Innovating Disaster Risk Reduction through a Novel Population Health Resilience Index - Project Summary/Abstract Natural disasters, particularly hurricanes and floods, disproportionately impact communities based on varying degrees of disaster susceptibility and community resilience, contributing to rising mortality, morbidity, and long-term health impacts. Despite decades of research and discourse surrounding the relationship between these constructs, a measure combining susceptibility and resilience into a single spectrum has not been empirically tested as a measure of disaster risk. Additionally, considering disasters disrupt progress towards achieving total population health (i.e. people living longer, healthier lives) due to the high incidence of adverse disaster-related health outcomes, another major gap is the lack of population health-based indices to measure these constructs. As such, current indices lack a whole-person resilience approach, focusing on physical, social, economic, and environmental domains while excluding biological, psychosocial, and behavioral factors. Therefore, the overall objective of this predoctoral fellowship is to address these gaps through a Population Health Disaster Resilience Index (PHDRI), a multidomain index that measures population resilience, integrating population health risk factors with established susceptibility and resilience indicators. Therefore, the goal of this predoctoral fellowship is to develop and assess a PHDRI to predict post-disaster health outcomes. This index will enable more accurate identification of communities whose disaster susceptibility is driven by both structural disadvantage and underlying health conditions, supporting more targeted public health interventions to improve preparedness, mitigation, and recovery efforts. The specific aims included in this research training project are (1) Develop and begin to validate a novel PHDRI; (2) Map the geographic distribution of population resilience using the new measure; and (3) Assess whether changes in PHDRI scores before and after hurricanes are associated with corresponding changes in county-level population health outcomes to evaluate predictive validity. The training goals are integrated within each aim, including developing skills in variable selection and data reduction, convergent validity, geospatial and spatial-temporal thematic mapping and analysis, and natural experiments using difference-in-differences methods, longitudinal data analysis, and multilevel modeling. A multitude of secondary data sources will be utilized to develop a PHDRI, and the scores will be applied to the Southeastern United States (US) case study area to perform Aims 2 and 3, with major hurricanes occurring between 2012-2016 acting as the exposure. The research training project will be completed as part of doctoral program in Population Health in the Program in Public Health at Stony Brook University, which includes coursework and training in related research topics as well as independent studies and assistantships with leading researchers in the field.
