Abstract: Examining Hurricane Helene Flooding Vulnerabilities and Health Disparities In Southern Appalachia (Society for Social Work and Research 31st Annual Conference)

Schedule:

Sunday, January 24, 2027

Union Station 3 & 4 (Hilton San Francisco Union Square)

* noted as presenting author

Jennifer M. First, PhD, Assistant Professor, University of Missouri-Columbia, Columbia, MO

Michael Sunde, PhD, Assistant Professor, MU Extension Natural Resources Specialist, and Missouri Resource Assessment Partnership (MoRAP) Director, University of Missouri-Columbia

Megan Waddle, BSW, MSW Student, University of Missouri-Columbia

Kelsey Ellis, PhD, Professor and Director of the Institute for Climate and Community Resilience, University of Tennessee, Knoxville, Knoxville, TN

Jordan Fazio, MA, PhD Student, University of Tennessee, Knoxville

Kristina Kintziger, PhD, Claire M. Hubbard Professor of Health and Environment and Associate Professor, University of Nebraska Medical Center

Sarah Elizabeth Scales, PhD, Assistant Professor, University of Nebraska Medical Center

J. Brian Houston, PhD, Professor and Director for the Disaster and Community Crisis Center, University of Missouri-Columbia

Background and Purpose
Hurricane Helene made landfall along Florida’s Big Bend on September 26, 2024, as a Category 4 storm before moving inland across the southeastern United States, producing catastrophic rainfall and flooding throughout Southern Appalachia. Mountainous terrain amplified precipitation and runoff, contributing to widespread infrastructure damage, community disruption, and over 120 fatalities in the region. Despite growing evidence of inland hurricane impacts, limited research has examined how hurricane-related flood exposure, health outcomes, and recovery needs unfold in rural and mountainous communities in Southern Appalachia. This study addresses this gap by examining Hurricane Helene’s inland flooding impacts across Southern Appalachia, with a focus on spatial patterns of exposure, associated physical and mental health outcomes, and ongoing recovery challenges.

Methods
This mixed methods study examined the spatial, physical, and psychosocial impacts of Hurricane Helene-related flooding in Southern Appalachian communities. Integrating county-level geospatial analysis (n = 22), a community survey (n = 700), and workshops with public health and emergency response professionals (n = 20), the study aimed to: (1) map flood exposure and vulnerability across rural and urban areas in the region; (2) identify physical and mental health impacts and the risk and protective factors associated with outcomes; and (3) assess public health and emergency management officials’ perceptions of essential community needs for addressing flooding and health risks in the region.

Results
Geospatial analyses identified areas within the high precipitation zones facing elevated risks due to greater flood inundation, flood damaged landscapes, road closures, population density, and higher social vulnerability. Survey results show that environmental contaminant exposure (e.g., visible mold, sewage, contaminated water) was the strongest predictor of adverse physical health symptoms, while cumulative flood exposure and post-flood stressors were key drivers of mental health symptoms (e.g., post-traumatic stress disorder, depression). Qualitative findings from public health and emergency management officials highlight essential needs including logistical coordination gaps, communication and information challenges, inequities in access for vulnerable populations, mental health strain among responders, and the need for strengthening preparedness and long-term recovery infrastructure.

Conclusion and Implications
This study provides a comprehensive assessment of Hurricane Helene’s flooding impacts across Southern Appalachia by linking geospatial exposure patterns with individual health outcomes and recovery experiences. Taken together, these results offer comprehensive insights into Helene’s flood exposure and health burdens, underscoring the need for multi-system flood resilience frameworks that strengthen both individual resources and community capacities to support recovery and reduce disparities in hazard-affected communities.