Higher ground: Community-level response to a natural disaster and long-term impacts on health and identity in rural North Carolina

Background/Purpose: For many people in rural North Carolina, their sense of community and identity is intimately linked to the area where they reside. Following a natural disaster, relationships integral to the community are severed, and the provision of basic social and healthcare services suffers in response to acute community needs and stressors. After a natural disaster, how does a community maintain its identity while still recovering from the loss of place? In 1999, floods after Hurricane Floyd decimated much of eastern North Carolina, uprooting entire communities. The purpose of this paper is to explore the ways two particular African American communities responded to a natural disaster, both in terms of rebuilding and reclaiming their identity. Methods: An Action-Oriented Community Diagnosis (AOCD) was conducted with the African American communities in two towns in eastern North Carolina over a seven-month period. Three qualitative data collection methods were used to assess the strengths and challenges facing these communities. These methods were participant observation field notes; semi-structured individual interviews with 40 community residents and service providers; and secondary data sources such as historical archives, technical documents, and websites. Data were analyzed using a transcript-based analysis approach to determine patterns of meaning related to community and identity. Results/Implications: Preliminary findings from the assessment indicate striking differences in the impacts of a natural disaster on these communities based on age, race, class, and health status (including detrimental effects on mental health). The paper identifies implications for disaster planning, specifically in a rural context, indicating a need for long-term commitment to recovery as well as inclusion of mental health services in disaster preparedness plans. By gaining an understanding of the various impacts of a disaster on different facets of these small communities, public health officials will be better equipped to respond to community needs in the future.