The Disparate Impact of Hurricane Maria: An Examination of Economic Disparities Among Survivors

Background.  Hurricanes Irma and Maria, which struck the Caribbean in September 2017, devastated the island of Puerto Rico. As a result of Maria, the entire electrical grid failed, most of the island was left without water service, and thousands of people were displaced from their homes. Six months after the storm, much of the island remained without power, many families had no access to clean water, approximately 60,000 homes remained roofless, and thousands of people were still displaced. Maria was declared the second deadliest hurricane in US history with an estimated 3,000 deaths. Disasters such as hurricane Maria disproportionately impact the economically disadvantaged. Those in poverty are more likely to lose their homes, suffer injuries or death, experience psychological trauma, and encounter obstacles during the response and recovery (Masozera, Bailey & Kerchner, 2007). Considering the level of devastation Maria caused and the disproportionate risk of the economically disadvantaged, this study sought to explore associations between income, length of time without services, and post-disaster mental health symptoms.  

 

Methods. This cross-sectional analysis is part of an ongoing study examining the long-term impact of a mental health intervention designed for care providers during the post Maria recovery. Surveys were conducted with participants from 37 healthcare organizations in Puerto Rico (N=796) between June and August 2018. The measures included in this study were length of time without electricity and water, income, family separation, and post-traumatic stress symptoms. Binary logistic regression and one-way ANOVA examined differences between level of impact of the hurricane, mental health symptoms, and income. 

 

Results.  One way ANOVA results illustrated that those making less than 2000 dollars a month went significantly longer without water F(1, 516)=6.050, p <.01, and electricity in their home F(1, 482)=4.31, p<.05. On average those with lower incomes averaged about 3 months without water service whereas the average was 2 months for those making above 2000 dollars month.  Regarding electricity, those with lower incomes averaged 4.5 months without power whereas the higher income group averaged 3.5 months. The mental health impact also disproportionately affected lower income individuals. These with lower incomes were more likely to have higher PTSD symptoms F(1, 645) = 4.186, p <.05. Binary logistic regression found that individuals with monthly incomes of 2000 dollars or less per month were 80% more likely to report family separation (OR=1.80, p<.01). There were no significant differences in the relationship between income and home damage.

 

Conclusions.  Our findings are consistent with previous research on the disproportionate impact of disasters among the economically disadvantaged. Findings suggest that interventions and services during the disaster response and recovery should target individuals and families who are economically disadvantaged to reduce disparities.