Long-term impact of a disaster on a rural, underserved, community's health

While there is an influx of interest in responding to a community's needs immediately following a disaster, there is little research documenting the effects on a community's health during the secondary surge recovery period. We present data gathered from community residents, healthcare providers, and hospital discharge data seven years after the deadly 2005 Graniteville train derailment and chlorine spill. Data were collected 2012-2013 from community residents and area healthcare providers using photovoice and semi-structured interview methodology. Photos and interview data were analyzed for themes regarding the long-term health impacts of community members since the accident. Additionally, a secondary data analysis of hospital discharge data for Graniteville-area healthcare facilities was conducted to determine utilization, severity, and frequency of various diagnoses and procedures three years pre- and three years' post-disaster. Concerns with physical health, specifically cancer and respiratory illness, were the most prominent themes from photovoice and the healthcare provider interviews. Additionally, community residents reported having concerns with mental health challenges, a factor that was also noted by many healthcare providers. Results from the secondary data analysis corroborated findings from residents and healthcare providers with significantly increased reports of respiratory and mental health discharges three years after the disaster. Individuals remain physically and mentally impacted by a disaster not solely in the immediate aftermath, but also in the long-term period after immediate response efforts have ceased. Public health practitioners and researchers should continue to examine and respond to the long-term impacts of disasters on vulnerable, medically underserved communities.