Building Back Better: Local Health Department Engagement and Integration of Health Promotion into Hurricane Harvey Recovery Planning and Implementation

Abstract

Disaster recovery provides an opportunity to build healthier and more resilient communities. However, opportunities and challenges encountered by local health departments (LHDs) when integrating health considerations into recovery have yet to be explored. Following Hurricane Harvey, 17 local health and emergency management officials from 10 agencies in impacted Texas, USA jurisdictions were interviewed to describe the types and level of LHD engagement in disaster recovery planning and implementation and the extent to which communities leveraged recovery to build healthier, more resilient communities. Interviews were conducted between December 2017 and January 2018 and focused on if and how their communities were incorporating public health considerations into the visioning, planning, implementation, and assessment phases of disaster recovery. Using a combined inductive and deductive approach, we thematically analyzed interview notes and/or transcripts. LHDs reported varied levels of engagement and participation in activities to support their community’s recovery. However, we found that LHDs rarely articulated or informed decision makers about the health impacts of recovery activities undertaken by other sectors. LHDs would benefit from additional resources, support, and technical assistance designed to facilitate working across sectors and building resilience during recovery.

Hybrid Resiliency-Stressor Conceptual Framework for Informing Decision Support Tools and Addressing Environmental Injustice and Health Inequities

“…For example, the Los Angeles County Community Disaster Resilience (LACCDR) project uses a collaborative partnership between the Los Angeles County Department of Public Health, local community members, academics, and business stakeholders to address issues of community resilience related to disaster preparedness [158]. Other communities have prioritized community-engaged research in their implementation strategies for improving community resilience to different environmental stressors like Baton Rouge, Louisiana [159], southeast Texas [160], and Charleston, SC [157].…”

Integrating Government Silos: Local Emergency Management and Public Health Department Collaboration for Emergency Planning and Response

“…There are numerous barriers to successful collaboration between the two local departments. The demographic and organizational differences identified by Botoseneanu et al (2010), and Kennedy et al (2019), described above, illuminate barriers, as does the enmity expressed by Botoseneanu and colleagues’ (2010) research participants. A professional with HealthCare Ready, an organization that strengthens health care supply chains, wrote that since public health professionals look to understand the scientific evidence in the field, their interpretation becomes political and thus shapes their emergency response (Baker, 2020).…”

“…The researchers reported that public health personnel remained concerned even when their agency’s authority was clear (Botoseneanu et al, 2010). Kennedy et al (2019) also identified public health personnel concerns about decision-making authority and status. In semistructured interviews with emergency and public health preparedness planners and other responders, these researchers found that while public health officials were represented at meetings, they questioned whether their participation was really meaningful.…”

“…In semistructured interviews with emergency and public health preparedness planners and other responders, these researchers found that while public health officials were represented at meetings, they questioned whether their participation was really meaningful. One respondent reported concern that public health ideas were not taken seriously and felt that public health participation did not influence actual emergency plans (Kennedy et al, 2019).…”

“…In semistructured interviews with emergency and public health preparedness planners and other responders, these researchers found that while public health officials were represented at meetings, they questioned whether their participation was really meaningful. One respondent reported concern that public health ideas were not taken seriously and felt that public health participation did not influence actual emergency plans (Kennedy et al, 2019). Botoseneanu et al (2010) found that public health personnel were concerned about agency and personal liability which led to a second concern, that collaboration with emergency management could lead to increased liability.…”