When the flood passes, does health return? A short panel examining water and food insecurity, nutrition, and disease after an extreme flood in lowland Bolivia.

OBJECTIVES: Flooding is the most frequent extreme-weather disaster and disproportionately burdens marginalized populations. This article examines how food and water insecurity, blood pressure (BP), nutritional status, and diarrheal and respiratory illnesses changed during the 2 months following a historic flood in lowland Bolivia. METHODS: Drawing on longitudinal data from Tsimane' forager-horticulturalist (n = 118 household heads; n = 129 children) directly after a historic 2014 flood and ~2 months later, we use fixed effects linear regression and random effects logistic regression models to test changes in the markers of well-being and health over the recovery process. RESULTS: Results demonstrated that water insecurity scores decreased significantly 2 month's postflood, while food insecurity scores remained high. Adults' systolic and diastolic BP significantly declined 2 months after the flood's conclusion. Adults experienced losses in measures of adiposity (BMI, sum of four skinfolds, waist circumference). Children gained weight and BMI-for-age Z-scores indicating buffering of children by adults from food stress that mainly occurred in the community closer to the main market town with greater access to food aid. Odds of diarrhea showed a nonsignificant decline, while cough increased significantly for both children and adults 2 months postflood. CONCLUSIONS: Water insecurity and BP improved during the recovery process, while high levels of food insecurity persisted, and nutritional stress and respiratory illness worsened. Not all indicators of well-being and health recover at the same rate after historic flooding events. Planning for multiphase recovery is critical to improve health of marginalized populations after flooding.

Consolidation of Class Advantages in the Wake of the Great Recession: University Enrollments, Educational Opportunity and Stratification.

Most U.S. universities have made explicit commitments to educating economically diverse student bodies; however, the higher education system is highly stratified. In this paper, we seek to understand stratification in the wake of the Great Recession by examining enrollment among students from differing income backgrounds by institutional type. Two theoretical frameworks suggest different conclusions. A Disaster Capitalism framework suggests that in places where the recession was most severe, enrollment by income would become more stratified than in places where the downturn was less severe. In contrast, Effectively Maintained Inequality would suggest that enrollments were already effectively stratified by income and would not necessarily be sensitive to exposure to an economic shock. Employing fixed effects modeling and novel data based on the tax records of 30 million Americans, we examine income composition by institutional type from 2004 to 2012. We find that although stratification by institutional type worsened during the recession and subsequent recovery, patterns of economic stratification were not more intense for institutions that enrolled students from states hardest hit by the recession. We conclude that these patterns are consistent with an Effectively Maintained Inequality framework. During the recession, the top quintiles continued to enjoy their longstanding disproportionate enrollment in the most selective institutions. For the bottom quintiles, the longstanding marginalization from 4-year college going persisted through the recession. These stratification patterns, however, were not more pronounced in places hardest hit by the recession.