Framework for a Community Health Observing System for the Gulf of Mexico Region: Preparing for Future Disasters

Abstract

The Gulf of Mexico (GoM) region is prone to disasters, including recurrent oil spills, hurricanes, floods, industrial accidents, harmful algal blooms, and the current COVID-19 pandemic. The GoM and other regions of the U.S. lack sufficient baseline health information to identify, attribute, mitigate, and facilitate prevention of major health effects of disasters. Developing capacity to assess adverse human health consequences of future disasters requires establishment of a comprehensive, sustained community health observing system, similar to the extensive and well-established environmental Sandifer et al. Community Health Observing System observing systems. We propose a system that combines six levels of health data domains, beginning with three existing, national surveys and studies plus three new nested, longitudinal cohort studies. The latter are the unique and most important parts of the system and are focused on the coastal regions of the five GoM States. A statistically representative sample of participants is proposed for the new cohort studies, stratified to ensure proportional inclusion of urban and rural populations and with additional recruitment as necessary to enroll participants from particularly vulnerable or under-represented groups. Secondary data sources such as syndromic surveillance systems, electronic health records, national community surveys, environmental exposure databases, social media, and remote sensing will inform and augment the collection of primary data. Primary data sources will include participant-provided information via questionnaires, clinical measures of mental and physical health, acquisition of biological specimens, and wearable health monitoring devices. A suite of biomarkers may be derived from biological specimens for use in health assessments, including calculation of allostatic load, a measure of cumulative stress. The framework also addresses data management and sharing, participant retention, and system governance. The observing system is designed to continue indefinitely to ensure that essential pre-, during-, and post-disaster health data are collected and maintained. It could also provide a model/vehicle for effective health observation related to infectious disease pandemics such as COVID-19. To our knowledge, there is no comprehensive, disaster-focused health observing system such as the one proposed here currently in existence or planned elsewhere. Significant strengths of the GoM Community Health Observing System (CHOS) are its longitudinal cohorts and ability to adapt rapidly as needs arise and new technologies develop.

Coastlines, Coastal Cities, and Climate Change: A Perspective on Urgent Research Needs in the United States

“…(M) 6. How can we use realized impacts of regional disasters such as major storms, wildfires, oil spills, and the like to inform planning to reduce climate change effects on coastal communities (Sandifer et al, 2020)? (N)…”

“…Climate change is now recognized as an existential threat to many coastal cities and communities as they grapple with rapidly increasing flooding, more frequent and intense storms, saltwater intrusion, and other issues directly related to climate change. Potential for exposures to harmful algal bloom toxins and infectious Vibrio bacteria is increasing in geographic extent, frequency, and/or severity (Scott et al, 2019;Sandifer et al, 2021a) as are disasters ranging from hurricanes to floods and wildfires (Anderegg et al, 2020;Sandifer et al, 2020). Multiple land-falling hurricanes occurring in succession within the same region, as has occurred in the Gulf of Mexico in 2020, along with the cumulative impacts on human health from repetitive social disruptions, associated with disaster after disaster and the ongoing COVID-19 pandemic (Sandifer et al, 2020), have amplified concerns of coastal communities.…”

“…One model for such an approach at a relatively small scale is that being taken by the four Oceans and Human Health Centers currently being supported by the National Institute of Environmental Health Sciences and the National Science Foundation 1 in the United States. In addition, the types of human health and socio-economic observing systems recommended in Sandifer et al (2020Sandifer et al ( , 2021b would provide a wealth of information for use in assessing, preparing for, mitigating, and preventing some of the adverse human and community effects of climate change.…”

Human Health and Socioeconomic Effects of the Deepwater Horizon Oil Spill in the Gulf of Mexico

“…Environmental disasters of various kinds and magnitudes occur frequently in the Gulf region (NOAA, 2020;Sandifer et al, 2020;Smith, 2020), with one often following another and compounding the impacts of the previous incident. Examples include the 2010 DWH oil spill that followed the catastrophic effects of Hurricane Katrina in 2005, and the health effects of which were then com-pounded by subsequent disasters such as Hurricane Harvey in 2017, and others (J.D.…”

Masks and distancing during COVID-19: a causal framework for imputing value to public-health interventions

“…The burst of the COVID-19 pandemic forced governments around the globe to take health care interventions. One that caused significant controversies is the use of masks among the general public 1 – 3 . Initially, it was assumed that the primary mode of transmission of SARS-CoV-2 was through coughing or contact with surfaces.…”