Many Maui residents have experienced declines in their physical and mental health as well as their economic stability following devastating wildfires that scorched the island in 2023, according to a new survey.

Researchers at the University of Hawaii surveyed 679 people in January and February to study the impact of last year’s wildfires, which was the deadliest wildfire in the country’s history in more than a century. Two-thirds of the study’s participants lived in Lahaina, a town destroyed by the disaster, at the time of the fires. Researchers shared findings from their survey on Wednesday but plan to continue the project for at least 10 years, so they can conduct a long-term analysis of wildfire survivors.

Here are the study’s major findings so far.

Physical health and medical care access

Nearly half of the study participants said their health declined compared to a year ago. Researchers noted that being exposed to smoke, ash, and debris is often associated with worse physical health outcomes. About 74% of participants are at greater risk of cardiovascular disease.

More than four in 10 participants said they faced challenges accessing medical care and medications, compared to about one in 10 before the fires. The survey also found that more than 13% of participants didn’t have insurance— while nearly 38% of Hispanic participants said they lacked insurance coverage.

“These health outcomes could deteriorate further if difficulties in accessing care and lack of health insurance are not addressed,” researchers said in the study.

Mental health

Researchers also found a significant increase in depression since the fires—more than half of the survey’s participants showed symptoms of depression, which is higher than state and local averages. Nearly a third of participants reported symptoms of moderate or severe anxiety.

Housing

Most participants surveyed for the study didn’t live in the homes they had lived in before the fire—only 34% of participants lived in their original homes. More than half of the participants lived in temporary housing, and 10% had moved into new permanent housing.

Income

About 74% of participants reported a reduction in their household income, the study found. Nearly half of the participants lost their jobs because of the wildfires, and 20% of them were still unemployed when the survey was conducted.

Food security

Nearly half of households said they had low food security—higher than rates that had previously been recorded both locally and across Hawaii.

What researchers recommend

Based on their initial findings, researchers recommended that officials increase access to health care and insurance coverage for people who were affected by the wildfires. They also recommended ensuring stable and long-term housing for people who were displaced by the fires and offering targeted support for people most affected by the disaster, including low-income households, food insecure households, people with disabilities, and immigrants, among others.