expected to provide new insights to inform development of economic policies that build social resilience and manifest improved public health.

Frontline Government Workers: An Assessment of Burnout and Quality of Life in the U.S. Virgin Islands Following Disasters

Kula Francis, University of the Virgin Islands
Nisha Clavier, University of the Virgin Islands
Kenny Hendrickson, University of the Virgin Islands

Recently, the U.S. Virgin Islands (USVI) have been impacted by disasters. Namely, Hurricane Irma, Hurricane Maria, and COVID-19. This research uncovers burnout and the quality of life for frontline workers of public agencies in the USVI. Frontline workers operate in harsh conditions during disasters. Examining burnout and professional quality of life offers insight on the wellbeing of employees in public organizations. An exploratory mixed-method design is used. Data collection uses modified versions of Professional Quality of Life Scale and Maslach Burnout Inventory. Regression analysis will examine the relationship between frontline government worker’s post-disaster burnout and professional quality of life.

Nonprofit Response to Concurrent Disaster Events

Ivis Garcia, University of Utah
Divya Chandrasekhar, University of Utah
N. Emel Ganapati, Florida International University
Pablo Jose Rivera Miranda, Métrika
Kevin Fagundo-Ojeda, University of Utah

Disaster planning policy and practice largely agree on the importance of nonprofits in recovery management but lack insight into how nonprofits navigate the recovery process themselves. In this study, we examine how health and allied sector nonprofits in Puerto Rico are faring under the compound effect of 2020 Southwest Puerto Rico Earthquake Sequence and COVID-19 pandemic, and what actions they are taking in response. We then compare these findings against findings of a similar study conducted after the 2017 Hurricanes Irma and Maria to produce a longitudinal understanding of nonprofit experience in contexts of consecutive, cascading, and compound disasters.

Impact of Cascading Disasters on High School Student Resilience, Coping, and Educational Performance in St. Thomas and St. John

Leonard Huggins, University of Phoenix
Ted Serrant, Houston Independent School District

More than 51 million people were hit by overlapping disasters during the COVID-19 pandemic. St. Thomas and St. John, US Virgin Islands have been experiencing such cascading disasters for decades. In September 2017, they were devastated by category 4 Hurricane Maria while still reeling from the destruction of category 5 Hurricane Irma. While some studies assessed the needs of vulnerable children and families in response to cascading disasters, we have limited evidence on how high-schoolers cope and adjust in the longer term. After 3 years, we examine how high-schoolers bounce-back, cope, and perform, academically, in anticipation of graduation.

Sharing is Caring: Experiences and Lessons from Islands

Karl Kim, University of Hawaii

This study focuses on sharing of housing, goods and services before, during and after extreme events. Using mixed methods (survey questionnaire, interviews, and workshop), the research will 1) describe sharing before, during, and after disasters in five islands and territories; 2) what are mechanisms and practices for sharing of shelter and mass care services and goods during disasters; 3) what is the role of global sharing industries during disasters in these communities; 4) how is sharing integrated in formal and informal initiatives to enhance preparedness and resilience; 5) what lessons, practices, and actions can be shared beyond these island communities?

When Nobody Came to Help Me: Protective Factors for College Students in Puerto Rico

María de Lourdes Lara-Hernández, University of Puerto Rico
Félix López-Román, University of Puerto Rico
Elena Martínez-Torres, Agenda Ciudadana Foundation
Sol Molina-Parrilla, University of Puerto Rico

In less than three years, college students in Puerto Rico survived multiple disasters (hurricanes Irma and María, earthquakes and the COVID-19 pandemic). Notwithstanding, they have continued studying and are about to complete their bachelor’s degree. The problems and the impact have been researched. How they managed to overcome them remains unknown. This research will document and identify, through in-depth interviews and focal groups, protective factors that supported the academic and mental health performance of low-income undergraduate students. Its results elucidate the practices and competences that could be integrated in community mental health services and public policies of the campus community.

Calculating the Social Vulnerability Index for Guam

Yvette Paulino, University of Guam
Grazyna Badowski, University of Guam
Jade Chennaux, University of Guam
Monica Guerrero, Guam State Data Center Bureau of Statistics and Plans
Sela Panapasa, University of Michigan

The Social Vulnerability Index (SVI) is a measure of a community’s vulnerability based on social, economic, and demographic factors. The SVI has been constructed for the communities defined by the census tracts in the United States and Puerto Rico, but not Guam. The SVI will be calculated for Guam using census data extracted from the 2010 Guam Demographic Profile Summary. The results may inform the government’s response plans and prioritization of resources according to community needs based on the vulnerability across the municipalities of Guam.

Risk Communication in Concurrent Disasters

Jenniffer Santos-Hernandez, University of Puerto Rico-Río Piedras
Lorna Jaramillo Nieves, University of Puerto Rico-Río Piedras
Sara McBride, U.S. Geological Survey
Nnenia Campbell, University of Colorado Boulder
Jeiselynn Ríos Rivera, University of Puerto Rico-Río Piedras
Leslie Martínez Román, University of Puerto Rico-Río Piedras

In the last three years, residents of Puerto Rico have been affected by hurricanes Irma and María, the 2020 earthquake sequence, and the COVID-19 pandemic. This project seeks to (1) understand the risk perception of diverse users of earthquake risk communication information in Puerto Rico, (2) how available risk communication products (e.g., aftershock forecasts), experience with other unfolding disasters, as well as their social characteristics and individual and familial situation, may inform hazard reduction and protective action decision making, and (3) co-design visualizations that allow governmental and non-governmental organizations to effectively and efficiently convey current and future earthquake risk.

The Effect of School Disruptions Due to Three Consecutive Natural Hazard Events on Educational Outcomes

Eileen Segarra-Alméstica, University of Puerto Rico Río Piedras
Yolanda Cordero-Nieves, University of Puerto Rico Río Piedras
Indira Luciano-Montalvo, University of Puerto Rico Río Piedras
Héctor Cordero-Guzmán, City University of New York
José Caraballo-Cueto, University of Puerto Rico Cayey

Major hurricanes hit Puerto Rico in September 2017. In January 2020, the Island experienced a 6.4 earthquake, and the COVID -19 emergency began in March 2020. These events forced schools to close temporarily. Our research focusses on the effects of school disruptions due to these events on educational outcomes, paying particular attention to vulnerable students from low socioeconomic backgrounds, with disabilities, or both. We propose a mixed-method approach combining quantitative analysis of administrative data with focus groups and interviews to identify challenges faced by vulnerable students and the strategies that would reduce the impacts of natural disasters on educational outcomes.

Co-Designing Cultural Probes for Participatory Community Mapping: Informal Emergency Shelter Planning and Management in Puerto Rico

Jonathan Sury, Columbia University
Robert Soden, University of Toronto
Yiyuan Jasmine Qin, Recollective

Puerto Rico faces a unique risk profile due to climate change, increased seismicity, the global pandemic, and slow recovery from Hurricane Maria. In the face of cascading and compounding disasters. The need to improve community-led disaster planning and management is of great importance. Our collaborative team seeks to improve informal emergency shelter planning and management through participatory action and design research framework. We aim to explore the novel approach of cultural probes for participatory community mapping in Puerto Rico under the physical distancing constraints imposed by the COVID-19 pandemic.

Cascading Disasters, Gender, and Vulnerabilities in the South-West Region of Puerto Rico

M. Gabriela Torres, Wheaton College
Alitza Cardona, Puerto Rico Science and Technology Research Trust
Mabel Crescioni, Puerto Rico Science and Technology Research Trust
Jane Henrici, George Washington University
Waleska Sanabria-León, Pontificia Universidad Católica Puerto Rico

Cascading disasters in Puerto Rico since 2015 have included hurricane, seismic, and epidemiological events as well as those that are socio-economic and governmental; all these processes disproportionately appear to have impacted those who reside in the southwestern part of the island, particularly those who are poorer women, while both being affected by and worsening the vulnerability of a weakened and mistrusted public health system. The proposed multi-site ethnography uses mixed methods for secondary and primary data collection and analysis to provide recommendations for a long-term plan to improve the public health system for the U.S. territory of Puerto Rico.


The Public Health Disaster Research Award Program is based on work supported by the Centers for Disease Control and Prevention (CDC) through supplemental funding to the National Science Foundation (NSF Award #1635593). Any opinions, findings, conclusions, or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the CDC, NSF, or Natural Hazards Center.