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Research has demonstrated that natural disasters, like flooding that are increasing with climate change, can have profound mental health effects. Moreover, these outcomes are not experienced evenly across the population with disadvantaged populations like racial/ethnic minorities and lower socio-economic status individuals being more likely to report psychological diagnoses and symptoms related to floods. However, the mechanisms that could account for the link between social vulnerability and worry about the threat of flooding remain poorly understood. In this analysis, we use a 2022 survey of Houston-area residents to examine how perceived flood risk and subjective flood preparedness relate to racial/ethnic differences in worry about the threat of flooding. We find that both individual-level and area-level race/ethnicity are significantly related to greater worry about the threat of flooding. Further, this is partially mediated by perceived flood risk, but not subjective flood preparedness. This suggests that policies and infrastructure priorities that reduce risk rather than prepare households for flooding would accomplish more in closing the gap in social disparities in mental health outcomes from flooding. 

Disasters, including floods, have increased in intensity over recent decades due to climate change and urbanization. Some local governments have attempted to engage communities in resilience efforts, referred to as Community-Based Disaster Resilience Management (CBDRM). However, it is unclear to what extent governments can effectively involve local communities in flood management plans, and how much flood management is perceived to be a “shared responsibility,” especially in low-income and minority areas. One city attempting to engage low-income and minority communities is Houston, Texas, which provides an opportunity to study how these efforts play out in the community in real time. Specifically, in this study, we examine Kashmere Gardens, a target neighborhood of the Houston initiative. We used a purposive and snowball sampling method and a grounded theory methodological approach to conduct qualitative in-depth interviews with 22 Kashmere Gardens residents. From this process, we found several themes, including affordability and convenience, neglect and distrust toward government, a lack of awareness concerning government flood management plans, and a sense of personal efficacy in the face of feelings of government neglect. The results of this study suggest that clearer communication from the city and more direct engagement with the community through on the ground programming may be necessary to develop better community trust and partnership in high flood risk areas. In terms of policy, utilizing funds to organize transportation or place meetings physically in the neighborhood, and employing more community organizers from within the community who have local knowledge, may foster better engagement to develop trust. 

Much research has been conducted that demonstrates a link between racial/ethnic residential segregation and health care outcomes. We suggest that minority segregated neighborhoods may have diminished access to organizations and that this differential access may contribute to differences in health care outcomes across communities. We analyze this specifically using the case of pediatric health care provider choice. To examine this association, we estimate a series of multinomial logistic regression models using restricted data with ZIP code level geoidentifiers from the 2011–2012 National Survey of Children’s Health (NSCH). We find that racial/ethnic residential segregation is related to a greater reliance on non-ideal forms of health care, such as clinics, and hospital outpatient departments, instead of pediatric physician’s offices. This association is at least partially attenuated by the distribution of health care facilities in the local area, physician’s offices, and health care practitioners in particular. Additionally, families express greater dissatisfaction with these other forms of care compared to physician’s offices, demonstrating that the lack of adequate health care provision is meaningful for health care outcomes. This study expands the literature by examining how the siting of health organizations has consequences for individuals residing within these areas. 

Previous work has suggested that minority segregated neighborhoods may have diminished access to health care, and that this may contribute to differences in health outcomes across communities. We analyze this using the case of pediatric provider choice. We estimate a series of multinomial logistic regression models using restricted data from the 2011-2012 National Survey of Children’s Health (NSCH). We find that racial/ethnic residential segregation is related to a greater reliance on non-ideal forms of health care, such as clinics and hospital outpatient departments, instead of pediatric physician’s offices. Additionally, families express greater dissatisfaction with these other forms of care.