The human health poverty trap

1. The human health poverty trap Poor people are at greater risk of ill health and… … poor health increases the likelihood of becoming poor. Establishes a self-perpetuating state that differs from health issue for the rich

2. Is there a natural disaster-poverty trap? Poor people are at greater risk of disaster situations but …… do disasters increases the likelihood of becoming or remaining poor?

3. Disasters drive lower growth - meager savings lost to recovery efforts

4. More likely to result from erratic growth and set backs creating a “recovery gap” Disaster events ?

5. Environmental factors and economic performance

6. SST control of Maize Yield and food security in Zimbabwe Climate variability and Malaria riskin Botswana

7. Disaster mortality risk from combined hazards (World Bank Hot Spots: Dilley, Chen, Lerner-Lam et al)

8. Poor country disaster characteristics • Large mortality relative to intensity of event, exposure levels and population density • Large mortality uncertainty - order of magnitude • Gender and age usually play a large roll • Economic impact variable

9. Aggregate Natural Disasters Source UNDP 2004

10. Distribution of fatalities

11. Flood disaster economic losses Flood disaster mortality

12. Global increase in disasters

13. Reported Disasters, 1993 – 2002, by HDI Level

14. Very old and young and women are at greatest risk

15. Very old and young and women are at greatest risk

16. Females have small survival advantage

17. Men have a small advantage

18. Amenabad India

19. Islamanbad Pakistan 2005

20. Northridge California

22. Mortality risk is a combination of physical and social Vulnerabilities: fragile dwellings in risky places.

24. HIGH RISK LOW RISK

25. Disaster shock moves economy into poverty trap region Economic Growth Shock event in growth zone moves economy into zone of Poverty Trap PovertyTrap M*(I): Per capita income as a function of disease prevalence, I. I*(M): Equilibrium disease prevalence as a function of income, M. Matthew Bonds Poverty Trap Theory

26. Were the people of New Orleans caught in a disaster-poverty trap?

28. Typical levee failures

29. Outcomes of Social and Physical Vulnerability East Orleans New Orleans Metairie (Lower Ninth Ward) Algiers Jefferson Parish St. Bernards Parish Sources: http://www.katrinadestruction.com/images/v/mapping/Flood+Depth+Estimation.html; http://en.wikipedia.org/wiki/Levee_and_flood_wall_failure_in_New_Orleans_(following_hurricane_Katrina)

31. Lower ninth ward NOLA

38. How many died? Total “official” deceases victims to date 1698. But there are very large uncertainties: • Who keeps the official count • How do you define a Katrina victim? • Does it include those who died during or after moving to a different state. • There are still approx 500 who remain unaccounted for. • Total may be as many as 3000

39. How do we count: who are the victims? • Traffic accident victims? • How should we consider suicides? • Should we consider those shot for “looting” and other crimes? • Should we include frail people who died from prior conditions long after Katrina (harvesting issue)? • How do we count (or even know about) people who died after being displaced from the disaster’s location? People who die from illnesses contracted in refugee camps having been displaced by armed conflict are counted as the victims of conflict. Those who die in FEMA trailer camps are not considered Katrina victims.

41. Flood vulnerability

42. Flood vulnerability

43. Outcomes of Social and Physical Vulnerability Sources: http://www.katrinadestruction.com/images/v/mapping/Flood+Depth+Estimation.html; http://en.wikipedia.org/wiki/Levee_and_flood_wall_failure_in_New_Orleans_(following_hurricane_Katrina)

45. Demographic and Geographic selectivity of deceased victims 910 deceased victims processed at St Gabriel Morgue as of Jan 18th, the main receiving center for New Orleans deceased 786 identified with age, gender and race (approx one third the total deceased victims; 124 unidentified) 629 released to families

46. Demographic and Geographic selectivity of deceased victims Gender not a factor 51% male 49% female Population densityNot a factor: fatality rates not related to pop. density Racial factor 50% African American 42% Caucasian All other groups less than 4% ` But AA’s were represented > 85% pre-flood Age played the greatest role:64% older than 60 yrs (15% pre flood) 39% older than 75 yrs 1% less than 5 yrs (one child less than 3yrs) less than 4% younger than 20 yrs less than 20% younger than 50 yrs

47. Families blame more deaths on Katrina By MICHELLE ROBERTS, Associated Press Writer Wed Dec 13, 1:56 PM ET NEW ORLEANS - You won't see Sylvester Major's name among the 1,698 listed officially as Hurricane Katrina victims. He survived the floodwaters that gushed through the windows and door of his house. He persevered through miserable, fearful days at the convention center. He endured separation from family and the only hometown he had ever known. And he lived more than a year after the Aug. 29, 2005, tragedy. Officially, he died of congestive heart failure at 59. But his family and a social worker who was with him when he died say the real cause was a broken heart, inflicted by Katrina and the loss of his elderly mother, who also died after being evacuated.

48. Katrinalist.columbia.edu objectiveA web-based search for ALL Katrina-related mortality • From direct result of storm – drownings, impact trauma, fire, explosions etc during hurricane impact • From indirect causes – traffic accidents, shootings associated with looting or other acts declared criminal, other types of accidents, suicides, increases in crime etc • From prior conditions – those who had conditions such as heart disease or respiratory illness and those conditions fatally exacerbated by the trauma of the storm or its aftermath. • Include a long (at least a year) harvesting period