SMART for Childcare: Protecting Young Children from Mold Exposure After Hurricanes and Flooding in North Carolina

The increased frequency and severity of hurricanes and flooding in North Carolina have heightened the public health risk of indoor mold exposure for young children, particularly those under ages zero to five. Evidence links post-disaster mold exposure to short- and long-term respiratory consequences, including respiratory illness and asthma development. Existing policies in North Carolina rely on reactive post-disaster efforts, but lack the coordination and standardization needed to protect vulnerable populations. This paper evaluates four potential policy options, including the status quo, direct cash assistance for low-income families, a childcare mold education certification program, and the creation of a State Mold Assessment and Remediation Team (SMART). Using a comparative policy analysis framework, options were assessed on cost, impact, equity, and political feasibility. Results indicate that while cash assistance and education programs offer targeted but limited benefits, establishing SMART provides strong political feasibility, moderate cost to the state, and high impact in communities most at risk.