1
|
Wang P, Asare EO, Pitzer VE, Dubrow R, Chen K. Floods and Diarrhea Risk in Young Children in Low- and Middle-Income Countries. JAMA Pediatr 2023; 177:1206-1214. [PMID: 37782513 PMCID: PMC10546297 DOI: 10.1001/jamapediatrics.2023.3964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/08/2023] [Indexed: 10/03/2023]
Abstract
Importance Climate change is associated with more frequent and intense floods. Current research on the association between flood exposure and diarrhea risk is limited mainly to short-term and event-specific analyses. Moreover, how prior drought or water, sanitation, and hygiene (WaSH) practices influence this association remains largely unknown. Objective To examine the association between flood exposure and diarrhea risk among children younger than 5 years and to evaluate the compounding influence of prior drought and effect modification by WaSH. Design, Setting, and Participants This cross-sectional study included multicluster surveys conducted by the Demographic and Health Surveys Program in 43 low- and middle-income countries during 2009 through 2019. This study included children younger than 5 years in all households from each survey cluster. Collected data were analyzed between September 1 and December 31, 2022. Exposures Historical flood events during 2009 through 2019 were obtained from the Dartmouth Flood Observatory. Main Outcome and Measures The main outcome was diarrhea prevalence among children younger than 5 years in the 2 weeks before the survey was conducted. Results were analyzed by binomial generalized linear mixed-effects logistic regression models with nested random intercepts for country and survey cluster. Results Among 639 250 children making up the complete data series (excluding 274 847 children with missing values for diarrhea or baseline characteristics), 6365 (mean [SD] age, 28.9 [17.2] months; 3214 boys [50.5%]; 3151 girls [49.5%]) were exposed to floods during the 8 weeks after a flood started. The prevalence of diarrhea was 13.2% (n = 839) among exposed children and 12.7% (n = 80 337) among unexposed children. Exposure to floods was associated with increased diarrhea risk, with the highest odds ratio (OR) observed during the second to fourth weeks after floods started (OR, 1.35; 95% CI, 1.05-1.73). When floods were stratified by severity and duration, significant associations were observed only for extreme floods (OR during the third to fifth weeks, 2.07; 95% CI, 1.37-3.11) or floods lasting more than 2 weeks (OR during the second to fourth weeks, 1.47; 95% CI, 1.13-1.92), with significantly stronger associations than for less extreme floods or shorter-duration floods, respectively. The OR during the first 4 weeks after the start of floods was significantly higher for floods preceded by a 6-month or longer drought (12-month drought OR, 1.96; 95% CI, 1.53-2.52) than for floods not preceded by a 6-month or longer drought (12-month drought OR, 1.00; 95% CI, 0.79-1.27). Conclusions These findings suggest that floods, especially severe floods, long-duration floods, and floods preceded by drought, are associated with an increased risk of diarrhea among children younger than 5 years living in low- and middle-income countries. With the projected increasing frequency and intensity of floods and drought under climate change, greater collective efforts are needed to protect children's health from these compounding events.
Collapse
Affiliation(s)
- Pin Wang
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, Connecticut
| | - Ernest O. Asare
- Department of Epidemiology of Microbial Diseases and the Public Health Modeling Unit, Yale School of Public Health, New Haven, Connecticut
| | - Virginia E. Pitzer
- Department of Epidemiology of Microbial Diseases and the Public Health Modeling Unit, Yale School of Public Health, New Haven, Connecticut
| | - Robert Dubrow
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, Connecticut
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, Connecticut
| |
Collapse
|
2
|
Qiu S, Liu K, Yang C, Xiang Y, Min K, Zhu K, Liu H, Du X, Yang M, Wang L, Sun Y, Zhou H, Mahe M, Zhao J, Li S, Yu D, Hawkey J, Holt KE, Baker S, Yang J, Xu X, Song H. A Shigella sonnei clone with extensive drug resistance associated with waterborne outbreaks in China. Nat Commun 2022; 13:7365. [PMID: 36450777 PMCID: PMC9709761 DOI: 10.1038/s41467-022-35136-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 11/21/2022] [Indexed: 12/05/2022] Open
Abstract
Antimicrobial resistance of Shigella sonnei has become a global concern. Here, we report a phylogenetic group of S. sonnei with extensive drug resistance, including a combination of multidrug resistance, coresistance to ceftriaxone and azithromycin (cefRaziR), reduced susceptibility to fluoroquinolones, and even colistin resistance (colR). This distinct clone caused six waterborne shigellosis outbreaks in China from 2015 to 2020. We collect 155 outbreak isolates and 152 sporadic isolates. The cefRaziR isolates, including outbreak strains, are mainly distributed in a distinct clade located in global Lineage III. The outbreak strains form a recently derived monophyletic group that may have emerged circa 2010. The cefRaziR and colR phenotypes are attributed to the acquisition of different plasmids, particularly the IncB/O/K/Z plasmid coharboring the blaCTX-M-14, mphA, aac(3)-IId, dfrA17, aadA5, and sul1 genes and the IncI2 plasmid with an mcr-1 gene. Genetic analyses identify 92 accessory genes and 60 single-nucleotide polymorphisms associated with the cefRaziR phenotype. Surveillance of this clone is required to determine its dissemination and threat to global public health.
Collapse
Affiliation(s)
- Shaofu Qiu
- grid.488137.10000 0001 2267 2324The Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Kangkang Liu
- grid.488137.10000 0001 2267 2324The Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Chaojie Yang
- grid.488137.10000 0001 2267 2324The Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Ying Xiang
- grid.488137.10000 0001 2267 2324The Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Kaiyuan Min
- grid.506261.60000 0001 0706 7839State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kunpeng Zhu
- grid.488137.10000 0001 2267 2324The Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Hongbo Liu
- grid.488137.10000 0001 2267 2324The Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Xinying Du
- grid.488137.10000 0001 2267 2324The Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Mingjuan Yang
- grid.488137.10000 0001 2267 2324The Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Ligui Wang
- grid.488137.10000 0001 2267 2324The Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Yong Sun
- grid.410620.10000 0004 1757 8298Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Haijian Zhou
- grid.198530.60000 0000 8803 2373National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention and State Key Laboratory for Infectious Disease Prevention and Control, Beijing, China
| | - Muti Mahe
- Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Jiayong Zhao
- grid.418504.cHenan Provincial Center for Disease Control and Prevention, Zhengzhou, China
| | - Shijun Li
- Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Deshan Yu
- grid.508057.fGansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Jane Hawkey
- grid.1002.30000 0004 1936 7857Department of Infectious Diseases, Monash University, Melbourne, VIC Australia
| | - Kathryn E. Holt
- grid.1002.30000 0004 1936 7857Department of Infectious Diseases, Monash University, Melbourne, VIC Australia
| | - Stephen Baker
- grid.5335.00000000121885934University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Juntao Yang
- grid.506261.60000 0001 0706 7839State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xuebin Xu
- grid.430328.eShanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Hongbin Song
- grid.488137.10000 0001 2267 2324The Chinese PLA Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
3
|
Lan T, Hu Y, Cheng L, Chen L, Guan X, Yang Y, Guo Y, Pan J. Floods and diarrheal morbidity: Evidence on the relationship, effect modifiers, and attributable risk from Sichuan Province, China. J Glob Health 2022; 12:11007. [PMID: 35871400 PMCID: PMC9308977 DOI: 10.7189/jogh.12.11007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Although studies have provided the estimates of floods-diarrhoea associations, little is known about the lag effect, effect modification, and attributable risk. Based on Sichuan, China, an uneven socio-economic development province with plateau, basin, and mountain terrains spanning different climatic zones, we aimed to systematically examine the impacts of floods on diarrheal morbidity. Methods We retrieved information on daily diarrheal cases, floods, meteorological variables, and annual socio-economic characteristics for 21 cities in Sichuan from January 1, 2017 to December 31, 2019. We fitted time-series Poisson models to estimate the city-specific floods-diarrhoea relation over the lags of 0-14 days, and then pooled them using meta-analysis for cumulative and lag effects. We further employed meta-regression to explore potential effect modifiers and identify effect modification. We calculated the attributable diarrheal cases and fraction of attributable morbidity within the framework of the distributed lag model. Results Floods had a significant cumulative association with diarrhoea at the provincial level, but varied by regions and cities. The effects of the floods appeared on the second day after the floods and lasted for 5 days. Floods-diarrhoea relations were modified by three effect modifiers, with stronger flood effects on diarrhoea found in areas with higher air pressure, lower diurnal temperature range, or warmer temperature. Floods were responsible for advancing a fraction of diarrhoea, corresponding to 0.25% within the study period and 0.48% within the flood season. Conclusions The impacts imposed by floods were mainly distributed within the first week. The floods-diarrhoea relations varied by geographic and climatic conditions. The diarrheal burden attributable to floods is currently low in Sichuan, but this figure could increase with the exposure more intensive and the effect modifiers more detrimental in the future. Our findings are expected to provide evidence for the formulation of temporal- and spatial-specific strategies to reduce potential risks of flood-related diarrhoea.
Collapse
Affiliation(s)
- Tianjiao Lan
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, China
| | - Yifan Hu
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Liangliang Cheng
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lingwei Chen
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, China
| | - Xujing Guan
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Yili Yang
- Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, China
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jay Pan
- HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, China
| |
Collapse
|
4
|
Yang X, Xiong W, Huang T, He J. Meteorological and social conditions contribute to infectious diarrhea in China. Sci Rep 2021; 11:23374. [PMID: 34862400 PMCID: PMC8642416 DOI: 10.1038/s41598-021-00932-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/20/2021] [Indexed: 11/09/2022] Open
Abstract
Infectious diarrhea in China showed a significant pattern. Many researchers have tried to reveal the drivers, yet usually only meteorological factors were taken into consideration. Furthermore, the diarrheal data they analyzed were incomplete and the algorithms they exploited were inefficient of adapting realistic relationships. Here, we investigate the impacts of meteorological and social factors on the number of infectious diarrhea cases in China. A machine learning algorithm called the Random Forest is utilized. Our results demonstrate that nearly half of infectious diarrhea occurred among children under 5 years old. Generally speaking, increasing temperature or relative humidity leads to increased cases of infectious diarrhea in China. Nevertheless, people from different age groups or different regions own different sensitivities to meteorological factors. The weight of feces that are harmfully treated could be a possible reason for infectious diarrhea of the elderly as well as children under 5 years old. These findings indicate that infectious diarrhea prevention for children under 5 years old remains a primary task in China. Personalized prevention countermeasures ought to be provided to different age groups and different regions. It is essential to bring the weight of feces that are harmfully treated to the forefront when considering infectious diarrhea prevention.
Collapse
Affiliation(s)
- Xiang Yang
- grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029 China
| | - Weifeng Xiong
- grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029 China
| | - Tianyao Huang
- grid.12527.330000 0001 0662 3178Tsinghua University, Haidian District, Beijing, 100084 China
| | - Juan He
- Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China.
| |
Collapse
|
5
|
Chen NT, Chen MJ, Wu CD, Guo YL. Emergency room visits for childhood atopic dermatitis are associated with floods? THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 773:145435. [PMID: 33940726 DOI: 10.1016/j.scitotenv.2021.145435] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 01/04/2021] [Accepted: 01/22/2021] [Indexed: 06/12/2023]
Abstract
Floods are known to increase the level of allergens such as molds in the environments. Under climate change, the frequency of floods could be increased, which highlights the importance of understanding the impacts of floods on atopic diseases. However, there was a lack of studies. This study examines whether floods induce attacks of childhood atopic dermatitis (AD). A retrospective population-based study was conducted in Taiwan Island using Taiwan's National Health Insurance Research Database. Emergency room (ER) visits for AD were identified among children aged 0-12 years. Weekly data of flood occurrence, number of flood sites, temperature, and air pollution were obtained for each township of the identified cases. A time-stratified case-crossover design was used. The relationship between ER visits for AD and floods was assessed by conditional logistic regression, adjusting for weekly mean temperature, PM2.5 and NO2. There were a total of 55,488 ER visits due to AD during the study period. Such visits increased when flood occurred, and then declined. The effects of floods at the week of flood remained robust, with OR of 1.14 (95% CI = 1.01-1.28) for flood occurrence and 1.31 (95% CI = 1.10-1.55) for the number of flood sites, after adjusting for covariates. Such effects were slightly higher in boys and children aged 1-12 years. This study demonstrated the impact of floods on flare-up of childhood AD, and the effect was most prominently at the week of flood. Healthcare workers should be alarmed for potential increase of AD flare ups after flood events.
Collapse
Affiliation(s)
- Nai-Tzu Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli 35053, Taiwan; Research Center of Environmental Trace Toxic Substances, National Cheng Kung University, Tainan 704302, Taiwan
| | - Mu-Jean Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli 35053, Taiwan
| | - Chih-Da Wu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli 35053, Taiwan; Department of Geomatics, National Cheng Kung University, Tainan 70101, Taiwan
| | - Yue Leon Guo
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli 35053, Taiwan; Department of Environmental and Occupational Medicine, College of Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan; Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 10055, Taiwan.
| |
Collapse
|
6
|
Kraay ANM, Man O, Levy MC, Levy K, Ionides E, Eisenberg JNS. Understanding the Impact of Rainfall on Diarrhea: Testing the Concentration-Dilution Hypothesis Using a Systematic Review and Meta-Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:126001. [PMID: 33284047 PMCID: PMC7720804 DOI: 10.1289/ehp6181] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/26/2020] [Accepted: 11/09/2020] [Indexed: 05/07/2023]
Abstract
BACKGROUND Projected increases in extreme weather may change relationships between rain-related climate exposures and diarrheal disease. Whether rainfall increases or decreases diarrhea rates is unclear based on prior literature. The concentration-dilution hypothesis suggests that these conflicting results are explained by the background level of rain: Rainfall following dry periods can flush pathogens into surface water, increasing diarrhea incidence, whereas rainfall following wet periods can dilute pathogen concentrations in surface water, thereby decreasing diarrhea incidence. OBJECTIVES In this analysis, we explored the extent to which the concentration-dilution hypothesis is supported by published literature. METHODS To this end, we conducted a systematic search for articles assessing the relationship between rain, extreme rain, flood, drought, and season (rainy vs. dry) and diarrheal illness. RESULTS A total of 111 articles met our inclusion criteria. Overall, the literature largely supports the concentration-dilution hypothesis. In particular, extreme rain was associated with increased diarrhea when it followed a dry period [incidence rate ratio ( IRR ) = 1.26 ; 95% confidence interval (CI): 1.05, 1.51], with a tendency toward an inverse association for extreme rain following wet periods, albeit nonsignificant, with one of four relevant studies showing a significant inverse association (IRR = 0.911 ; 95% CI: 0.771, 1.08). Incidences of bacterial and parasitic diarrhea were more common during rainy seasons, providing pathogen-specific support for a concentration mechanism, but rotavirus diarrhea showed the opposite association. Information on timing of cases within the rainy season (e.g., early vs. late) was lacking, limiting further analysis. We did not find a linear association between nonextreme rain exposures and diarrheal disease, but several studies found a nonlinear association with low and high rain both being associated with diarrhea. DISCUSSION Our meta-analysis suggests that the effect of rainfall depends on the antecedent conditions. Future studies should use standard, clearly defined exposure variables to strengthen understanding of the relationship between rainfall and diarrheal illness. https://doi.org/10.1289/EHP6181.
Collapse
Affiliation(s)
- Alicia N. M. Kraay
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Olivia Man
- Department of Epidemiology, University of Michigan–Ann Arbor, Ann Arbor, Michigan, USA
| | - Morgan C. Levy
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, California, USA
- School of Global Policy and Strategy, University of California San Diego, La Jolla, California, USA
| | - Karen Levy
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Edward Ionides
- Department of Epidemiology, University of Michigan–Ann Arbor, Ann Arbor, Michigan, USA
| | | |
Collapse
|
7
|
Abstract
This study aimed to assess the interrelationship among extreme natural events and their impacts on environments and humans through a systematic and quantitative review based on the up-to-date scientific literature. Namely, the main goal was to add additional knowledge to the existing evidence of the impacts related to floods, droughts, and landslides on humans and the environment in China; this in order to identify knowledge gaps in research and practice to aid in improving the adaptation and mitigation measures against extreme natural events in China. In this study, 110 documents were analyzed in the evaluation of several impacts triggered by extreme events. Records were obtained from Scopus and Web of Science and examined with a text mining instrument to assess the pattern of publications over the years; the problems linked to extreme weather events were investigated, and the study gaps were discussed. This paper extends work by systematically reviewing recent evidence related to floods, droughts, and landslides in China. We listed the critical studies that focused on the impact of extreme events on both humans and the environment described in current reviews. The findings revealed that goods safety, social safety, and financial losses are of significant concern to the scientific community due to extreme natural events, which from our analysis resulted in being more frequent and intense. It is still underdeveloped to implement distant sensing and imaging methods to monitor and detect the impact of severe weather occurrences. There are still significant study gaps in the fields of the effects of extreme weather events. The analysis result shows that extreme events are increased during the time, so more in-depth investigation and efforts on adaptation, mitigation measures, and strategical governance plans are desperately required.
Collapse
|
8
|
Collins TW, Grineski SE, Chakraborty J, Flores AB. Environmental injustice and Hurricane Harvey: A household-level study of socially disparate flood exposures in Greater Houston, Texas, USA. ENVIRONMENTAL RESEARCH 2019; 179:108772. [PMID: 31593835 DOI: 10.1016/j.envres.2019.108772] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/20/2019] [Accepted: 09/22/2019] [Indexed: 06/10/2023]
Abstract
Environmental justice research on flooding has relied heavily on analyses of aggregated geographic areal units and assessing exposure to 'pre-flood' risks (e.g., residence in 100-year flood zones) rather than actual flood events. To address these limitations, we examined disproportionate exposure to flooding caused by Hurricane Harvey in 2017 in Greater Houston (Texas). Using primary survey data collected from 377 representative households before Harvey and spatial data on Harvey-induced inundation developed by the US Federal Emergency Management Agency, we found that the areal extent of flooding around residents' home sites was distributed inequitably with respect to race/ethnicity and socioeconomic status (SES). Hispanic, black and other racial/ethnic minority households experienced more extensive flooding than white households, and lower SES households faced more extensive flooding than higher SES households. Findings align with prior flood risk research in Greater Houston and provide cause for concern, as social inequities in flood exposure may have influenced social disparities in flood impacts and post-disaster needs. Since flood events in Greater Houston are expected to increase in frequency and magnitude due to climate change, socially disparate impacts are likely to become an increasingly salient public policy issue. Thus, proactive approaches for reducing flood risks and ameliorating disparities should be implemented.
Collapse
Affiliation(s)
- Timothy W Collins
- Department of Geography, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA.
| | - Sara E Grineski
- Department of Sociology, University of Utah; 380 S 1530 E, Rm. 301, Salt Lake City, UT, 84112, USA
| | - Jayajit Chakraborty
- Department of Sociology & Anthropology, University of Texas at El Paso; 500 West University Avenue, El Paso, TX, 79968, USA
| | - Aaron B Flores
- Department of Geography, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA
| |
Collapse
|