Health Impact Assessments and Extreme Weather-Challenges for Environmental Health

Background: The Florida Department of Health, Environmental Public Health Tracking Program, in collaboration with the Escambia County Health Department and the University of West Florida, used the Health Impact Assessment Framework to examine adverse health outcomes that may be related to an extreme flood event in Pensacola, Florida (Escambia County) during April 29 to May 3, 2014. In this 2014 flood event, portions of Pensacola received more than 15.5 in of rain in a single day. Infrastructure impacts from this extreme event included destroyed bridges and roads and the failure of many sewage lift stations. Objective: To determine whether there were associated increases in injury, illness, and death, data on reportable diseases, hospitalizations, emergency department (ED) visits, and deaths that occurred during the impact period in 2014 were compared with a control period in 2008. Design: We used an ecological design to compare impact and control periods and examined the proportion of hospitalizations, ED visits, and deaths potentially attributable to the extreme flood event. Results: The results of this comparison were mixed, with some Escambia County zip codes showing increased hospitalizations and ED visits, and some zip codes showing a decrease. However, countywide, there were increases in the proportion of both injury- and respiratory-related hospitalizations and ED visits during the impact period. Conclusions: It is challenging to characterize human health impacts from natural disasters such as extreme floods. Still, it is believed that specific policy changes could result in fewer health impacts during future flood events. For example, this study recommended raising the electric panels on lift stations above the flood elevation to keep them operational during extreme rainfall events. For more maps and tables, consult the complete project report available online at http://www.floridatracking.com/HealthTrackFL/document/Escambia_HIA_Report.pdf.