How do natural disasters affect electoral participation? This study examines the impact of Hurricane Helene on the 2024 presidential election in North Carolina using a difference-in-differences design comparing 13 affected counties to 87 control counties across four election cycles (2012–2024). The evidence suggests that the hurricane significantly increased voter displacement – affected counties experienced approximately a six-percentage-point rise in mail ballots sent out of state and an eight-percentage-point increase in mail ballots sent outside voters’ home ZIP codes. Despite this displacement and substantial physical damage, however, turnout remained stable and voters did not alter their voting methods. These findings suggest that with proactive institutional response, voters and election administration can show resilience, even in the face of a disaster that displaced thousands of voters.

This paper examines the dynamic impact of natural disasters on the individual acceptance of a physical form of intimate partner violence (IPV). Based on a global sample of individual survey data and historical geo-referenced records of natural disasters at a subnational level, we show that natural disasters have long-lasting effects on IPV acceptance, increasing it in the short- (0–4 years) and medium- (10–14 years) run. Furthermore, heterogeneity analyses reveal that lower-educated individuals are more affected than higher-educated individuals, men are more affected than women, and older cohorts are more affected than younger cohorts. There are no differences in the effects of disasters on IPV attitudes between individuals with high and low incomes. Drawing on theories of IPV, we also uncover that likely mechanisms that may link disasters to the increased acceptance of IPV are psychological distress and economic insecurity fears.

Climate change-induced disasters continue to disproportionately affect low, middle and upper-middle income countries (LMICs), often leaving survivors at risk of serious mental health challenges. Yet, mental health interventions in these settings remain limited and poorly integrated into health systems. This study explores the types and levels of existing mental health interventions for individuals affected by climate-induced disasters, using the Inter-Agency Standing Committee’s framework on Mental Health and Psychosocial Support. A systematic review was conducted following PRISMA guidelines across six databases, yielding 14 studies for final analysis. Key data on study design, disaster type, mental health conditions, intervention types and service providers were extracted and mapped against the Inter-Agency Standing Committee framework. While interventions were identified across all four layers of support, most were concentrated at the individual level, focusing on non-specialised services delivered by trained non-specialist providers (e.g., community health workers or lay counsellors) and specialised services provided by licenced clinical professionals, with limited emphasis on community-based or systems-level approaches. Results indicate such a significant gap, about 79% of the studies focused on the individual level, in mental health interventions in LMICs. It is therefore crucial to address these gaps to ensure comprehensive mental health care is available in disaster-prone countries.

How do voters react to the individual characteristics of crises following events such as pandemics or floods? In the aftermath of crises following such events, governments may find they are sanctioned by voters, because the crises can provide voters with important information concerning the qualities of incumbents in handling crisis or their responsibility for the ensuing hardships. However, existing research provides limited evidence concerning the characteristics of crises that voters rely on to evaluate the government’s responsibility for or performance in handling them. The present article addresses this gap by providing evidence obtained from a conjoint experiment conducted among British voters. The results show that when voters sanction governments following a crisis, they focus overwhelmingly on the government’s perceived crisis management performance. Voter perceptions of crisis management performance are driven by the severity of the crisis, prevention and relief spending, as well as the behaviour of the political elites. In contrast, voter perceptions of government responsibility for the crisis are affected less strongly by crisis characteristics, such as crisis severity, prevention spending and expert statements.

Climate change disproportionately affects people with pre-existing mental illness, yet there is a critical shortage of targeted interventions serving their needs. This Commentary argues for the further development and evaluation of preventative, structural interventions, including cash transfers, in the context of climate-change related disasters to reduce vulnerability among people with mental illness.

Medical shelters are frequently utilized after major disasters to care for displaced individuals with severe mobility limitations and chronic medical conditions that may be inadequately addressed in general population sheltering. A retrospective chart review was conducted on 680 patients served in state-operated Medical Needs Shelters (MNS) in Louisiana following three major hurricanes from 2020 to 2021. The authors aimed to produce a descriptive analysis of the degree and variety of medical complexity of patients within the shelters to guide future shelter planning. Data illustrate demographic characteristics, clinical attributes, and outcomes among shelter patients. Patients were found to have numerous medical comorbidities, often with serious concomitant neuropsychiatric, cardiovascular, and pulmonary conditions. The shelter population was highly dependent on nursing staff for medication management and activities of daily living. They also had high utilization of respiratory therapies, hemodialysis, and wound care. Clinically significant events (e.g., falls, mental status changes, vital sign abnormalities), often resulting in transport to local hospitals, occurred in approximately 20% of all patient stays. Limitations of the study include suspected underreporting of disease prevalence and the study’s retrospective approach. Public health planners should consider the clinical needs of this population when designing strategic and tactical approaches to mass care for medically vulnerable individuals. Future research might examine which factors place individuals at higher risk for decompensation within a medical shelter.

When communities are struck by natural disasters, human service organizations play an important role in supplementing governmental aids and catering to immediate humanitarian needs. Social capital is one of many factors affecting resource mobilization directed toward human service organizations as a proxy for local philanthropy. This study analyzed the effect of social capital on local philanthropy in communities affected by natural disasters and compared it to the effect of corporate philanthropy. In addition, this study examined how the relationships among social capital, corporate philanthropy, and local philanthropy were moderated by racial diversity to answer a long-standing argument regarding the effect of racial diversity on philanthropy. To this end, a panel dataset covering three given years and 3121 US counties was analyzed using GEE models. The results suggest that social capital does not always facilitate local philanthropy and its influence on local philanthropy is catalyzed by racial diversity. Also, corporate philanthropy positively influences resource mobilization toward human service organizations, more noticeably in communities affected by natural disasters.

Nonprofits operate in increasingly complex and turbulent environments. However, few studies have explored nonprofits’ resilience during natural disasters. This study uses Hurricane Katrina as a case study to explore whether nonprofits can regain their original financial performance after significant natural disasters and what organizational capacities and abilities influence their ability to bounce back. The results show that recovery is slow, taking between three and five years for half of the nonprofits in the sample. Recovery depends on factors such as organizational size, equity, surplus, and commercial revenue. This study enriches the nonprofit financial health literature and reveals that the factors associated with financial resilience are different from those that predict financial vulnerability.

Key to the success of international peace-building efforts is the cooperation and support of civilian populations. Studies show that economic considerations shape combatants’ willingness to lay down their arms. We study a related but under-studied question: does economic hardship impact civilian support for conflict cessation? If reintegration of former combatants into productive economic sectors threatens civilians’ own incomes, then support for peace-building may diminish. We investigate localized effects of the 2015 Hindu Kush earthquake using individual-level survey data on support for Taliban reintegration. The earthquake reduced support for reintegration into disproportionately impacted economic sectors. We observe no effect for less impacted sectors. Results are robust to a battery of tests, including a novel spatial randomization leveraging geocoded fault lines corresponding to the universe of counterfactual earthquakes. Our findings provide new insight into the resolution of violent conflict: economic hardship may undermine civilian support for rebel reintegration.

Triage approaches for treating individuals in disaster settings historically have been focused on identifying acute decompensation, injuries, and death. For displaced populations that had limited function prior to ta disaster event, the emphasis during and after a disaster becomes identification of the proper level of support needed to survive in a shelter and selection of an appropriate post-shelter destination. The US Public Health Service Rapid Deployment Force team PHS-1 developed tools to address the needs of such displaced populations. The tools, described in detail in this report, address assessment, tracking, planning, resource utilization, and decision making and were field tested over the course of multiple deployments to refine them and validate their utility.

During the years 2005-2018, the US Public Health Service (PHS) deployed teams, known as Rapid Deployment Forces (RDF), as a component of disaster response. One component of the disaster response was for a PHS RDF to establish a Federal Medical Station and work with other federal and civilian partners to provide health care to individuals with chronic medical conditions that routinely required additional support for activities of daily living. These individuals were usually housed in private residences or residential facilities and were displaced by the disaster. The operational model was to gather the target population in a temporary facility, assess the needs of each individual and accompanying caretakers, provide health care and social support, and plan a discharge to either an intermediate facility or return to their original residence, if conditions became appropriate. RDF PHS-1 developed approaches for assessment, tracking, planning, resource utilization, and decision making that were field tested, refined them, and then validated their utility. The experience is shared here to inform other disaster responders who may encounter similar displaced populations and circumstances.

Between January 29 and February 11, 2019, the Townsville region in Australia experienced a major flooding event. This study explored impacts on affected community pharmacies. Semi-structured phone interviews were conducted with six pharmacists who worked in affected Townsville community pharmacies during this flood. De-identified transcript data were analyzed using reflexive thematic analysis. The thematic analysis yielded six themes – “financial impact on pharmacy owners,” “engagement with Local Disaster Coordination Center (LDCC) important,” “workload pressures,” “preparedness,” “medication supply impacts,” and “communication and collaboration.” Financial impacts to owners included loss of property (two pharmacies were completely flooded), purchase or hire costs of generators when power was lost, and loss of revenue from complete or early closure of pharmacies and when patients could not pay or did not have a prescription and did not return to the pharmacy after the event. Engagement with the LDCC assisted pharmacy responsiveness. Medication supply issues were experienced by patients whose houses had flooded, or who had left their prescriptions with pharmacies that had flooded. Opioid Replacement Therapy (ORT) program patients were also impacted due to communication difficulties between them, their clinics, and their pharmacies. Increased customer numbers by those whose regular pharmacy was closed, reduced staff numbers, and austere working conditions increased workload pressures. Pharmacists collaborated to consolidate resources with those whose pharmacy had closed, working in pharmacies that were open. This research highlights a critical need for improved flood preparedness among Townsville pharmacists. Regardless, they collaborated to ensure there were minimal critical medication delays.