Research-Based Position about flooding in Houston and or its surrounding areas
Zahraa Azzawi
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Introduction On Friday, August 25, 2017, at approximately 10 p.m. local time, Hurricane Harvey made landfall near Rockport, Texas, as a Category 4 major hurricane (National Weather Ser- vice, 2017). Over the next 7 days, the slow- moving storm caused widespread, intense rainfalls throughout southeast Texas, with Houston receiving 24 in. of rain in 48 hr (Di Liberto, 2017). Storm totals across the region ranged from 20–40 or more inches of rain (Figure 1), with a record amount of 49.6 in. reported near Clear Creek at Interstate High- way 45 in Houston and over 1 trillion gallons of water falling in Harris County (Di Liberto, 2017; Harris County Flood Control District [HCFCD], 2017). The rainfall led to record fl ooding, closing major roads throughout the
area, fl ooding an estimated 136,000 struc- tures in Harris County, and resulting in 38 storm-related deaths (HCFCD, 2017; Hous- ton Recovers, 2017).
The devastation was not limited to Hous- ton. According to the Federal Emergency Management Agency (FEMA) summary, across southeast Texas nearly 80,000 homes had at least 18 in. of fl oodwater in them, and 23,000 had more than 5 ft of water. More than 780,000 individuals evacuated, with more than 42,000 Texans temporar- ily housed in 692 shelters. First responders rescued 122,331 people in addition to pets (Federal Emergency Management Agency [FEMA], 2017a). The rescue numbers might not include the countless numbers of people and animals rescued by individual residents.
Geography of Harris County, Texas Harris County is located on the Gulf of Mexico in southeast Texas, and is comprised of 1,777 mi2, 4.1% (72.5 mi2) of which are covered by water (U.S. Census Bureau, 2017a). Most of the waterways are in the eastern portion of the county, including Lake Houston and the multiple smaller lakes and bays formed at the mouth of the San Jacinto River. The area also has numerous bayous, or slow-moving coastal rivers or streams. Sev- eral small creeks are not actively monitored, while 22 named waterways are actively mon- itored by the Harris County Flood Control District (HCFCD, 2017). Approximately 25% of Harris County lies within the 100- year fl ood plain, including low-lying areas near the creeks and bayous, as well as coastal areas (Harris County, 2007).
Buffalo Bayou forms part of Port Hous- ton, a 25-mile complex of diversifi ed public and private land that includes the Houston Ship Channel. In 2016, Port Houston was the largest U.S. port for foreign tonnage and third-largest U.S. port for total foreign cargo value (Port Houston, n.d.). In addition to shipping-related facilities, Harris County is also home to numerous industrial com- plexes, including a number of petrochemi- cal facilities. The county has 16 current and former federally designated Superfund sites in addition to 9 other sites identifi ed by the Texas Commission on Environmental Qual- ity (TCEQ) as in need of cleanup and reme- diation (TCEQ, 2013).
Community Overview Harris County is the third-largest county in the U.S. by population; the county seat
Dhitinut Ratnapradipa, PhD Christine Cardinal, MPH, JD
Department of Population Health Sam Houston State University
Kendra L. Ratnapradipa, PhD Department of Epidemiology
& Biostatistics Saint Louis University
Amanda Scarbrough, PhD Yue Xie, MHA, MEng, PhD
Department of Population Health Sam Houston State University
A b s t r a c t Hurricane Harvey, a Category-4 hurricane, dropped more than 40 in. of rain across Harris County, Texas, over 4 days, inundating
the third-most populous county in the U.S. and damaging an estimated
136,000 structures. Most major roadways were fl ooded, impeding rescue
and recovery efforts. An estimated 120,000 customers in the Houston area
experienced power outages; many were without power for several days. The
heavily industrialized area experienced accidental releases of numerous air
pollutants from the petrochemical industry, and several Superfund sites
were underwater for days, delaying assessment of the potential chemical
contamination to nearby waterways. The purpose of this article is to 1) provide
an overview of the historic fl ooding event, 2) identify vulnerable populations,
3) highlight the potential environmental public health risks associated with
the storm, and 4) provide recommendations for future action.
1 table, 3 fi gures
Implications of Hurricane Harvey on Environmental Public Health in Harris County, Texas
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is Houston, the fourth-largest city in the U.S., with a 2016 estimated population of 2,303,482 (U.S. Census Bureau, 2016). Table 1 presents a community overview of both Harris County and Houston. Only 1.2% of the county is considered rural (Texas Association of Counties, 2015). Many parts of Texas, and in particular Harris County, have experienced a rapid, ongoing population increase since 2000. From 2010–2016, Houston is estimated to have grown by 9.7%, while Harris County has grown by 12.1% (U.S. Census Bureau, 2016). In the wake of Hurricane Katrina in September 2005, Harris County experienced an influx of displaced people from Louisiana, and many people made Houston their per- manent residence. While estimates vary, one report indicated that approximately 250,000 Katrina evacuees came to Houston in 2005, with an estimated 100,000 living there 10 years later (Dart, 2015).
Harris County residents are more mobile than the state or national averages. In 2010, 44% of people living in Harris County had
moved within the past 5 years, and 18% had moved within the past year. Among Harris County residents who had moved during the past 5 years, 71% had moved from another house in the same county, 12% from elsewhere in Texas, 12% from another state, and 5.4% had moved from abroad (Harris County, 2007).
Harris County has high income inequality, which continues to increase. In 2015, the ratio of mean income for the top quintile of earners compared with the bottom quintile was 17.3, up from 16.1 in 2010 (U.S. Census Bureau, 2017b). Numerous neighborhoods experi- ence social vulnerability due to high poverty/ low income rates, high unemployment rates, and low high school graduation rates (Figure 2). Another measure of social vulnerability is defined by housing and transportation (Fig- ure 3). According to FEMA, there are only 245,249 flood insurance policies in force in Harris County through the National Flood Insurance Program, meaning that only 15.3% of housing units in Harris County have flood insurance (FEMA, 2017b).
Disaster Response Planning for Vulnerable Populations Houston’s population is diverse, and as such, there are several identifiable vulnerable pop- ulations. Specifically, individuals with dis- abilities, noncitizens, the poor, and older and pediatric populations each present unique challenges in the face of disaster.
People With Disabilities Due to differing transportation requirements, disabled individuals face difficulties in evacu- ating, and they also pose potential challenges for rescuers if they choose to stay. For exam- ple, the morbidly obese and those in wheel- chairs both affect the weight limitations that are in place for boat and helicopter rescue units, which can slow rescue times for others and subject those with decreased mobility to a longer exposure to flood waters and risk of drowning. Following Hurricane Sandy, dis- abled New Yorkers sued Mayor Bloomberg, citing the city’s failure to offer people with disabilities meaningful access to New York’s emergency preparedness program.
The Court identified the following failures of New York’s plan and specified a need to 1) modify evacuation transportation to meet the needs of the disabled, 2) make shelter provi- sions for the disabled, 3) canvass buildings and neighborhoods for the disabled who might not be able to notify rescue workers of their locations, 4) notify disabled individuals of shelters with resources for them, 5) edu- cate and encourage disabled people to form their own emergency preparedness plans, and 6) confirm the existence and location of accessible services for disabled people in an emergency (Brooklyn Ctr. for the Independence of the Disabled v. Bloomberg, 2013).
Houston’s disabled population encountered many of the same issues during and after Har- vey. It should be noted that the State of Texas Emergency Assistance Registry maintains a free, voluntary special-assistance registry for residents of the Gulf Coast who might need assistance during a general evacuation (dial 2-1-1), but individuals must register in advance and services vary by community (Texas Department of Public Safety, 2018).
Noncitizens Noncitizens face unique healthcare chal- lenges, especially in regard to insurance. For instance, Houston’s large refugee popu-
Rainfall Totals Across Southeast Texas, August 25–30, 2017
Source: National Oceanic and Atmospheric Administration (www.climate.gov/news-features/event-tracker/reviewing- hurricane-harveys-catastrophic-rain-and-flooding).
FIGURE 1
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lation has access to refugee medical assis- tance coverage for 9 months after arrival, and then they are eligible for several dif- ferent public health insurance programs through the Affordable Care Act (ACA), but many of them require language trans- lation services that are not widely avail- able (Siskin & Lunder, 2016). Despite public insurance options for refugees and those granted asylum, “Dreamers” under the Deferred Action for Childhood Arriv- als (DACA) provision is the only legally deferred action group that is ineligible for ACA coverage (Siskin & Lunder, 2016). Therefore, their only option for healthcare is to pay out of pocket or obtain health insurance coverage through private insur- ance, which is often unaffordable, leaving many DACA recipients uninsured. Even more problematic, several DACA recipients contributed to Harvey rescue efforts, which exposed them to increased risk of injury (Lavandera, Morris, & Kopan, 2017).
Low-Income Housing Recipients Many impoverished noncitizens and citi- zens living in Houston avail themselves of low-income housing. Houston, however, has suffered from a shortage of affordable residences in recent years, and during Har- vey, many of these units flooded (Schaper, 2017). Low-income residents are more likely to live in flood-prone areas, and therefore faced increased challenges dur- ing and after Harvey (Graif, 2016). More- over, rental prices increased after Harvey, as available properties within the city are so scarce. Not only has this trend resulted in a rise in the homeless population in Hous- ton, but it will also likely slow repatria- tion of the city because there are fewer safe and cheap locations available (Graif, 2016; Schaper, 2017).
Age-Based Vulnerability Age can also be a source of vulnerability dur- ing disasters. Those individuals who are in the very young or very old age groups are at an increased risk of adverse health effects from environmental exposures (Hersher & Schaper, 2017; Morello-Frosch, Zuk, Jerrett, Shamasunder, & Kyle, 2011). Additionally, age-related dependency might necessitate additional assistance with meeting basic needs and with evacuation planning.
Characteristics of Harris County and Houston, Texas
Population Characteristic Harris County Houston
Geographya
Land mass (mi2) 1,703.5 599.6
Population density (persons/mi2) 2,402.4 3,501.5
Populationa
Total population (2016 estimate) 4,589,928 2,303,482
Total population (2010 census) 4,092,459 2,099,451
Age and sexb
Median age (year) 32.2 32.1
<18 years old 28.0% 25.9%
≥65 years old 8.1% 9.0%
Female 50.2% 49.8%
Raceb
White 56.6% 50.5%
Black 18.9% 23.7%
American Indian and Alaska Native 0.7% 0.7%
Asian 6.2% 6.0%
Other 14.4% 15.8%
≥2 races 3.2% 3.3%
Hispanic or Latinob (any race) 40.8% 43.8%
Foreign borna 25.4% 28.5%
Language other than English spoken at home for persons >5 years of agea
43.1% 47.1%
Housingb
Total units 1,598,698 892,646
Owner occupied 51.0% 39.8%
Renter occupied 38.8% 47.9%
Vacant 10.2% 12.3%
Residential stabilitya (persons >1 year of age living in the same house 1 year ago)
82.6% 79.6%
Highest educational attainmenta (% of population ≥25 years of age)
High school graduate or equivalent 79.6% 76.7%
Bachelor’s degree or higher 29.5% 30.4%
Income and povertya
Median household income $54,457 $46,187
Persons in poverty 16.6% 22.5%
aU.S. Census Quick Facts, 2016 (www.census.gov/quickfacts/fact/table/harriscountytexas,houstoncitytexas,US/ PST045216). bAmerican Fact Finder, 2010 Census Summary for Harris County and Houston city, Texas (https://factfinder.census.gov/ faces/nav/jsf/pages/community_facts/xhtml?src=bkmk).
TABLE 1
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Environmental Public Health Concerns
Electricity-Dependence According to the U.S. Department of Health and Human Services (HHS) Public Health Surveillance website, 15,192 of the 456,577 Medicare beneficiaries residing in Harris County as of the end of 2016 were consid- ered electricity-dependent for medical and assistive devices such as ventilators, oxygen, in-home dialysis, IV pumps, and mobility devices (HHS, 2017). Center Point Energy reported an estimated 120,000 customers in the Houston area experienced a power out- age during Harvey; as of August 30, 2017,
approximately 80,000 customers were still without power due to street flooding imped- ing restoration efforts (Handy & Alfonso, 2017). In addition to the vulnerable popula- tions requiring electricity for medical devices, lack of electricity also potentially contributed to health problems due to lack of refrigeration for certain medications and food spoilage.
Air Quality Even under normal conditions, air qual- ity in Houston is problematic—particularly for individuals in the very young or very old age groups—due to emissions (Hersher & Schaper, 2017; Morello-Frosch et al., 2011). Harvey created unplanned industrial releases
of hazardous chemicals due to petrochemical plant shutdowns, restarts, and damaged facili- ties (Hersher & Schaper, 2017). Accidentally released airborne chemicals included more than an estimated 1 million pounds of ben- zene, ethylbenzene, ethylene, 1,3-butadiene, hexane, toluene, xylene, and other volatile organic compounds (Environmental Defense Fund, 2017; Hersher & Schaper, 2017). In addition, a fire at the Arkema chemical plant in Crosby, Texas, led to mandatory evacuations. When the evacuation was lifted, residents liv- ing within 1.5 miles of the site remained under a health advisory to use protective clothing and surgical masks and drink bottled water due to the ongoing health concerns (Harris County Public Health [HCPH], 2017a).
Many of the city’s air monitoring sites were not operational during and immedi- ately after the storm, as stations were shut down during hurricane preparations to pre- vent damage to the equipment and many stations were inaccessible due to flooding in the immediate aftermath (Hersher & Schaper, 2017; TCEQ, 2017).
Contaminated Flood Waters As previously mentioned, Harris County has numerous Superfund sites. The extent of contamination spread due to the flood- ing is unknown because several sites were inaccessible immediately following Harvey and water quality testing is ongoing. The Associated Press reported that at least seven sites were underwater in the days after Har- vey, and the company overseeing cleanup at U.S. Oil Recovery, a former hazardous waste treatment plant in Pasadena, made at least three reports of spills affecting Vince Bayou (Biesecker & Bajak, 2017). After the flood- ing began to recede, the U.S. Environmental Protection Agency (U.S. EPA) identified 14 Superfund sites that needed additional test- ing to determine potential leakages (Ebbs, 2017). While testing will continue, the U.S. EPA already confirmed that the Superfund site known as the San Jacinto River Waste Pits leaked dioxins as a result of Harvey. Additionally, U.S. EPA found dioxin levels as high as 70,000 ng/kg, substantially more than the 30 ng/kg that is the standard accept- able level for the site (Ebbs, 2017). Dioxins are known carcinogens, hormone disrup- tors, and can also cause developmental and reproductive problems, as well as damage to
Hurricane Harvey Damage by Socioeconomic Status Vulnerability
Source: Federal Emergency Management Agency damage model and the Centers for Disease Control and Prevention’s Social Vulnerability Index (https://svi.cdc.gov).
FIGURE 2
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the immune system (World Health Organi- zation, 2018).
Superfund sites were not the only source of contamination in the flood waters. Other sources included household and industrial chemicals and sewage. In Harris County, 65 releases resulted in 20.7 million gallons of raw sewage contaminating the floodwaters during the hurricane. Three weeks after Har- vey, six plants in the Houston area remained inoperable and the total amount of release was unknown (Stuckey, 2017). Water and sediment testing also found elevated levels of heavy metals including lead and arsenic (Kaplan & Healy, 2017). Footage during Harvey revealed the very young and very old navigating the floodwaters, and each of these groups face an increased susceptibility to contaminants and injury (Kaplan & Healy, 2017; Morello-Frosch, et al., 2011).
Drinking Water Although most municipal drinking water supplies in Harris County were unaffected by the flooding, multiple locations received boil water notices due to compromised sys- tems. Harris County Public Health (HCPH) provided daily updates via written notices and an interactive map on its website. Any well heads that were covered by floodwater were potentially contaminated with bacte- ria and/or toxic chemicals including gaso- line, oil, and industrial pollutants. HCPH issued a private well water advisory on September 5, 2017, and offered free well water testing through September 22, 2017 (HCPH, 2017a). It should be noted that boiling water only redresses biological con- taminants and does not eliminate chemicals present in the water.
Storm Debris Assessment and Cleanup The sheer number of damaged homes and businesses has created a massive, ongoing cleanup effort. As of the end of September 2017, 48,415 residential and commercial structures had been assessed as damaged and more than 900,000 yd3 of debris had been col- lected in Houston (Houston Recovers, 2017). While storm debris collection continues, the city of Houston suspended curbside recy- cling and yard waste collection until further notice (City of Houston, 2018). Mold growth was extensive and occurring even before the floodwaters receded (Kaplan & Healy, 2017).
Hospital Impacts Of the 80 licensed hospitals in Harris County, only nine evacuated patients and a majority of these continued to operate in some capacity (Fink & Blinder, 2017; Pulsinelli, 2017; Texas Department of State Health Services, n.d.). Together these nine facilities account for over 2,100 inpatient beds, including 213 intensive care unit (ICU) beds and 87 neonatal intensive care unit (NICU) beds, or 14.6% of the county’s overall bed capacity (Texas Department of State Health Services, n.d.).
Ben Taub Hospital, a public facility and one of the only two Level I trauma centers in the
city of Houston, initiated evacuations when the facility’s basement flooded on August 27, 2017 (Harris Health System, n.d.). Inun- dated streets surrounding the hospital meant that only three ambulances were able to get through to transfer patients to other facilities. In the end, most of the 350 patients stayed in the facility, and the hospital had to make a call to the public for emergency resupply of food because the food preparation and medi- cal supply storage areas were located in the flooded basement. The facility returned to normal operations and began accepting new patients on August 31, 2017 (Goldstein & McGinley, 2017).
Hurricane Harvey Damage by Housing and Transportation Vulnerability
Source: Federal Emergency Management Agency damage model and the Centers for Disease Control and Prevention’s Social Vulnerability Index (https://svi.cdc.gov).
FIGURE 3
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The healthcare delivery community was generally well prepared to function during the flooding, in large part due to lessons learned from Tropical Storm Allison in 2001, which caused power outages and flood- ing. The facilities at Texas Medical Center (TMC) relocated critical functions and ser- vices such as back-up generators and fuel supplies (water contaminated fuel systems), water supply lines (water contamination), pharmacy, blood bank, laboratories, medi- cal supplies, and sterile processing to higher ground (Berger, 2001; Nates, 2004). Flood- gates and submarine doors were installed at TMC to prevent basement water penetration. Ride-out and recovery teams up to twice the normal staffing size and emergency sup- plies prepared each hurricane season to be delivered prior to the arrival of large storms became standard operating policies. Above all, however, Harris County and the sur- rounding region also came together and cre- ated a Catastrophic Medical Operations Cen- ter to coordinate resources to safely transfer patients to facilities that have the capabilities to meet patient needs (Texas Department of State Health Services, 2013).
Discussion Overall, the greatest environmental public health impacts from Harvey were directly related to the pre-existing industrial nature of Harris County. Air monitoring stations were shut down to protect the equipment from wind damage, but street flooding pre- vented the stations from being reactivated quickly while hazardous chemicals were being released from petrochemical facili- ties. Water quality throughout the area also suffered from the large-scale flooding and multiple Superfund sites were inundated by water—which in at least one case caused a breach of toxic chemicals.
Residents might not be fully aware of the potential health hazards posed by these sites, as evidenced from a media report of children swimming in flooded retention pools down- stream from the Brio Refinery site (Guarino, 2017). Active, ongoing monitoring of the sites, as well as the long-term health of resi- dents across the affected areas, is necessary to determine the long-term effects of these pol- lutants. Long-term health monitoring, how- ever, is potentially complicated by the high mobility within Harris County and the need
to have accurate residential address history to link to potential exposure sites.
Emergency preparedness requires long- term fiscal and collaborative devotion, as suc- cessful investments require ongoing mainte- nance to ensure trust and competency (Katz, Staiti, & McKenzie, 2006). Unfortunately, a zero sum mentality prevails in the allocation of public health budgets, and when funding is diverted towards emergency preparedness or recovery efforts, it is often diverted from other vital public health programs and initia- tives (Lurie, Wasserman, & Nelson, 2006). While substantial funding has been diverted to Harvey recovery efforts, the Texas General Land Office and other state and federal agen- cies are offering grants to support continued resiliency and improvement of local emer- gency preparedness programs.
Environmental Public Health Response HCPH created a webpage with resources related to Harvey on which they posted a variety of public notices and information sheets (HCPH, 2017b). Flood advisory sheets indicated potential hazards in the floodwater including snakes and insects, debris, oil and industrial waste, raw sewage, and downed powerlines. A flood recovery tip sheet cov- ered the following topics: proper attire for cleanup, mold, food safety, proper ventila- tion when using generators, mosquitoes, and drinking water. The tip sheet also recom- mended frequent hand washing, making sure tetanus shots were up to date (dose every 10 years), and pacing cleanup efforts.
Due to the intensity of the flooding, the capacity of local public health departments to respond was exceeded, and the Texas Depart- ment of State Health Services (DSHS) inter- vened. In their after-action report, DSHS dis- closed that 689 staff members were involved in the Harvey response, and staff engaged in 990 medical response missions, 3,200 medical patient evacuations, the treatment of 1,800 patients by mobilized medical units, the transfer of 142 patients, the distribu- tion of 70,000 vaccines, and the treatment of 6,765,971 acres for mosquito control (Heller- stedt, 2017).
Furthermore, the role of volunteers in the rescue efforts led to the organization of a Har- ris County Volunteer Disaster Response Team conceived of by Constable Sherman Eagle- ton (Zaveri, 2017). The sheriff’s after-action
report and Constable Eagleton’s response team plans are still being finalized; however, both recognized the inability to fully prepare for a natural disaster as extreme as Harvey and in turn acknowledged the importance of calling on spontaneous volunteer aid and col- laboration with DSHS (Zaveri, 2017).
Planning for Vulnerable Populations As suggested in the New York lawsuit, bet- ter education is needed to protect vulner- able populations. Children, the very old, the impoverished, noncitizens, and the disabled all would substantially benefit from emer- gency plans tailored to their unique require- ments. Admittedly, tailoring emergency pre- paredness plans for different groups costs additional time and resources. Training com- munity health workers who are already mobi- lized to communicate with diversified patient groups in emergency preparedness, however, could potentially cut costs and provide for an increased reception and comprehension of the emergency preparedness materials appropriate for each subset of the population (Freudenberg & Tsui, 2011).
Flood Insurance and Residential Flooding Risk Given that the majority of residents impacted by flooding in Harvey did not have flood insurance, greater efforts are needed to accu- rately inform the public of their flooding risks. In a recent study of the flood plains in East Texas (1999–2009), researchers noted that the vast majority of flood dam- age occurred outside the FEMA-designated 100-year flood plain (Blessing, Sebastian, & Brody, 2017). This gap might be due in part to the fact that several years passed in between FEMA’s map updates.
Houston is a fast growing urban environ- ment, and alterations to the topography such as new building developments and other changes to the built environment change the locations where flooding occurs after a major weather event. Newly updated FEMA flood risk maps for Houston, Texas, went into effect in January 2017, and 8,000 more Houstonians were listed at risk; however, a National Flood Insurance Program insur- ance specialist explained that homeowners have an entire year to decide whether or not to update their coverage (Pitman, 2016). The extended timeline provided to reevalu-
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ate flood insurance coverage under the new maps likely contributed to poor flood insur- ance coverage in Houston. The authors of the 1999–2009 study suggest that recent advances in hydrologic models that focus on spatial distribution can improve FEMA’s accuracy of the flood risk assessment (Brody, Highfield, Blessing, Makino, & Shepard, 2017). This proffered improvement in flood zone identification and risk assessment will require a substantial federal investment, but would likely improve resident confidence in purchasing flood insurance.
Many Houstonians impacted by Harvey flooding were not in a 100-year flood plain and were not informed of the potential risk of flooding due to a close proximity to reservoirs, bayous, and other flood pools. In fact, due to resulting flooding after Harvey, impacted homeowners not informed of this risk are suing the U.S. Army Corps of Engineers for their failure to inform homeowners of their need for flood insurance due to their proxim- ity to flood pools (Olsen, 2017).
The state of Texas and the U.S. Army Corps of Engineers have no statutes or regulations, however, requiring notice to homebuyers informing them of the risk posed by reservoir pools (Olsen, 2017). While writing legislation requiring that homeowners be advised of these risks is feasible, such legislation would likely
face fierce opposition in the state legislature due to lobbying efforts by real estate develop- ers. Nonetheless, transparency to homebuy- ers is ethically responsible and would likely improve flood insurance purchasing and reten- tion, which would ultimately benefit taxpayers. Similarly, researchers correlated an increase in flood insurance purchasing and retention dur- ing FEMA’s 2004 Floodsmart public awareness campaign (Michel-Kerjan, Lemoyne de Forges, & Kunreuther, 2012). Despite the effect trans- parency regarding flood risk might have on the real estate market, informing residents of their risks through new legislation or advertising campaigns would not only better protect indi- vidual property owners but also in turn protect county tax dollars.
Conclusion Hurricane Harvey dropped more than 40 in. of rain across Harris County, Texas, over 4 days, inundating the third-most populous county in the U.S. and damaging an estimated 136,000 structures. The historic nature of this extreme weather event precluded the ability to fully plan for such an emergency, but environmental health practitioners can still gain insight from the response and recovery efforts. As a heavily industrialized area built in low-lying areas, Harris County experienced numerous accidental releases
of air- and waterborne chemical pollutants, with flooding often delaying the ability to fully assess the damage.
In preparation for future disasters, it is essential that public health officials assist vul- nerable populations—including people with disabilities, noncitizens, low-income hous- ing recipients, and those vulnerable due to youth or advanced age—to create a plan for individual and community response tailored to the population’s needs. Special attention might need to be focused on residential areas in the vicinity of industrial sites. The ability to quickly mobilize and organize volun- teer efforts is another lesson learned from this experience. Grant funding is currently available to support continued resiliency and improvement of local emergency prepared- ness programs, but such efforts will require long-term fiscal and collaborative input. Fur- ther, environmental health practitioners must continue to monitor the affected communities looking at the long-term effects of the storm on the health status of Harris County.
Corresponding Author: Dhitinut Ratnapra- dipa, Department of Population Health, Sam Houston State University, Huntsville, TX 77341. E-mail: [email protected].
Berger, E. (2001, June 15). UT veterinary official laments drown- ings of research animals. Houston Chronicle. Retrieved from http:// www.chron.com/news/article/UT-veterinary-official-laments- drownings-of-2021076.php
Biesecker, M., & Bajak, F. (2017, September 19). One of Houston’s dirtiest Superfund sites is suffering from multiple toxic-waste spills—And the government has yet to acknowledge it. Business Insider. Retrieved from http://www.businessinsider.com/ap-ap- exclusive-evidence-of-spills-at-toxic-site-during-floods-2017-9
Blessing, R., Sebastian, A., & Brody, S.D. (2017). Flood risk delinea- tion in the United States: How much loss are we capturing? Natu- ral Hazards Review, 18(3), 4017002.
Brody, S.D., Highfield, W.E., Blessing, R., Makino, T., & Shepard, C.C. (2017). Evaluating the effects of open space configurations in reducing flood damage along the Gulf of Mexico coast. Land- scape and Urban Planning, 167, 225–231.
Brooklyn Ctr. for the Independence of the Disabled v. Bloomberg, 980 F.Supp.2d 588 (S.D.N.Y. 2013).
City of Houston, Solid Waste Management Department. (2018). Hur- ricane Harvey—Garbage collection service. Retrieved from http:// www.houstontx.gov/solidwaste/harvey_09202017_app.html
Dart, T. (2015, August 25). “New Orleans West”: Houston is home for many evacuees 10 years after Katrina. The Guardian. Retrieved from https://www.theguardian.com/us-news/2015/aug/25/new-orleans- west-houston-hurricane-katrina
Di Liberto, T. (2017). Reviewing Hurricane Harvey’s catastrophic rain and flooding. Retrieved from https://www.climate.gov/news- features/event-tracker/reviewing-hurricane-harveys-catastrop hic-rain-and-flooding
Ebbs, S. (2017, September 29). Houston Superfund site leaked toxic chemicals after Harvey: EPA. ABC News. Retrieved from http://abcnews.go.com/US/houston-superfund-site-leaked toxicchemicals-harvey-epa/story?id=50181549
Environmental Defense Fund. (2017). Toxic air pollution is one of Harvey’s “unseen dangers” Retrieved from https://www.edf.org/ media/toxic-air-pollution-one-harveys-unseen-dangers
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