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UH study finds widespread health effects remain after Maui fires

                                Wildfire wreckage is left behind following a stubborn blaze on Thursday, Aug. 10, 2023, in Lahaina, Hawaii.
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Wildfire wreckage is left behind following a stubborn blaze on Thursday, Aug. 10, 2023, in Lahaina, Hawaii.

Six months after the devastating Maui wildfires, many survivors are suffering from depression, poor health and financial struggles, according to researchers from the University of Hawaii at Manoa.

The initial findings of the “Maui Wildfire Exposure Cohort Study,” released Thursday, found 3 out of 4, or 74%, may be suffering from respiratory issues, with half showing signs of mild to severe lung obstruction and about a third suffering from compromised lung function.

More than half, 55%, are exhibiting signs of depression, which increased with age and was particularly high for survivors in their 50s.

These numbers are sobering, according to UH Manoa professors and study leads Ruben Juarez and Alika Maunakea.

“We would expect to see these acute conditions appear in a community that’s been affected by the wildfires, especially the mental health issues,” said Maunakea, a professor at the John A. Burns School of Medicine. “That was unfortunately not surprising, but very sobering to know that it’s pervasive. ”

Rates of respiratory issues and depression were higher than expected for the initial cohort of 224 participants, they said, indicating signs of potential long-term complications down the line.

Juarez said he also was surprised how many participants said they had no help or support for their health concerns. Many asked where they could get treatment, especially for pulmonary or mental health.

Roughly a quarter of the cohort, 24%, reported they did not have steady access to medical care. Another 13% said they had no health insurance, which is a significant increase from 1.7% reported among Maui residents prior to the fires.

It’s a wake-up call, according to the researchers, who launched the study in December to examine the short- and long-term health effects of the Aug. 8 wildfires, considered the deadliest in the U.S. in more than a century.

It takes a comprehensive look at not just the emotional, mental and physical trauma from the wildfires, but socioeconomic factors and social impacts, as well.

Researchers found that the majority of their cohort, 65%, still live in temporary housing, while 58% lost their jobs to the wildfires and 24% are still jobless and searching. Most, 74%, reported a drop in their household income.

The lack of access to care shows numerous issues still need to be addressed, said Juarez, and that “we’re just not doing a good job.”

“We see an early need for interventions,” he said, “to immediately start tackling respiratory conditions, mental health concerns, and access to health care services for the uninsured population.”

Maunakea said his hope is that the preliminary findings “help nudge agencies” into working with the community to address these emerging issues.

“These are just warning signs leading to potential long-term complications our community might suffer from beyond the immediate tragedies of the wildfires,” he said, “so we’re hoping to rally support addressing those immediate, critical needs.”

Addressing these needs now, he said, likely would decrease long-term chronic diseases and mortality down the line.

The high rates of respiratory distress are cause for concern, according to Maunakea, and the study will examine potential links to environmental hazards from the fire, including the impacts of trace amounts of heavy metals and other toxics on health.

“It’s not just the initial shock and exposure from breathing in the air from the wildfire six months ago,” he said, “but also things that remain in the land, in the water, in the atmosphere, that could be contributing to these issues as people go back to the burn zones and get repeated exposures.”

The study will help answer these questions, he said. It also will look at how community-based groups play a role in providing needed services, and what has helped survivors become resilient in the face of the tragedy.

The initial findings come from 224 adult participants who signed up in the first two weeks of the study, but the researchers hope to expand the cohort to 1,000. The goal is to monitor their health over 10 years, possibly longer.

The study involves questionnaires; a health exam for lung, cardiovascular, and mental health; along with blood samples.

Juarez is the HMSA Endowed Professor with the UH Economic Research Organization, while Maunakea is a professor and director of the Epigenomics Research Program at JABSOM.

The next recruitment events are scheduled to take place today and Saturday at the Royal Lahaina Resort in Lahaina, and Feb. 17 at Kula Lodge. To register, visit MauiWES.info.

The study is sponsored by the Hawaii Community Foundation Maui Strong Fund. UH seeks additional funding to expand the study to include children and first responders.


Self-reported health outcomes

>> 49% said their health is now worse than last year (prior to wildfires)

>> 24% reported not having regular access to medical care

>> 13% reported not having health insurance (compared with 1.7% in a previous survey)

Physical health

>> 74% may be experiencing poor respiratory health

>> 49% exhibiting signs of mild to severe lung obstruction

>> 33% have compromised lung function linked to impaired tissue oxygenation

>> 21.5% have high blood pressure (stage 1 and 2 hypertension)

>> 8-18% may have compromised kidney function

Mental health

>> 55% are exhibiting depressive symptoms (compared with 33% previously)

>> Depression rates increased with age, peaking at 75% in those age 50-59

>> 34.6% reported low self-esteem

>> 1.3% reported recent suicidal thoughts



Recruitment events

>> 9 a.m.-4 p.m. today and Saturday at Royal Lahaina

>> 10 a.m.-4 p.m. Feb. 17 at Kula Lodge

>> Must be 18 years or older to participate; must have lived/worked near areas affected by the Maui wildfires; expect to be in Hawaii at least five years. $100 will be offered for participation, which includes a health exam.

>> Visit MauiWES.info.

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