Nearly half of the people affected by the Maui wildfires in August 2023 suffered a decline in health, according to a study that aims to track the well-being and social conditions of those exposed to the disaster.
Researchers from the University of Hawai‘i at Manoa released an initial report Tuesday based on surveys and tests collected from Maui residents in February.
The Maui Wildfire Exposure Study features the results from 679 adult participants of various ethnicities, two-thirds of whom lived in Lahaina at the time of the fires. The other participants either worked in Lahaina, or lived or worked in fire-affected areas in Kula.
Like the studies launched after 9/11, this one aims to follow the health of the survivors over time, for a decade or longer, in hopes of heading off the long-term health and social impacts of the massive Aug. 8, 2023, wildfire, which killed 101 people and destroyed thousands of homes and buildings in the heart of Lahaina town.
“Maui and its communities are forever changed by the wildfires,” said Ruben Juarez, a UH Manoa professor of health economics and one of the co-authors of the study, at a news conference. “But we’re working to assist recovery by understanding impacts and anticipating requirements to help people heal.”
The study found that 46 percent of survivors experienced a decline in health from the previous year. In addition, roughly 74 percent of participants face a heightened risk of cardiovascular disease due to elevated or prehypertension levels, and up to 60 percent may suffer from poor respiratory health. Kidney function also may be compromised in up to 20 percent of the participants.
As for mental health, the survey found a sizable increase in depression compared to before the fires, with more than 50 percent expressing symptoms, which is much higher than state and local averages. Nearly a third of the participants reported symptoms of moderate or severe anxiety, with elevated levels of low self-esteem (35 percent) and suicidal thoughts (4.4 percent) detected.
The study found that more than four in 10 people were having trouble getting medical care and medications, compared with about 1 in 10 before the fires, and more than 13 percent were lacking insurance, including 38 percent of Hispanic respondents.
“When it comes to security, we know that only one-third of the affected individuals still lived in their original homes, nearly half lost their jobs and 20 percent remain unemployed. Household incomes have fallen by two-thirds and more than 40 percent of households are finding it harder than ever to get enough food,” Juarez said, adding however that things may have changed since the data was collected in February.
On the positive side, those who maintained strong social connections with family and friends experienced better health outcomes and fewer symptoms, the study found, and many of the survivors were found to trust and depend on community organizations more than government agencies.
“This is telling us that grassroots groups are addressing urgent needs, assisting to access urgent care and delivering wraparound services, making their role vital to the response and recovery,” Juarez said.
The research team launched an online interactive dashboard, which holds all of the study’s data. All health and social impact metrics can be broken down by age, race and income groups. The dashboard web address is analytics.uhero.hawaii.edu/maui-wes.
“It took more than 20 years to observe the long-term health consequences of 9/11,” Juarez said. “We are committed to following our participants as long as needed to support recovery for the people of Maui.”
Co-author Alika Maunakea, a professor in UH Manoa’s Department of Anatomy, Biochemistry and Physiology, said the plan is to offer a health check to all study participants every year as long as it is needed, along with questionnaires to allow an annual collection of data.
Maunakea said 9/11 led to much higher mortality rates from cancer and other diseases that took more than 20 years to manifest.
“So we’re trying to be able to provide an idea of what people might be experiencing now and identify early bio-markers that can help us identify those who might be on that trajectory, so we can prevent that from occurring.” he said.
The researchers said they would like to expand the number of study participants to as many as 2,000 to get a larger sample of the 10,000 or more people who lost their homes in the fire.
In their paper, the authors offered a set of recommendations for those handling the recovery effort. They include:
• Focusing on expanding access to health care and insurance coverage for individuals affected by the wildfires, particularly in light of urgent health needs in pulmonary, cardiovascular and behavioral health.
• Establishing polices to support housing supply, financial aid and access to affordable options to ensure stable, long-term housing solutions for those who were displaced by the fire.
• Reducing post-wildfire environmental hazards by cleaning up the burn zone, monitoring air and water quality during cleanup, and educating residents about protective measures.
• Engaging local organizations to provide culturally sensitive support.
• Developing strategies to support the health care and other needs of the most vulnerable individuals, including those from low-income households, food insecure households, immigrants, people with preexisting physical and mental health conditions and people with disabilities.
Launched by the UH Economic Research Organization and UH’s John A. Burns School of Medicine, the initiative is a partnership with community-based organizations including the Maui Medic Healers Hui, Roots Reborn, Tagnawa for Maui, and supported by a combined $500,000 in seed funding from the Hawai‘i Community Foundation Maui Strong Fund and Kaiser Permanente.
Additionally, more than $2 million in funding was approved by the state Legislature and is waiting for the governor’s signature.
It’s time to rethink how Maui got this disaster