Funded Projects

Call 1: Research in U.S. Territories

The following is a list of awards funded as part of the 2020 Call for Research in U.S. Territories.

Real-Time Migration Tracking to Puerto Rico after Natural Hazard 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 Shelter Choices: Implications for Public Health Practices in the Puerto Rico and the U.S. Virgin Islands

Jennifer Collins, University of South Florida
Amy Polen, 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 Oceanic and Atmospheric Administration
Delián Colón-Burgos, Pennsylvania State University

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.

Excess Mortality and Associated Risk Factors Related to 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 in St. Croix

Monique Constance-Huggins, Winthrop University
Alexis 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.

Relationships Between Distribution of Disaster Aid, Poverty, and Health 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: Assessing Post-Disaster Burnout and Quality of Life

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 and Consecutive Disaster Events in Puerto Rico

Ivis Garcia, University of Utah
Divya Chandrasekhar, University of Utah
N. Emel Ganapati, Florida International University
Pablo Jose Rivera Miranda, Métrika Inc.
Kaila Witkowski, Florida Atlantic University
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.

Exploring the Long-Term Impact of Cascading Disasters in the U.S. Virgin Islands on High School Student and Teacher Mental Health and Resilience

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 During Disasters: Learning From Islands Preliminary Findings and Initial Implications for Action

Karl Kim, University of Hawaii
Jiwnath Ghimire, University of Hawaii
Eric Yamashita, 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 During Disasters in Puerto Rico

María L. Lara Hernandez, University of Puerto Rico Humacao
Félix A. López-Román, University of Puerto Rico Humacao
Elena Martínez-Torres, Agenda Ciudadana Foundation
Sol Molina-Parrilla, University of Puerto Rico Río Piedras

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 S. N. Chennaux, University of Guam
Monica Guerrero, Guam State Data Center Bureau of Statistics and Plans
Casierra Cruz, University of Guam
Romina King, University of Guam
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 Services Disruptions on Educational Outcomes After Consecutive Disasters in Puerto Rico

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
Sylvia Martínez-Mejias, University of Puerto Rico Río Piedras
Hilda Rivera-Rodríguez, University of Puerto Rico Río Piedras

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 a Participatory Community Mapping Method for Informal Sheltering in Puerto Rico

Jonathan Sury, Columbia University
Robert Soden, University of Toronto
Jasmine Yiyuan Qin, re+connect
Gabriela Quijano, University of Massachusetts Amherst
Yesenia Delgado-Castillo, Independent Researcher

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 Vulnerability in Southwestern Puerto Rico

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

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.

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

The following is a list of awards funded as part of the 2021 Call for Strengthening Community Resilience in U.S. Territories.

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

Lily 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.

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

Susan Spierre Clark, State University of New York at Buffalo
Ralph Rivera-Gutirrez, University of Puerto Rico
Michael Shelly, State University of New York at Buffalo
Sara Peterson, State University of New York 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 García, 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 Abandoned Spaces in Post-Maria Puerto Rico

Michelle Alvarado, Center for Habitat Reconstruction
David Carrasquillo, Hispanic Federation
Luis Gallardo, 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.

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

Greg Guannel, University of the Virgin Islands
Hilary Lohman, U.S. 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 A. Hendrickson, University of the Virgin Islands
Kula A. Francis, University of the Virgin Islands
Anna M. 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, Towson University
Elizabeth Rivera, Ponce Neighborhood Housing Services
Divya Chandrasekhar, University of Utah
Ivis García, Texas A&M University

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
Simon Priest, University of New Hampshire
Joan M. Flores, Northern Marinas College
Geraldine A. Rodgers, Rodgers Educational Consulting

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.

Exploring Post-Disaster Transportation Barriers to Health Care for Socially Vulnerable Puerto Rican Communities

Diana Ramirez-Rios, State University of New York at Buffalo
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.

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

Anaís Delilah Roque, The Ohio State University
Sameer H. Shah, University of Washington
Fernando Tormos-Aponte, University of Pittsburgh
Enid Quintana Torres, University of Puerto Rico

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.

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.

Call 3: Research in U.S. Territories, Tribal Areas, and Rural Communities

The following is a list of awards funded as part of the 2022 Call for Research in U.S. Territories, Tribal Areas, and Rural Communities.

Validating the Disaster Food Security Scale for Rural U.S. Populations

Lauren Clay, University of Maryland, Baltimore County
Nadia Koyratty, International Food Policy Research Institute
Anna Josephson, University of Arizona
Carmen Byker Shanks, University of Montana

There's a wealth of research on food insecurity, however, research is limited in disaster settings. Rural areas are especially at risk for adverse disaster consequences and for food insecurity. This project uses a four-step methodology to validate the Disaster Food Security Scale for rural populations (DFSS-Rural). Rural population specific validation is needed to ensure that the scale reliably measures the barriers to food security in rural populations. The DFSS-Rural can be used by rural public health organizations to collect actionable data for developing mitigation strategies for bolstering food security, planning for future disasters, and for managing response and recovery from disruptions.

Resilience Planning for Climate-Influenced Hazards and Health Impacts for Virginia Tribes

Nicole Hutton, Old Dominion University
Wie Yusuf, Old Dominion University
Jesse Palma, Old Dominion University

Resilience building strategies require adaptation to improve the integration of tribal areas and connect health with hazards planning. Plans to reduce hazard risk should seek synergies between long-term and short-term health issues and mitigation and adaptation priorities. This pilot study involving one federally- and one state-recognized tribe uses participatory research methods to develop a gap assessment and resilience integration model to adapt resilience planning tools to tribal governance structures. Findings will facilitate interaction between tribes and local, state, and—potentially—federal agencies with which they interact to synergistically improve health and hazard risk.

Public Health Computer Simulation Tool to Support Disaster Preparedness in Rural Communities

Kristina Kintziger, University of Nebraska Medical Center
Tom Berg, University of Tennessee, Knoxville
Tracey Stansberry, University of Tennessee, Knoxville
Scott Lawson, University of Tennessee, Knoxville
Gerald Jones, Jr., University of Tennessee, Knoxville
Liem Tran, University of Tennessee, Knoxville

Rural areas, which are commonly economically stressed and underserved, are vulnerable to poorly coordinated disaster responses and the long-term physical and economic effects of disasters. This research uses a model-based systems engineering approach and seeks to improve rural disaster preparation, response, and recovery using a computer simulation and stakeholder engagement. This project will build on our previous dynamic systems research to include the effects of social drivers of health in response and outcomes. We will verify and validate the new model (a planning and predictive analytics tool) through community stakeholder engagement, expert review, and data-driven testing to improve rural public health outcomes following natural disasters.

Assessing Impacts of Hurricane Maria for Promoting Healthcare Resilience in Puerto Rico

Pallab Mozumder, Florida International University
Linnette Rodríguez-Figueroa, University of Puerto Rico
Mayra Quiles-Miranda, University of Puerto Rico
Barsha Manandhar, Florida International University
Nafisa Halim, Boston University
Sisi Meng, University of Notre Dame

The overarching aim of this project is to understand the extent to which key challenges for building a more resilient health system in Puerto Rico are related to resource constraints, and to what extent they are related to management practices and policy constraints. What are the actionable instruments to overcome these constraints and make changes on the ground to reduce mortality and morbidity risks in the next disaster? More broadly, how we can build a conduit between the community, public health stakeholders, and emergency management agencies for laying down the foundation for a resilient health system for Puerto Rico.

Harmful Algal Blooms: Community-Based Participatory Research to Improve Rural Public Health Practice

Amber Roegner, University of Oregon
Mike Mader, Tenmile Lakes Basin Partnership
Anjana Adhikari, University of Wisconsin-Milwaukee
Zarah Wemple, University of Oregon
Summer Zelinsky, University of Oregon
Keira Embry, University of Oregon
Todd Rex Miller, University of Wisconsin-Milwaukee

Harmful freshwater cyanobacterial algal blooms are an emerging public health risk as climate change makes these events more frequent, severe, and unpredictable. Rural households are particularly at risk because they often rely on unmonitored private wells or surface water. This study is based in Tenmile Lakes, Oregon, where harmful algal blooms have recurred since the 1980s. Using community-based methods, we will be the first to evaluate the effects of algal bloom disasters on the health of the rural community and tribal members. We will also engage project participants in developing public health preparedness and risk communication guidance concerning algal blooms.

Risk and Health Communication During Hurricane Fiona in Puerto Rico and Hurricane Ian in Florida

Federico Subervi-Vélez, University of Puerto Rico Cayey
Sandra M. Fábregas-Troche, Latino Center for Bioethics and Humanities **
**Mirelsa Modestti-González, Latino Center for Bioethics and Humanities

Gary L. Kreps, George Mason University
Hilda Patricia García-Cosavalente, University of Maryland

This study assesses how risk- and health-focused news and government communication worked in Puerto Rico and Florida during Hurricanes Fiona and Ian, as well as if they improved since previous emergency situations. Based on the evidence gathered, policy recommendations will be developed, including those for education and training of media staff and government personnel. While this is important for nearly all news and government personnel in Puerto Rico, in Florida recommendations will be focused on those whose communication efforts are imperative to safeguard Puerto Rican and other Spanish-speaking populations.

Energy Service Security for Public Health Resilience in Michigan’s Western Upper Peninsula

Shardul Tiwari, Michigan Technological University
Zoē Ketola, Michigan Technological University
Chelsea Schelly, Michigan Technological University
Eric Boyer-Cole, Michigan Technological University

This study will assess the disaster preparedness of health facilities in six counties of the Western Upper Peninsula of Michigan, focusing on their energy service needs during extreme weather events. Recently, major floods, snowstorms, and polar vortexes have disrupted healthcare access in this remote rural region. Climate change will make such events more frequent and intense. This project employs an energy services perspective to study the security of services dependent on electricity, such as lifesaving devices, refrigeration, and communication. It will assess the vulnerabilities of healthcare facilities to power system disruption and inform policies to improve disaster preparedness.

Steep Risks: Assessing Social Vulnerability to Landslide Hazards in Rural Puerto Rico

Jocelyn West, Natural Hazards Center
Luis Alexis Rodríguez-Cruz, Caribbean Climate Hub
K. Stephen Hughes, University of Puerto Rico Mayagüez

Although landslides frequently affect mobility and health across rural Puerto Rico, it is still unknown how many people live in high-risk areas for landslides. This study will first estimate the population exposed to landslide hazards based on a high-resolution susceptibility map. Then, this study will quantitatively analyze social vulnerability among the exposed populations. Finally, we will validate the quantitative analysis through qualitative fieldwork with key rural communities, resulting in a map-based public health tool in both Spanish and English for understanding and addressing the needs of populations at risk to landslides in Puerto Rico.

Call 4: Community-Based Research on Public Health and Equity

The following is a list of awards funded as part of the 2023 Call for Community-Based Research on Public Health and Equity.

Predicting Rural Public Health Disaster Needs: Analyzing 911 Calls During Climatic Hazards

Christina Barsky, University of Montana
Lauren McKeague, University of Montana
Blake Emidy, University of Montana
Josephine Hazelton-Boyle, University of Montana
Adriane Beck, Missoula Office of Emergency Management
Damian Chase-Begay, Missoula City-County Health Department

Acute climatic events can have disproportionate impacts on vulnerable groups, including those living in rural communities. Through quantitative analysis and spatial visualization of extant secondary data related to extreme temperature and poor air-quality events, factors known to create vulnerability to public health threats and public health disaster outcomes as operationalized by emergency 911 calls, this community-engaged study seeks to advance the knowledge on rural vulnerability to climatic events as well as equitable public health disaster preparedness and response. Ultimately, this project will inform disaster response practitioners in their efforts to serve vulnerable communities.

Factors Associated With Recovery and Resilience of Rural Children and Families After a Wildfire

Rita Burke, University of Southern California
Santina Contreras, University of Southern California

The Slater Wildfire in 2020 devastated the small rural community of Happy Camp, CA. People living in rural communities are more likely to belong to groups vulnerable to disasters. Yet, most published disaster literature focuses on urban communities. We have assembled an interdisciplinary team to conduct a mixed methods study that identifies the key drivers and barriers to disaster recovery and resilience among rural adults and children. The proposed research aims to advance public health disaster practices in small rural communities and drive policy approaches for wildfires.

Rural Community Capacity: Evacuation Experiences and Health Outcomes of Incarcerated Women

Benika Dixon, Texas A&M University
Carlee Purdum, Texas A&M University
Tara Goddard, Texas A&M University
TyKeara Mims, Texas A&M University
Jennifer Toon, Lioness: Justice Impacted Women's Alliance
Marci Simmons, Lioness: Justice Impacted Women's Alliance

Disaster impacts to incarcerated people are inextricably linked to rural capacity. Prisons are often intentionally placed in rural communities, yet these facilities remain socially and spatially isolated, leading to restricted access to resources. Prisons depend on local support and engagement in disasters, but rural communities often have lower capacity. Incarcerated women have different needs in evacuations and may be more vulnerable to negative mental health impacts during these events. Through focus groups with formerly incarcerated women and analysis of carceral evacuation processes, we aim to contribute to the knowledge base on evacuations and effects on mental health of incarcerated women.

Building a Social Vulnerability Index for Migrant and Seasonal Farmworkers

Paul Monaghan, University of Florida
Miranda Carver Martin, University of Florida
Amr Abd-Elrahman, University of Florida

Migrant and seasonal farmworkers are a vulnerable population due to employment precarity, lack of healthcare, low levels of education, poor housing, discrimination, and dangerous workplaces. Recent hurricanes in Florida have demonstrated the increased risks experienced by these hidden populations. The Centers for Disease Control and Prevention (CDC) Social Vulnerability Index has limited utility for informing hazard mitigation and preparedness for migrant and seasonal farmworkers due to their mobility and seasonal changes in planting and production. A community advisory board—composed of representatives from public health, Cooperative Extension, advocacy groups, and industry—will improve the CDC Social Vulnerability Index by combining geographic information system (GIS) maps of agricultural production with ethnographic interviews conducted by community health workers.

Public Health Risks and Resilience to Climate-Related Disasters Among Refugees in Rural Communities

Ming Xie, West Texas A&M University
Li Chen, West Texas A&M University

This study explores how social determinants of health and exposure to health information affect how refugees perceive risks associated with climate-related disasters and their intentions to take preventive actions. We will conduct survey research with 300 refugees in the Texas Panhandle, a rural area where a large number of refugees from diverse countries, cultures, and ethnic groups reside. We will use the survey outcomes to understand the specific barriers refugees are facing in response to climate-related disasters and suggest solutions to remove these barriers.

Continuation Award 1: Extending Public Health Disaster Research and Community Engagement in the U.S. Territories

The following is a list of awards funded as part of the 2022 Continuation Award 1: Extending Public Health Disaster Research and Community Engagement in the U.S. Territories.

Evacuation Decision-Making Post-Vaccine: Implications of Compound Hazards in U.S. Territories

Jennifer Collins, University of South Florida
Elizabeth Dunn, University of South Florida
Justin Hartnett, State University of New York at Oneonta
Leslie Maas Cortes, Puerto Rico Science, Technology, & Research Trust
Rashida Jones, University of South Florida

Through interdisciplinary mixed-method research, this study aims to provide insight for evacuation preparation in Puerto Rico and the U.S. Virgin Islands (PRVI) examining data collected on residents intended evacuation behavior in the COVID-19 post-vaccination era, and on data to be collected post Hurricane Fiona examining recovery. Plans have to be tailored to accommodate new challenges (including pandemics), which are compounded to existing pressures (impacts from hurricane hazards) that need to be addressed. Analyses inform planners in emergency management/public health. Researchers engage in resident surveys examining their risks and vulnerabilities pre- vs. post-vaccine, and post-Hurricane Fiona, providing analyses and trainings.

Support for Frontline Government Workers At-Risk for Burnout in the U.S. Virgin Islands: The Coping With Burnout Webinar Series

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

Frontline government workers find themselves with increased workloads. Over time, the added pressures lead to burnout and diminished quality of life. The conclusions of our previous work were integral in creating our plan for achieving best practices in reducing burnout in U.S. Virgin Islands government organizations. Using expert trainings and workshops, this project will increase support and offer techniques to improve the quality of life for frontline workers. We anticipate direct advances to overall employee health and well-being as a result of increased coping and resiliency strategies. Most importantly, this initiative will lessen the effects of burnout on frontline employees.

Strengthening Disaster Preparedness and Response in the Northern Mariana Islands Through First Aid Training: The Basic Disaster First Aid Curriculum

Todd Miner, University of Colorado School of Medicine
Tayna Belyeu-Camacho, Northern Marianas College
Geraldine T. A. Rodgers, Rodgers Educational Consulting
Patrick I. George, Northern Marianas Islands Fire & Emergency Services
Steve A. Aguon, Northern Marianas Islands Homeland Security and Emergency Management

The Community First Aid Training: A Tool To Strengthen Community Resilience project was successful in providing Disaster Response Advanced First Aid (DRAFA) instruction to communities in the Northern Mariana Islands, but didn't meet a goal for sustainable training. To achieve sustainable training, this current project uses curriculum mapping to create a customized course, using national and local expertise. Local experts who will largely inform the curriculum mapping will also be trained to teach the adapted course they helped design. Finally, offerings of the new course will be piloted, testing the curriculum while providing new instructors opportunities to teach, with coaching from the DRAFA creator.

Assessing Intra-Community Public Health Impacts from Compounding Food, Energy, and Water Insecurities

Anaís Roque, Ohio State University
Enid Quintana Torres, University of Puerto Rico
Sameer H. Shah, University of Washington
Mary Painter, Natural Hazards Center
Fernando Cuevas, Interamerican University of Puerto Rico
Fernando Tormos-Aponte, University of Pittsburgh

This project develops, pilots, and validates a standardized household survey to more precisely quantify public health impacts originating from combined food, energy, and water (FEW) insecurities in compounding hazard contexts. We are motivated by the understanding that existing public health assessments—focused on single food, energy, or water insecurities in one hazard context—cannot capture the complexity or magnitude of the health risks experienced by communities facing diverse and recurring climatic and non-climatic hazards. The survey will be actionable and accessible, with the purpose of being used by community members to understand health and FEW needs, and outline prospective solutions.

Mapping Puerto Rican Student Vulnerability and Risk To Improve School Emergency Planning

Eileen V. Segarra-Alméstica, Unviersity of Puerto Rico Río Piedras
Yolanda Cordero-Nieves, Unviersity of Puerto Rico Río Piedras
Amílcar Vélez-Flores, University of Puerto Rico Río Piedras

As hazard events have become more frequent, developing new tools to enhance schools' capacity to assess risks and vulnerabilities is essential for mitigation, preparation, and recovery efforts. We will explore the potential of combining data from the Puerto Rico Department of Education Student Information System (PRDE-SIS), environmental risk geodata, and socioeconomic data from the Puerto Rico Community Survey to develop a tool that could help Puerto Rican public schools identify their communities' specific risks and vulnerabilities. The information gathered is intended to assist schools in implementing effective hazard mitigation, preparation, and recovery plans.

Improving Disaster Information and Communication Technology Solutions In Puerto Rico: Co-Designed Community-Based Tabletop Exercises

Yiyuan Jasmine Qin, re+connect
Wei-Ching Azury Lin, re+connect
Pamela Silva Díaz, re+connect
Natalia Arcila, re+connect
Jonathan Sury, Columbia University
Robert Soden, University of Toronto

Puerto Rico has a unique combination of risks that include climate change, seismicity, the global pandemic, and slow recovery from Hurricane Maria. Faced with these cascading and compounding disasters, the need to improve disaster information management, especially at the community level is of great importance. Building upon extensive previous research and community engagements, we aim to collaborate with residents, community-based organizations, and humanitarian aid agencies to deploy a novel methodological approach, community-based tabletop exercises, informed by participatory action research principles to share prior research findings regarding information and communication technologies to support community needs and situational awareness for mass care and shelter management.

Continuation Award 2: Extending Public Health Disaster Research and Community Engagement in Understudied Areas

The following is a list of awards funded as part of the 2023 Continuation Award 2: Extending Public Health Disaster Research and Community Engagement in Understudied Areas.

Validating the Disaster Food Security Scale-Rural for Racial and Ethnic Minority Subpopulations

Lauren Clay, University of Maryland Baltimore County
Nadia Koyratty, International Food Policy Research Institute
Anna Josephson, University of Arizona
Carmen Byker Shanks, Gretchen Swanson Center for Nutrition

While extensive research exists on food security and systems, similar research is limited in disaster settings, especially among racial and ethnic minorities. Our prior research revealed disaster-related disruptions in food accessibility, availability, acceptability, and individual agency. Nonwhite groups face heightened risk for food insecurity, but there are no quantitative measurement tools for these groups. The purpose of this project is to validate our previously developed rural Disaster Food Security Scale (DFSS-Rural) for racial and ethnic minorities. We will use a quantitative approach to perform the validation through the implementation of a survey among the selected groups.

Equitable Resilience Hub Structuring With Eastern Tribes

Nicole Hutton, Old Dominion University
Wie Jusuf, Old Dominion University
Jessica Rich, Virginia Polytechnic Institute and State University
Megan Brondon, Virginia Polytechnic Institute and State University

Resilience hubs have been designed in some communities as shelters that address the needs of vulnerable households during natural hazard events and to promote resilience by reducing disparities in access to infrastructure and services. Alternatively, other communities have made plans to develop virtual resilience hubs that can address the needs of geographically dispersed populations. In tribal nations, exposure to hazards and social vulnerability to disasters is disproportionately high. Many tribal citizens also live in geographically dispersed areas. Resilience hubs in tribal nations require adaptation to improve their capacity to accommodate hazard-related public health threats and the geographic distributions of their citizens. This study engages the Upper Mattaponi Indian Tribe and the Mattaponi Indian Tribe and Reservation in designing a resilience hub plan and resource guide that are adapted to their citizens’ capacities and geographic dispersion. Findings will facilitate the implementation of tribal resilience hubs to improve health and hazard risk.

Participatory Budgeting: A Community-Led Intervention for Resource Security Following a Disaster

Anaís Delilah Roque, The Ohio State University
Enid Quintana Torres, University of Puerto Rico
Edna Torres, Comité Comunal de Corcovada, Inc.
Fernando Tormos-Aponte, University of Pittsburgh
Mary Angelica Painter, Natural Hazards Center
Fernando Cuevas, University of Puerto Rico

This project utilizes participatory budgeting to implement a community-led intervention that can aid in community health resilience following a disaster. Specifically, this participatory budgeting exercise allows residents to have decision-making power over the implementation of a project designed to promote resilience to recurring hazards and disasters that disrupt food, energy, and water (FEW) security and public health. Ultimately, by utilizing this bottom-up, community-centered approach, we seek to support community cohesion, reduce FEW-related public health risks following disasters, and strengthen community resilience.

Enhancing Disaster Resilience and Support for Vulnerable Puerto Rican Students

Eileen V. Segarra-Alméstica, University of Puerto Rico Río Piedras
Hilda Rivera-Rodríguez, University of Puerto Rico Río Piedras
Indira Luciano-Montalvo, University of Puerto Rico Río Piedras
Sylvia Martínez-Mejias, University of Puerto Rico Río Piedras

Puerto Rico's public school students have endured multiple disruptions to their education due to recent disasters, including Hurricanes Irma and Maria (2017), the seismic sequence (2020), the COVID-19 lockdown (2020), and Hurricane Fiona (2022). Our previous study revealed that students—particularly those from impoverished households or those with a disability—had suffered significant academic setbacks. This follow-up study aims to assess the implementation of post-disaster programs and services designed to help students who have fallen behind academically or socio-developmentally due to school disruptions. We will focus in particular on vulnerable students and their experiences. The study will be based in two of the schools where we originally conducted research and we will interview principals, social workers, and teachers and conduct focus groups with students to gain insights into their experiences. This study will provide recommendations for improving services for children affected by educational disruptions.

Risk Communication Practices at Municipal Levels in Puerto Rico

Federico Subervi-Vélez, University of Wisconsin–Madison
Sandra M. Fábregas-Troche, Latino Center for Bioethics and Humanities
Mirelsa Modestti-González, Latino Center for Bioethics and Humanities
Gary L. Kreps, George Mason University

This continuation project will assess the risk communication policies and practices of municipal government officials in Puerto Rico who are responsible for reaching out to local populations during emergencies. We will conduct the study in ten municipalities located in areas at risk for landslides or coastal flooding and with high proportions of their population socially vulnerable to disasters due to poverty, age, or health conditions. The study will also inquire about the most pressing needs those officials have for improving their risk communication efforts. The results of this continuation study will be disseminated in academic publications and in forums for local and state risk communication officials and the public at large.


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.