Impacts of Recent Federal and State Actions on Natural Disaster Preparedness and Response on Health
Introduction
What used to be rare extreme weather events have increased in both intensity and frequency due to climate change. August 29, 2025 marked the 20th anniversary of Hurricane Katrina’s landfall in the Gulf Coast region of the U.S. Hurricane Katrina was one of the deadliest storms to hit the continental U.S., resulting in the deaths of nearly 2,000 people and the displacement of over one million. Since Katrina, major hurricanes such as Rita, Sandy, Harvey, Maria, and Helene, have resulted in massive loss of life and billions of dollars of damage. In January 2025, Los Angeles County experienced one of the deadliest wildfires in California’s history, killing over 30 people and injuring many more. In early May 2025, tornadoes in Kentucky, Missouri, and Virginia killed at least 25 people. In early July 2025, communities in Texas, New Mexico, and North Carolina experienced deadly flash floods, with over 100 people dying in the Texas floods. This brief provides an overview of who is impacted by health risks of natural disasters and recent federal and state actions related to disaster preparedness and response.
Reflecting underlying structural inequities, low-income communities, people of color, and other historically underserved groups are at increased risk of being affected by a natural disaster. In addition to the immediate hazards created by extreme weather events, their impacts can extend to miles away and years into the future. Natural disasters also have significant economic impacts. It is estimated that if left unaddressed, climate change related natural disasters could cost the U.S. economy approximately $14.5 trillion over the next fifty years.
While prior administrations have taken steps to bolster the nation’s efforts to prepare for and respond to natural disasters, the Trump administration has recently taken actions that may reverse some of these efforts. Weakened federal protections may deepen existing disparities, leaving communities that already face disproportionate climate risks with fewer safeguards against natural disasters. The elimination of key offices, programs, and data tools may also make it more difficult to assess and mitigate the health risks associated with natural disasters. As climate change-related disasters worsen, the federal government’s shrinking of emergency and disaster preparedness support to state and local governments may leave millions of people vulnerable and unable to recover from natural disasters. As of October 2025, more than two dozen local jurisdictions sued the federal government over the withholding of more than $350 million in emergency and disaster funds unless they complied with immigration enforcement efforts and federal policies against diversity, equity, and inclusion conditions. The lawsuit follows a recent decision by a federal judge blocking the Trump administration’s efforts to freeze federal emergency preparedness funds for states that opposed the administration’s mass deportation efforts. Some states have taken actions to prepare for and respond to natural disasters, however variation in state-level actions may leave some areas and communities at increased risk.
Who is at Increased Risk for Negative Health Impacts Due to Natural Disasters?
Many of the same factors that contribute to health inequities leave some communities at higher risk of being affected by a natural disaster. Low income communities and communities of color are often on the front lines of natural disasters and climate change. Due to historical residential segregation, including redlining, people of color are more likely to live in neighborhoods that have worse infrastructure, increasing their risk of harm and limiting their ability to prepare or safely shelter-in-place. Rural communities face challenges responding to natural disasters, ranging from physical isolation, high poverty rates, to limited access to health care as well as limited financial capacity. Barriers such as language access and immigration-related fears may prevent immigrants from receiving timely warnings or recovery assistance and financial challenges make it harder for low income families to evacuate, with surveys showing that costs often run into the thousands of dollars. Further, there are gaps in federal disaster management and response efforts. Recovery efforts are not always distributed equitably, with research finding wealthier and White communities more likely to benefit than communities of color. For example, during the 2025 L.A. County wildfires, fewer fire trucks were deployed to west Altadena, a historically Black neighborhood that experienced the greatest loss of life.
Natural disasters have immediate negative impacts on health and can limit access to health care and basic necessities. In addition to immediate loss of life and injury, damage to infrastructure caused by storms can also compromise emergency response efforts, limit access to basic needs, and disrupt access to health care and needed medications. These disruptions can be particularly severe for people who rely on continuous medical treatments or who live in communities with limited health care capacity. For example, immediately after Hurricane Maria, residents in Puerto Rico reported difficulties in accessing basic needs, including health care, water, food, gas and money. Those with chronic conditions such as asthma, diabetes and kidney disease had trouble managing their conditions due to power outages that impacted dialysis centers and their ability to refrigerate their medicines. A KFF Health News investigation found that at least 170 hospitals in the U.S. are at risk of severe flooding, potentially jeopardizing access to care and endangering the lives of hospital workers and people reliant on hospital care during flooding disasters. The cumulative effects of these challenges can widen existing health disparities, leaving some groups at greater risk of adverse outcomes during and after natural disasters.
Impacts of natural disasters can extend beyond the immediately affected area to people miles away. For example, in 2023, smoke from wildfires in Canada caused air pollution that affected more than 60 million people in the U.S. During that time, U.S. emergency room visits for asthma increased by nearly 20%. Research also shows that wildfire smoke accounts for significant amounts of particulate matter, worsening air pollution and creating persistent and chronic health risks. Communities of color are particularly susceptible to the adverse impacts of wildfires and wildfire smoke exposure due to their higher rates of underlying conditions including higher rates of asthma among American Indian and Alaska Native and Black people compared to White people.
Natural disasters can also affect communities years after their immediate impacts. For example, research shows that years after hurricanes have occurred, excess mortality persists, with Black people experiencing higher cumulative excess deaths than their White counterparts. One year after Hurricane Katrina, about one third (32%) of New Orleans residents reported that their lives remained “very disrupted” or “somewhat disrupted” by the storm, with this share rising to about six in ten (59%) of African American residents in Orleans Parish compared to about three in ten (29%) of White residents. Ten years after the storm, KFF survey data also showed that New Orleans residents who lived in the area during Katrina still reported lingering stress and problems with their mental health due to the hurricane.
What Are Recent Federal Actions Related to Natural Disasters and Health?
Prior administrations took steps to strengthen the nation’s capacity to prepare for and respond to natural disasters. These efforts focused on building federal infrastructure, improving coordination, and investing in hazard mitigation. For example, after Hurricane Katrina, President George W. Bush signed the Post-Katrina Emergency Management Reform Act of 2006 to overhaul the Federal Emergency Management Agency (FEMA), which included creating regional offices and stronger protections for people with disabilities and those with limited English proficiency. Later, the Obama administration expanded flexibility for states and Tribes in using recovery funds and allowed Tribes to make disaster declarations independently. The Preparing the United States for the Impacts of Climate Change Executive Order directed federal agencies to integrate climate preparedness into operations and planning. During its first term, the Trump administration established a national fund for pre-disaster mitigation, giving states more reliable access to resources for strengthening infrastructure. Together, these actions enhanced the federal framework for disaster preparedness, improved coordination, and increased protections for disproportionately affected populations.
The Biden administration took additional steps to prepare for, respond to, and address the impacts of climate change, natural disasters, and emergency and rescue services on health. The passage of the Infrastructure Investment and Jobs Act in 2021 and the Inflation Reduction Act in 2022 dedicated significant funds to disaster mitigation and resilience, including increasing the resilience of infrastructure and investing in more resilient energy grids to reduce power outages during extreme weather events. The National Climate Resilience Framework launched a whole-of-government climate resilience strategy, which directed agencies to integrate climate risk into planning and strengthening building standards to withstand disasters. Through the Building Resilience Infrastructure and Communities (BRIC) program and the Hazard Mitigation Assistance (HMA) Grant, FEMA awarded billions of dollars for pre-disaster mitigation and resiliency projects, with an emphasis on projects in underserved communities. By mid-2024, more than 20 federal agencies released climate adaptation plans that aligned with the National Climate Resilience Framework, which emphasized environmental justice and Tribal engagement.
On the first day of its second term, the Trump administration began implementing policies and regulations that cut funding and reversed efforts to mitigate the impacts of natural disasters and extreme weather events on health. In March 2025, the administration announced the cancelation of grants worth $1.7 billion aimed at preparing communities for extreme weather events as well as improving their air and water quality. In April 2025, FEMA suspended the BRIC and HMA programs, both of which funded flood control, wildfire mitigation, and infrastructure resilience projects. FEMA also reduced staff and training capacity by 20%, limiting the agency’s ability to coordinate disaster response and recovery. In addition to significant workforce cuts, the National Oceanic and Atmospheric Administration (NOAA) faces significant budget cuts that are expected to hinder severe weather forecasting and early warning systems that are key for preparing for natural disasters and extreme weather events. NOAA is one of the few reliable sources that people can access when determining how and when to respond to a natural disaster; cuts to its programs may contribute to increases in loss of life. Further, the Trump administration stopped updating the Billion-Dollar Weather and Climate Disasters database, which documented the economic cost of natural disasters. The loss of this source of data will leave researchers, policymakers, and other actors with less reliable information to determine the impacts of natural disasters and plan for future events.
Beyond the changes at FEMA, the administration has pursued broader policy shifts that affect disaster preparedness and health. The administration has made major cutbacks to the Environmental Protection Agency’s (EPA) climate and resilience programs, including reduced enforcement of clean air and water standards that help protect communities during and after extreme weather events. In July 2025, the EPA finalized its proposal to rescind the 2009 Endangerment Finding under the Clean Air Act, which found that greenhouse gas emissions endangered public health and welfare and implemented greenhouse gas emissions standards for vehicles and other sectors. If this finding is eliminated, the EPA could no longer limit emissions from cars or power plants. The administration also eliminated the U.S. Global Change Research Program and fired the scientists who worked on the National Climate Assessment, a report that outlined the dangers of climate change and global warming, which the government used to help prepare for extreme weather events. The administration also eliminated or restructured federal environmental justice and diversity, equity, and inclusion initiatives, scaling back efforts designed to identify and address disproportionate environmental burdens on low income communities and communities of color. Areas like the Southeast U.S. are particularly vulnerable to the impacts of these changes as they are often affected by severe tropical storms and have high concentrations of low income communities and communities of color who due to underlying factors are less able to prepare for and recover from natural disasters. These actions reduce the agency’s ability to monitor risks, provide data to communities, and enforce protections in areas most likely to experience climate-related harm.
The Trump administration has also taken actions that block or weaken state level climate measures, including responses to natural disasters. Through the Executive Order, “Protecting American Energy From State Overreach,” the federal government directed the Department of Justice to challenge state and local climate resilience policies, including building codes and emission standards that support disaster preparedness. By targeting these measures, the order weakens safeguards that protect buildings against natural disasters and cuts emission standards that lower the production of greenhouse gas emissions that cause extreme weather events and mitigate toxin exposures during natural disasters. Further, the Trump administration’s efforts to limit the role of the federal government in state disaster response and management efforts will have significant effects for states that do not have the fiscal capacity or resources to adequately prepare for and recover from natural disasters. In 2019, of the 31 states that received federal disaster response and recovery resources, only five states would have had enough disaster-specific relief funds to cover the costs of disasters in 2019 without the support of the federal government.
What are Recent State Actions Related to Natural Disasters and Health?
Reflecting the increase in frequency and intensity of extreme weather and other natural disasters and the resultant economic losses associated with these events, several states have passed recent legislation focused on disaster preparedness and recovery. Most state policies emphasize centralized planning, identifying at-risk communities, developing mitigation strategies, and building infrastructure and community resilience. For example, New Jersey and South Carolina enacted bills that require all land-use agreements to include resiliency clauses or climate change-related hazard vulnerability assessments that take into account the impacts of natural disasters on local communities and built infrastructure. In Colorado, SB222-206 established the Office of Climate Preparedness to coordinate disaster recovery and develop a statewide climate roadmap, integrating climate adaptation, mitigation, and resilience strategies to support long-term environmental and community health efforts. The bill also created the Disaster Resilience Rebuilding Program to provide financial support for rebuilding homes, businesses, and infrastructure after disasters, as well as encouraging sustainable rebuilding projects that promote high-efficiency and sustainable reconstruction efforts.
Some states have integrated actions into their disaster response policies to help identify and reach historically marginalized populations who are often left behind during disaster preparedness and recovery efforts due to social and economic inequities. For example, Washington’s Greenhouse Gas Emissions-Cap and Invest Program encourages the use of an environmental justice assessment to ensure that funds and programs provide benefits to and reduce disparities faced by overburdened communities−“communities that have historically borne the disproportionate impacts of environmental burdens and now bear the disproportionate negative impacts of climate change.” As part of HB 1237, Colorado directed funds to study how to improve language access in their warning systems by hiring multilingual staff and translating materials into languages other than English. They are also developing best practices for engaging with communities in other languages. Hawaii established a recovery fund for Native Hawaiian people who are at the frontline of climate change and experiencing loss from natural disasters. While Hawaii has dedicated funds to support Native Hawaiian people, the Lahaina fire from 2023 highlighted the hurdles survivors faced in accessing and utilizing recovery funds. Challenges in accessing funds, inability to pay rent and mortgages, and difficulty rebuilding have forced many Native Hawaiian survivors to move out of West Maui. For survivors who stayed, substantial increases in housing costs and recent changes to FEMA may jeopardize their ability to stay on their ancestral land long-term. Research shows that two years after the fire, survivors continue to report worsened mental and physical health and about four in ten (41%) adults still live in temporary housing.