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In response to multiple concerns about water quality expressed by residents, EJCAN launched a water quality testing initiative with university-based collaborators from UNC Chapel Hill and Appalachian State University. Threats to water include but are not limited to industrialized agriculture. Industrialized hog feces contain pathogens, heavy metals, and antibiotic-resistant bacteria that growers store in large, open pit lagoons (Grant 1999; Wing et al. 2008; Blanchette 2019; Christenson et al. 2022). When operators spray the waste onto nearby fields, they also release air and waterborne contaminants. Scholars have linked airborne emissions from industrial hog operations to respiratory dysfunction, mood disorders, compromised immune function, anemia, kidney disease, tuberculosis, and low birth weight (Wing et al. 2000; Kravchenko et al. 2018; Guidry et al. 2018). Moreover, the odor is noxious, causing nausea, embarrassment, disorientation, and social loss in cultural continuity as people cease culturally meaningful practices like gardening, going for walks, or gathering outside to share food (Herring 2014; Blanchette 2019). The impacts to water include contamination, harmful algal blooms, fish kills, and eutrophication in rivers and estuaries, especially when hurricanes flood the inner coastal plains with industrialized animal waste (Wing et al. 2000; Wing et al. 2008; NCCN 2021; Emanuel 2018; Christenson et al. 2022). Access to water infrastructure in Sampson County is highly uneven, and residents have been advocating for improved access for more than a decade. 

In response to concerns expressed by community members, EJCAN launched a water quality testing initiative with university-based collaborators to increase knoweldge about the impacts of multiple hazards on water. Industrialized hog feces contain pathogens, heavy metals, and antibiotic-resistant bacteria that growers store in large, open pit lagoons (Grant 1999; Wing et al. 2008; Blanchette 2019; Christenson et al. 2022). When operators spray the waste onto nearby fields, they also release air and waterborne contaminants. Scholars have linked airborne emissions from industrial hog operations to respiratory dysfunction, mood disorders, compromised immune function, anemia, kidney disease, tuberculosis, and low birth weight (Wing et al. 2000; Kravchenko et al. 2018; Guidry et al. 2018). Moreover, the odor is noxious, causing nausea, embarrassment, disorientation, and social loss in cultural continuity as people cease culturally meaningful practices like gardening, going for walks, or gathering outside to share food (Herring 2014; Blanchette 2019). The impacts to water include contamination, harmful algal blooms, fish kills, and eutrophication in rivers and estuaries, especially when hurricanes flood the inner coastal plains with industrialized animal waste (Wing et al. 2000; Wing et al. 2008; NCCN 2021; Emanuel 2018; Christenson et al. 2022).Through Sampson County there is uneven access to water quality infrastructure, and residents have been advocating for improved access for water quality for more than a decade.   

The main findings of the article are that the relationship between natural disasters and communicable diseases is not as much due to dead bodies or high trauma as it is to population displacement and a lack of preparredness of the local governing body for the disaster and the crowding of survivors that follows a disaster as this

This article has been referenced in a wide variety of emergency medicine journal articles, ranging from flood protocols, use of cell phones in disaster enviroments, earthquakes and medical complications, to the costs of disaster consequences. Many of the articles referencing this paper appear to go into greater depth for some of the epidemics and diseases that were touched on in the research article. These include hepatitis E, Leptospirosis, cholera, and tetanus.

This article shows how some communities that, in the opinion of the Disaster Accountability Project organization, are within an effective radius of a nuclear incident at Indian Point and have little or no emergency plan for this kind of event. This is primarily due to these communities not having the knowledge that they could be effected by an event of this nature if they are over 10 miles away from the plant. Also, many of the communities that said they had not undergone any studies in relation to the plant's effects on their own community or developed any emergency plans because they cannot without federal aid. These counties and towns are not well-enough informed and are lacking the funding from the government in order to provide for their own safety if a nuclear accident were to occur

Emergency response is addressed in a broad sense of the major risk factors associated with a natural disaster and epidemics. The main points they make are that preparedness, with a focus on availability of safe water and primary healthcare services, along with surveillance for the beginnings of an epidemic, are necessessay for a strong response to a disaster situation   

The article looks at the "chronic disaster syndrome" - consisting of a multitude of factors that all act upon a person or family after a disaser like Katrina. The aftermath of the distaster lasts years, and this can wear on one's health if they are unable to return to their normal lives. Being displaced for a long period of time, in less optimal conditions, in a new environment, with new schools and jobs, can be traumatic