Flood exposure, health outcomes, and recovery needs following Hurricane Helene in Southern Appalachia

The current study examines Hurricane Helene’s inland flooding in Southern Appalachia to generate understanding into flood exposure, health outcomes, and long-term recovery needs. Using a mixed-methods case study design that combined county-level geospatial analysis with a community survey (N = 700), the objectives were threefold: (1) to map flood exposure and vulnerability across rural and urban areas in the region, (2) identify the physical and mental health impacts of Helene flooding and risk and protective factors influencing these outcomes, and (3) describe unmet needs five months post-disaster. Geospatial analyses identified county areas that faced flood inundation, damaged landscapes, road closures, population density, and heightened social vulnerability. Quantitative survey results found county impact, exposure to environmental contaminants (e.g. visible mould, sewage, contaminated water), flood event exposure (e.g. injury, losses), and post-flood stressors were associated with adverse health. Qualitative analysis of open-ended survey responses identified four main themes of unmet needs five months post-disaster, including: health, housing and shelter, financial, and community infrastructure. These findings provide comprehensive insights into Helene’s flood exposure, associated health outcomes, and recovery challenges, highlighting the multifaceted health, social, and infrastructural impacts of hurricane-induced flooding in Southern Appalachia.