Floods devastated the eastern part of Kentucky in July of this year. Just months before, tornadoes tore a path of destruction through towns in West Kentucky. A few states south of us, Jackson, Mississippi, saw heavy rains that caused flooding, overwhelming a water treatment plant and leaving a city of 150,000 without safe water. While the affected areas in Kentucky are rural, they share with urban Jackson years of underinvestment in infrastructure and a lack of adequate resources, making their populations—which are disproportionately impacted by storms and floods—that much more vulnerable to the effects of extreme weather events and presenting huge challenges in recovering from these disasters.

Such weather events impact the health of individuals living in affected communities. Low-income individuals live with higher rates of chronic disease, are more likely to be exposed to environmental hazards, have substandard housing, and often lack access to nutritious foods and adequate medical care. When disaster strikes, many are left displaced or homeless, without transportation and access to necessary physical and mental health services, exacerbating existing health problems. The precariousness of their situation affects their ability to cope with a disaster, leading to higher levels of post-traumatic stress and depression than experienced by those of higher socio-economic standing.

In the aftermath of a natural disaster, the focus is usually on returning a community to its previous state. For those who have endured economic, racial, and health inequities, such a focus is not good enough. The root causes of disparities must be addressed in the rebuilding effort to achieve true recovery, improve the lives of impacted people, and prevent similarly disastrous effects from occurring.

Philanthropy can play a crucial role in supporting underserved and marginalized communities in their rebuilding process. To do so, we must form strong partnerships with community leaders and local organizations, for only thus will we learn where needs are greatest in the evolving recovery effort and be able to develop culturally appropriate and sustainable solutions that align with communities’ distinct needs. Alongside that, successful philanthropy also requires a long-term commitment—continuing the work for months and often years to make a real and lasting difference.

Be there for the long hall

When a disaster hits, media attention draws eyes and dollars to the emergency. According to research by the Conrad N. Hilton Foundation, a third of total giving is completed less than a month after the disaster occurs; within two months, two-thirds of philanthropic assistance is done. That leaves minimal funding available when recovery efforts first get underway. In fact, a 2021 report by the Center for Disaster Philanthropy and Candid found that 51 percent of dollars go to response and relief efforts, while only six percent are dedicated to recovery and reconstruction, and a mere four percent support resilience efforts.

While there are huge needs in the immediate aftermath of a disaster, the road to recovery is long, and sustained funding is critical after the TV cameras are gone. There are no cookie-cutter solutions to post-disaster reconstruction—it takes a commitment to understanding the ever-changing needs of a community during the recovery process. That requires ongoing dialog and partnership with local leaders and organizations, including local government officials, faith-based groups, and grassroots nonprofits that have ears to the ground and are closest to the issues impacting residents. Those relationships are important sources of information about where and what types of resources are most needed, helping to avoid duplication or gaps in efforts.

In addition to working closely with community partners, collaborating with other philanthropic groups to share information and pool funds can lead to more efficient use of resources for long-term rebuilding.

From a health justice lens, the Humana Foundation’s partnership with the Center for Disaster Philanthropy (CDP) helped us decide if we should invest regularly in organizations that work with medically underserved communities and frontline healthcare workers, such as the National Association of Free and Charitable Clinics and the National Rural Health Association. When data demonstrated that the COVID-19 pandemic disproportionately impacted people of color, the Humana Foundation’s support of CDP’s COVID-19 Response Fund allowed us to direct grants to organizations enhancing access to equitable healthcare and promoting culturally sensitive and linguistically tailored outreach. Through CDP, we supported Louisiana-based Crescent Care, which assisted Black residents of communities with high fatality rates to understand how to use telehealth services, access testing and screening services, and enroll in Medicaid. Humana also worked with Grace at the Greenlight to provide unhoused people with hygiene supplies and education on social distancing and infection prevention.

Build community resiliency

Resiliency is achieved when the impacted community leads and helps itself in the rebuilding process rather than depending on support from external sources that leave sooner or later. Long-term philanthropic support can help achieve just that.

For example, CDP dispersed several resiliency-related grants to underserved Texas communities impacted by Hurricane Harvey. Golden Crescent Habitat for Humanity received funding to expand its reach into six additional counties, enabling the hiring of project managers and contractors to work with low-income homeowners in rebuilding houses damaged by the storm. Funding also supported Houston Responds in its work mobilizing coalitions of local churches for disaster response in up to 22 regions, helping to build sustainable networks of 20 or more churches and involving thousands of volunteers in the effort.

Support advocacy efforts

Research shows that people of color with fewer resources to spare prior to natural disasters end up further behind as they try to reconstruct their lives, while white Americans, particularly those who received ample disaster recovery aid and those with higher levels of education, gain wealth as they recover. In other words, natural disasters exacerbate existing inequities, widening the racial economic divide.

A myriad of structural and systemic forces contribute to the barriers that low-income individuals and communities—particularly those of color—face when engaged in the task of recovery. For example, many live in flood-prone areas but are not able to afford flood insurance. In 2017, when Hurricane Harvey caused severe flooding in Houston, more than 80 percent of homeowners in the eight counties that were hardest hit by the storm did not have flood insurance policies. Meanwhile, data from the Federal Emergency Management Agency (FEMA) confirms these disparities, showing that FEMA often provides less aid to households and communities of color than to their white counterparts.

Funders can play a key role by supporting organizations and helping residents navigate bureaucratic hoops to obtain governmental assistance. They can also help raise the voices and visibility of affected communities by funding grassroots organizing efforts to advocate for systemic changes that address inequities and build stronger, more resilient communities.

Address health disparities

Just as natural disasters widen the economic divide, they also exacerbate existing health inequities. The Resilience in Survivors of Katrina (RISK) Project analyzed 15 years of pre- and post-Katrina data and found that trauma-induced mental health problems disproportionately impacted low-income, vulnerable Katrina survivors, persisted for many years following the disaster, and increased the risk of physical health conditions, including asthma attacks, migraines, back pain, and digestive problems. Based on the study’s findings, researchers provide a blueprint for mitigating health disparities after a natural disaster. This blueprint includes five action recommendations that philanthropies should consider in their future disaster funding.

  • Primary prevention of disaster exposure: The fewer resources an individual has and the more vulnerable they feel, the greater the degree of trauma they’ll experience during and after a disaster. In addition to addressing larger infrastructural and environmental issues needed to decrease disaster exposure, trauma can be reduced by ensuring evacuation options for those who lack transportation, providing short-term affordable housing, and implementing systems that quickly locate and reunite loved ones.
  • Improve post-disaster health care: Following a disaster, there is a particularly high need for healthcare but difficulty in obtaining it. Those not able to access their medications or medical care had higher rates of posttraumatic stress, psychological distress, and poor health for many years following Katrina. Expanding access to all types of care, including mental health services, is critical in the aftermath of a disaster.
  • Social services integration: In the wake of a disaster, social services and supports can be disrupted. While assistance program disparities need to be addressed, funders can help people get back on their feet by aiding them in securing financial assistance and coordinating and filling gaps in other social service needs, such as food, housing, and transportation, which are known social determinants of health.
  • Aid in social support and community building: In addition to access to social services, having strong social supports is critical to good health. Hurricane Katrina survivors with greater social supports had more positive health outcomes and greater happiness and posttraumatic growth. Investing in local neighborhood and religious organizations and programs designed to increase community cohesion can help the community revitalization process and re-engage individuals with each other.
  • Targeted, long-term services for highly affected survivors: The mental health and consequent physical health effects of a disaster can continue for years. Four years post-Katrina, one in three survivors still experienced posttraumatic stress, and about half that number were still affected 12 years after the disaster. Long-term mental health services are needed for those who continue to struggle with the psychological effects of a disaster.

Studies like the RISK project have informed the Humana Foundation’s disaster funding efforts. In response to the recent hurricanes, Ian and Fiona, we established a crisis intervention hotline through LifeWorks, with free counseling services for anyone needing support to cope with a disaster and its consequences. Outside of Humana, another example of initiatives aimed at addressing mental health issues is the New Jersey Hurricane Sandy Relief Fund (NJHSRF), which funded nonprofits’ proactive community outreach, partnering with libraries, schools, and churches to let people know about available mental health services and resources. The fund recognized that services needed to be varied and flexible, so in addition to traditional counseling, peer-to-peer support groups, art therapy, and animal assisted therapy were made available to assist diverse communities in dealing with the mental health impacts of the storm.

Create evidence-based solutions

Disaster response must be tailored to each community’s unique needs, but funders learn important lessons from each disaster that can inform their next response. Monitoring and measuring the immediate and long-term impacts of their efforts, particularly on reducing disparities, provides valuable information to philanthropies and can also be shared with other funders, nonprofits, and government agencies. The CDP and Candid provide a tremendous service by collecting and analyzing data in their Measuring the State of Disaster Philanthropy report, guiding philanthropies in determining where needs are and where their investment has the greatest impact.

More research is needed to test and develop effective solutions for addressing systemic health inequities. To that end, the University of Louisville, in partnership with the Humana Foundation and Humana, launched the UofL Health Equity Innovation Hub to create evidence-based, scalable, and financially sustainable solutions to close health equity gaps and improve health outcomes and the quality of life of vulnerable, marginalized populations.

Natural disasters are increasing in frequency and intensity with climate change. Philanthropy can help to prevent such events from worsening the lives and circumstances of already vulnerable individuals and rebuild healthier communities by partnering with local leaders and organizations, committing to long-term investments, and addressing the health disparities that existed before disaster struck.