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LeBlanc JA, Jones W, Harewood H. The lived experiences and perceptions of middle-aged adults in Dominica who have survived severe storms-a qualitative exploration. Front Psychiatry 2024; 15:1372971. [PMID: 38895038 PMCID: PMC11184466 DOI: 10.3389/fpsyt.2024.1372971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/17/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction The Eastern Caribbean island of Dominica has experienced diverse negative effects from the North Atlantic hurricane season, including deadly storms like Hurricane Maria in 2017. Vulnerability is increased by geographic location, small island developing state (SIDS) status, and ecosystem characteristics. A variety of negative health effects including stress and anxiety are caused by powerful storms. The perspectives of middle-aged (the "sandwich generation") survivors in this post-storm milieu are understudied. Methods This phenomenological qualitative study describes the perceptions of middle-aged (35-55 years) Dominicans, purposively recruited with gatekeeper assistance from communities stratified according to four natural hazard vulnerability categories designated by the Climate Resilience Execution Agency for Dominica (CREAD), regarding their lived experiences in the context of severe storms. Data was collected between June and August 2022, using primarily Zoom-based semi-structured, individual interviews (12 of 13), guided by the principles of saturation and maximum variation. Verbatim interview transcripts were thematically analyzed with constant comparison using an ATLAS.ti-supported hybrid deductive-inductive coding frame. Reflexivity and contact summary sheets were used to minimize bias. Results Ten women and three men from diverse CREAD vulnerability and sociodemographic backgrounds were recruited. Data condensation yielded three organizing themes: (i) "The diverse health effects of severe storms", (ii) "Response to and recovery from severe storms", and (iii) "Preparedness and precaution for severe storms". These themes encapsulated the health impacts of severe storms on Dominicans and elucidated the role of facilitating and barricading resilience factors. Discussion Severe storms produced direct and indirect mental, social, and physical health impacts on middle-aged Dominicans, including anxiety and burnout. Participants used faith-based, tangible community-based support, and emotional mechanisms to cope with and demonstrate resilience. Better risk communication and early warning systems would improve population readiness. Persistent dispirited attitudes toward storm preparedness among some participants suggest the need for targeted methods to enhance community involvement in disaster planning, including traditional approaches like "coup-de-main" (self-help).
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Affiliation(s)
| | | | - Heather Harewood
- Faculty of Medical Sciences, The University of the West Indies, Bridgetown, Barbados
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2
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Deng CZ, Lee HC, Chen LYA, Chen SH. The Impact of Relocation Patterns on Psychological Stress. Psychol Sci 2024; 35:597-612. [PMID: 38648277 DOI: 10.1177/09567976241239915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
This study investigated how relocation patterns affect disaster survivors' psychological stress on the diverse durations and spaces of relocation. It analyzed a 10-year data set of 1,236 families affected by 2009's Typhoon Morakot in Taiwan, identifying six relocation patterns through dynamic time warping (DTW). A hierarchical linear model was utilized, revealing the discernible impacts of environmental factors, sociocultural factors, and family-level socioeconomic factors on psychological stress. The study revealed that survivors who quickly found stable residences after the disaster initially experienced lower stress levels, but in the long term, their stress increased. Conversely, those with unstable residences experienced higher initial stress but lower long-term stress. Comparing similar patterns, we found that survivors who had more time for preparation and who sought opportunities, coped, or adapted to secondary stressors before long-distance relocation faced lower stress levels. These findings suggest that relocation patterns have a greater impact on the psychosocial stress of disaster survivors than time or relocation distance.
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Affiliation(s)
- Chuan-Zhong Deng
- National Science and Technology Center for Disaster Reduction, Taiwan
| | - Hsiang-Chieh Lee
- National Science and Technology Center for Disaster Reduction, Taiwan
| | - Lu-Yen A Chen
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University
| | - Sue-Huei Chen
- Department of Psychology, National Taiwan University
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3
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Liu X, Berberian AG, Wang S, Cushing LJ. Hurricane Harvey and the risk of spontaneous preterm and early-term birth. Environ Epidemiol 2024; 8:e312. [PMID: 38799265 PMCID: PMC11115986 DOI: 10.1097/ee9.0000000000000312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 04/16/2024] [Indexed: 05/29/2024] Open
Abstract
Background Hurricane Harvey made landfall in August 2017 and resulted in catastrophic flooding in Houston, Texas. Prior studies of hurricanes and preterm birth have found conflicting results. We tested the hypotheses that exposure to Hurricane Harvey was associated with a higher risk of spontaneous pre- and early-term birth and assessed vulnerable subpopulations. Methods We conducted a retrospective study of singleton births using administrative birth records in the nine-county greater Houston area from 2015 to 2019. We estimated the likelihood of pre- and early-term births using logistic regression, comparing births occurring during or within 1, 2, or 4 weeks of Hurricane Harvey to unexposed reference periods encompassing the same dates 2 years prior and after. Stratified models assessed effect modification by degree of flooding, birth parent age, high- vs. low-risk pregnancy, race/ethnicity, and prenatal care. Results Among 15,564 births, we found no association between exposure to Hurricane Harvey and spontaneous preterm birth within 1 week adjusted (odds ratio [OR], 1.06; 95% confidence interval [CI] = 0.91, 1.25) but a 14% higher odds of spontaneous early-term birth (OR, 1.14; 95% CI = 1.04, 1.25). The odds of early-term birth were even higher in neighborhoods with severe flooding (OR, 1.21; 95% CI = 1.05, 1.38), segregated neighborhoods (OR, 1.23; 95% CI = 1.03, 1.47), and among foreign-born Hispanics (OR, 1.21; 95% CI = 1.04, 1.53) and pregnant people receiving no prenatal care (OR, 1.37; 95% CI = 1.03, 1.82). Effect estimates were attenuated or null when considering 2-week or 4-week lags to define exposure. Conclusions Hurricane Harvey was associated with higher odds of spontaneous early-term birth up to 1 week later, especially among socially marginalized populations.
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Affiliation(s)
- Xinyue Liu
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, California
| | - Alique G. Berberian
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, California
| | - Sophia Wang
- Institute of the Environment and Sustainability, University of California Los Angeles, California
| | - Lara J. Cushing
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, California
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4
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Cohen GH, Wang R, Rosenberg SB, Sampson L, Lowe SR, Cabral H, Ruggiero K, Galea S. Neighborhood-level economic characteristics and depression and PTSD symptoms among Houstonians who have experienced Hurricane Harvey and COVID-19. Psychiatry Res 2024; 333:115766. [PMID: 38335779 PMCID: PMC10964477 DOI: 10.1016/j.psychres.2024.115766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
Little is known about how neighborhood economic characteristics relate to risk of depression and Posttraumatic Stress Disorder (PTSD) in the context of multiple disasters. We sampled 88 super neighborhoods in Houston, Texas and surveyed 872 residents who were living in Houston during Hurricane Harvey and COVID-19 and lived in the same residence since Hurricane Harvey, about their demographics and symptoms of depression and PTSD. Using data from the American Community Survey, we estimated neighborhood-level unemployment, median income, and income inequality (i.e., Gini coefficient). We investigated whether these underlying neighborhood socioeconomic factors were associated with the mental health consequences of mass traumatic events. We examined associations between neighborhood-level constructs and individual-level depression and PTSD, using multilevel linear models. Partially adjusted multilevel models showed that lower neighborhood median income was associated with higher symptom scores of PTSD, while greater neighborhood income inequality was associated with higher symptom scores of depression and PTSD. However, fully adjusted models showed that these associations are better accounted for by event-specific stressors and traumas. These findings suggest that in the context of multiple large scale traumatic events, neighborhood socioeconomic context may structure individual-level exposure to stressful and traumatic events.
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Affiliation(s)
- Gregory H Cohen
- Boston University School of Public Health, Department of Epidemiology 715 Albany St., Boston, MA 02118, United States.
| | - Ruochen Wang
- Boston University School of Public Health, Department of Epidemiology 715 Albany St., Boston, MA 02118, United States
| | - Samuel B Rosenberg
- Boston University School of Public Health, Department of Epidemiology 715 Albany St., Boston, MA 02118, United States
| | - Laura Sampson
- Renaissance School of Medicine, Stony Brook University, Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook, New York, United States
| | - Sarah R Lowe
- Yale School of Public Health, Department of Social and Behavioral Sciences, New Haven, Connecticut, United States
| | - Howard Cabral
- Boston University School of Public Health, Department of Biostatistics, Boston, Massachusetts, United States
| | - Kenneth Ruggiero
- Medical University of South Carolina, College of Nursing, Charleston, South Carolina, United States
| | - Sandro Galea
- Boston University School of Public Health, Dean's Office, Boston, Massachusetts, United States
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5
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Cohen GH, Wang R, Sampson L, Lowe SR, Ettman CK, Abdalla SM, Wellenius GA, Cabral H, Ruggiero K, Galea S. Depression and PTSD among Houston Residents who Experienced Hurricane Harvey and COVID-19: Implications for Urban Areas Affected by Multiple Disasters. J Urban Health 2023; 100:860-869. [PMID: 37550501 PMCID: PMC10447846 DOI: 10.1007/s11524-023-00767-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 08/09/2023]
Abstract
Little is known about the combined impact of the COVID-19 pandemic and other major disasters on mental health. Hurricane Harvey hit the Gulf Coast in 2017, resulting in substantial costs, significant levels of displacement, and approximately 100 deaths, and was followed in 2020 by the COVID-19 pandemic. We randomly sampled 1167 Houstonians from 88 designated super-neighborhoods and surveyed them about their demographics, event-specific traumas and stressors, and symptoms of current depression and post-traumatic stress disorder (PTSD). We estimated the prevalence of depression (5.8%) and PTSD (12.6%) more than three years after Hurricane Harvey, and assessed the relative influence of event-specific stressors and traumas on current mental health. Overall, we observed evidence for two key findings that are salient for residents of urban environments in the context of multiple disasters. First, stressors were primary influences on depression, whereas both stressors and traumas influenced PTSD. Second, the influences of stressors and traumas on depression and PTSD symptoms faded with time.
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Affiliation(s)
- Gregory H Cohen
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Ruochen Wang
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Laura Sampson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sarah R Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Catherine K Ettman
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Salma M Abdalla
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Gregory A Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Howard Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Kenneth Ruggiero
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Sandro Galea
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Dean's Office, Boston University School of Public Health, Boston, MA, USA
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Abstract
PURPOSE OF REVIEW In this article, we outline an up-to-date overview of the climate change impact on mental health of urban population, conducted by searching the PubMed database for relevant studies published in the past 12-18 months, in English. RECENT FINDINGS Climate change is part of a larger systemic ecological problem in which human demands are exceeding the regenerative capacity of the biosphere. We are witnessing a 'climate chaos', a phase of instability and transformation, which is leading humans into a psychological condition of 'systemic insecurity' and a shared feeling of uncertainty. Currently, one of the places where our species is particularly exposed to climate change are cities, due to build-up in urban infrastructure, rapid and chaotic urbanization, high densities and recent rapid growth, social inequality, and 'heat island effect'.The impact of climate change on cities exposes vulnerable groups to the worse mental health consequences. These groups include the homelessness, slum dwellers for whom the 'neighbourhood effects' are being discussed, climate refugees and migrants, young people, and finally those who assist these people. SUMMARY In order to realize broader mental health prevention in cities exposed to climate change phenomena, public health approaches are needed. Institutions must avoid reinforcing inequalities among the more vulnerable groups or create new inequalities.
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Affiliation(s)
- Paolo Cianconi
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome
| | - Batul Hanife
- Provincial Agency for Health Services, Institute of the Autonomous Province of Trento, Italy
| | - Daniele Hirsch
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome
| | - Luigi Janiri
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome
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Balderas J, Bistricky SL, Gimenez-Zapiola M, Pascuzzi B, Millmann M, Short MB. Brief Online Intervention Model Promotes Sustained Helping Behavior Across 6 Months Following a Population-Wide Traumatic Event. Psychol Rep 2023:332941231164071. [PMID: 37079929 DOI: 10.1177/00332941231164071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
BACKGROUND Following natural disasters, early helping behavior often dissipates despite remaining disaster-related suffering and affective vulnerability in the community. Interventions that have successfully increased helping behaviors have included components of motivational interviewing (MI) and mindful compassion; however, this research is limited by laboratory-based settings and lengthy training sessions. Brief, portable, and efficient intervention is needed to increase accessibility to large groups simultaneously. METHOD The current study piloted a brief, online, self-administered MI and mindful compassion intervention administered 4-10 weeks post-Hurricane Harvey examining if it would sustain helping behaviors over the ensuing year. The study also examined potential moderators of the relationship between compassion for others and internalizing symptoms, and whether helping behaviors predicted post-traumatic stress symptoms. RESULTS The intervention group sustained the use of helping behaviors more than an active control group after 9-12 months. Also, compassion satisfaction and burnout moderated the relationship between compassion for others and post-traumatic stress and depressive symptoms at follow-up. CONCLUSIONS Results suggest a potentially useful model of how an efficiently distributed intervention might sustain helping behaviors after a natural disaster and provide insight into possible longitudinal risk and protective factors for post-traumatic stress and depressive symptoms among helping volunteers.
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Affiliation(s)
- Jessica Balderas
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Steven L Bistricky
- Department of Psychology, University of Houston-Clear Lake, Houston, TX, USA
| | | | - Bailey Pascuzzi
- Department of Psychology, University of Houston-Clear Lake, Houston, TX, USA
| | - Megan Millmann
- Department of Psychology, University of Houston-Clear Lake, Houston, TX, USA
| | - Mary B Short
- Department of Psychology, University of Houston-Clear Lake, Houston, TX, USA
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8
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Ramesh B, Callender R, Zaitchik BF, Jagger M, Swarup S, Gohlke JM. Adverse Health Outcomes Following Hurricane Harvey: A Comparison of Remotely-Sensed and Self-Reported Flood Exposure Estimates. GEOHEALTH 2023; 7:e2022GH000710. [PMID: 37091294 PMCID: PMC10120588 DOI: 10.1029/2022gh000710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 02/10/2023] [Accepted: 03/21/2023] [Indexed: 05/03/2023]
Abstract
Remotely sensed inundation may help to rapidly identify areas in need of aid during and following floods. Here we evaluate the utility of daily remotely sensed flood inundation measures and estimate their congruence with self-reported home flooding and health outcomes collected via the Texas Flood Registry (TFR) following Hurricane Harvey. Daily flood inundation for 14 days following the landfall of Hurricane Harvey was acquired from FloodScan. Flood exposure, including number of days flooded and flood depth was assigned to geocoded home addresses of TFR respondents (N = 18,920 from 47 counties). Discordance between remotely-sensed flooding and self-reported home flooding was measured. Modified Poisson regression models were implemented to estimate risk ratios (RRs) for adverse health outcomes following flood exposure, controlling for potential individual level confounders. Respondents whose home was in a flooded area based on remotely-sensed data were more likely to report injury (RR = 1.5, 95% CI: 1.27-1.77), concentration problems (1.36, 95% CI: 1.25-1.49), skin rash (1.31, 95% CI: 1.15-1.48), illness (1.29, 95% CI: 1.17-1.43), headaches (1.09, 95% CI: 1.03-1.16), and runny nose (1.07, 95% CI: 1.03-1.11) compared to respondents whose home was not flooded. Effect sizes were larger when exposure was estimated using respondent-reported home flooding. Near-real time remote sensing-based flood products may help to prioritize areas in need of assistance when on the ground measures are not accessible.
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Affiliation(s)
- Balaji Ramesh
- College of Public HealthThe Ohio State UniversityColumbusOHUSA
| | | | - Benjamin F. Zaitchik
- Department of Earth and Planetary SciencesJohns Hopkins UniversityBaltimoreMDUSA
| | | | - Samarth Swarup
- Biocomplexity InstituteUniversity of VirginiaCharlottesvilleVAUSA
| | - Julia M. Gohlke
- Department of Population Health SciencesVirginia TechBlacksburgVAUSA
- Environmental Defense FundWashingtonDCUSA
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Sri A, Bhugra D, Persaud A, Tribe R, Gnanapragasam S, Castaldelli-Maia JM, Torales J, Ventriglio A. Global mental health and climate change: A geo-psychiatry perspectiv. Asian J Psychiatr 2023; 84:103562. [PMID: 37030088 DOI: 10.1016/j.ajp.2023.103562] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 04/10/2023]
Abstract
Climate changes affect planet ecosystems, living beings, humans, including their lives, rights, economy, housing, migration, and both physical and mental health. Geo-psychiatry is a new discipline within the field of psychiatry studying the interface between various geo-political factors including geographical, political, economic, commercial and cultural determinants which affect society and psychiatry: it provides a holistic overview on global issues such as climate changes, poverty, public health and accessibility to health care. It identifies geopolitical factors and their effects at the international and national levels, as well as considers the politics of climate changes and poverty within this context. This paper then introduces the Compassion, Assertive Action, Pragmatism, and Evidence Vulnerability Index (CAPE-VI) as a global foreign policy index: CAPE-VI calculates how foreign aid should be prioritised for countries that are at risk or already considered to be fragile. These countries are characterised by various forms of conflict, disadvantaged by extremes of climate change, poverty, human rights abuses, and suffering from internal warfare or terrorism.
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Affiliation(s)
- Anna Sri
- Core Trainee Psychiatrist, Cornwall Partnership NHS Trust, Cornwall, UK
| | | | - Albert Persaud
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Rachel Tribe
- School of Psychology, UEL and Department of Psychiatry and Mental Health, Queen Mary, University of London, UK
| | - Sam Gnanapragasam
- NIHR Academic Clinical Fellow, South London and Maudsley NHS Foundation Trust, UK
| | - João M Castaldelli-Maia
- Department of Neuroscience, Medical School, FMABC University Center, Santo André, SP 09060-870, Brazil
| | - Julio Torales
- Department of Medical Psychology, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
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10
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Lu Y, Zhang Z, Yang S. Heterogeneity Influence of Financial Digitalization and Inclusion on Employees’ Psychological States. Behav Sci (Basel) 2023; 13:bs13030263. [PMID: 36975288 PMCID: PMC10045181 DOI: 10.3390/bs13030263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/08/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
Digital inclusive finance (DIF) has the power to spawn a new system of Internet finance and realize financial inclusion. However, the role of DIF in improving the health status of individuals is largely unknown. This study aims to demonstrate whether and how the development of DIF impacts the mental health of Chinese employees. This paper performs an empirical study based on the city-level data of the digital inclusive financial index with the China family panel studies. Ordinary least squares (OLS), probit models and mediation techniques are employed with appropriate instruments to alleviate endogeneity concerns. The results show that DIF can help employees improve their mental health. The results were robust to a variety of checks. Moreover, increasing income is the main pathway in which DIF improves individual mental health. Finally, it also reveals the heterogeneous effects of DIF on individual mental health. That is, the use depth of DIF has a significant positive effect on mental health status, but not on other sub-indicators, such as coverage breadth and degree of digital service provision; on those vulnerable groups containing females and employees with low education, its decisive role is larger than their counterparts who are males and have high levels of education. These results highlight the vital role of DIF in improving the mental health status of individuals. Consequently, there is a need to strengthen the construction of financial infrastructure and achieve a deeper integration of the financial system with digital technologies.
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Affiliation(s)
- Yue Lu
- School of Business and Management, Jilin University, Changchun 130012, China
| | - Zuoqian Zhang
- School of Business, Qingdao University, Qingdao 266075, China
| | - Siying Yang
- School of Economics, Liaoning University, Shenyang 110136, China
- Correspondence:
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11
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Zacher M, Arkin M, Rhodes J, Lowe SR. The Effects of Maternal Disaster Exposure on Adolescent Mental Health 12 Years Later. Res Child Adolesc Psychopathol 2022; 50:1191-1205. [PMID: 35316440 PMCID: PMC9910088 DOI: 10.1007/s10802-022-00917-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 01/26/2023]
Abstract
Natural disasters adversely impact children's mental health, with increased parent or child exposure and subsequent parental distress predicting poorer outcomes. It remains unknown, however, whether the psychological consequences of disasters for children persist long-term, and if so, why and for whom. We therefore examined the effects of mothers' exposure to Hurricane Katrina on adolescent children's mental health 12 years later, distinguishing between direct effects of disaster exposure and effects mediated by maternal distress, and evaluating moderation by child age and gender. Data were from a 2003-2018 study of young, low-income, primarily African American mothers living in New Orleans when Hurricane Katrina occurred in 2005 (n = 328). Mothers rated their mental health about one year pre-Katrina and one, four, and 12 years afterwards. They reported on an adolescent child's (ages 10-17, mean = 14.46) internalizing and externalizing symptoms 12 years post-Katrina using the Strengths and Difficulties Questionnaire. Path analytic models adjusting for mothers' pre-disaster distress showed that, whereas the direct effects of maternal hurricane exposures on child mental health were not significant, the indirect effects were. Specifically, mothers who experienced more Katrina-related stressors had higher distress thereafter, which predicted poorer child outcomes. Results did not differ significantly by child age. Gender differences are discussed. Findings suggest that disasters can affect child mental health for many years, even for those who were very young or not yet born at the time, due to parents' disaster-related distress. Addressing parents' mental health needs in the aftermath of disasters may improve child well-being long-term.
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Affiliation(s)
- Meghan Zacher
- Population Studies and Training Center, Brown University, Providence, RI, USA.
- Data Science Initiative, Brown University, Providence, RI, USA.
| | - Monica Arkin
- Department of Psychology, University of Massachusetts, Boston, MA, USA
| | - Jean Rhodes
- Department of Psychology, University of Massachusetts, Boston, MA, USA
| | - Sarah R Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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12
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Walker IF, Asher L, Pari A, Attride-Stirling J, Oyinloye AO, Simmons C, Potter I, Rubaine V, Samuel JM, Andrewin A, Flynn J, McGill AL, Greenaway-Duberry S, Malcom AB, Mann G, Razavi A, Gibson RC. Mental health systems in six Caribbean small island developing states: a comparative situational analysis. Int J Ment Health Syst 2022; 16:39. [PMID: 35962382 PMCID: PMC9372926 DOI: 10.1186/s13033-022-00552-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
Background Small island developing states (SIDS) have particular mental health system needs due to their remoteness and narrow resource base. We conducted situational analyses to support mental health system strengthening in six SIDS: Anguilla, Bermuda, British Virgin Islands, Cayman Islands, Montserrat and Turks and Caicos Islands. Methods The situational analyses covered five domains: 1. Socio-economic context and burden of mental disorders, 2. Leadership and governance for mental health 3. Mental health and social care services 4. Strategies for promotion and prevention in mental health and 5. Information systems, evidence and research for mental health. First, a desk-based exercise was conducted, in which data was drawn from the public domain. Second, a field visit was conducted at each site, comprising visits to facilities and consultation meetings with key stakeholders. Results Our key findings were 1. Despite most of these SIDS being high-income economies, social inequalities within states exist. There was no population-level data on mental health burden. 2. All SIDS have a mental health policy or plan, but implementation is typically limited due to lack of funds or staff shortages. There was minimal evidence of service user involvement in policy or service development. 3. All SIDS have a specialist, multi-disciplinary mental health workforce, however Montserrat and Anguilla rely on visiting psychiatrists. Child and adolescent and dedicated crisis intervention services were found in only two and one SIDS respectively. A recovery-oriented ethos was not identified in any SIDS. 4. Mental illness stigma was prevalent in all SIDS. Promotion and prevention were objectives of mental health strategies for all SIDS, however activities tended to be sporadic. No mental health non-Governmental organisations were identified in three SIDS. 5. Health information systems are generally underdeveloped, with paper-based systems in three SIDS. There has been no rigorous local mental health research. Conclusion Cross-cutting recommendations include: to develop mental health action plans that include clear implementation indicators; to facilitate community surveys to ascertain the prevalence of mental disorders; to explore task-sharing approaches to increase access to primary mental health care; and to develop programmes of mental health promotion and prevention. Supplementary Information The online version contains supplementary material available at 10.1186/s13033-022-00552-9.
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Affiliation(s)
- Ian F Walker
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK.
| | - Laura Asher
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK.,University of Nottingham, School of Medicine, Academic Unit of Population and Lifespan Sciences, Nottingham, UK
| | - Anees Pari
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | | | | | | | - Irad Potter
- Ministry of Health and Social Development, Government of the Virgin Islands, Tortola, British Virgin Islands
| | - Virginia Rubaine
- Health Services Authority, Government of the Virgin Islands, Tortola, British Virgin Islands
| | - June M Samuel
- Ministry of Health and Social Development, Government of the Virgin Islands, Tortola, British Virgin Islands.,Health Services Authority, Government of the Virgin Islands, Tortola, British Virgin Islands
| | - Aisha Andrewin
- Ministry of Health and Social Development, Government of Anguilla, The Valley, Anguilla
| | - Janett Flynn
- Ministry of Health, Environment, Culture and Housing, Cayman Islands Government, Grand Cayman, Cayman Islands
| | - Arline L McGill
- Health Services Authority, George Town Hospital, Cayman Islands Government, Grand Cayman, Cayman Islands
| | | | - Alicia B Malcom
- Ministry of Health, Agriculture, Sports and Human Services, Government of the Turks and Caicos Islands, Grand Turk, Turks and Caicos Islands
| | - Gemma Mann
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Ahmed Razavi
- Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Roger C Gibson
- Department of Community Health & Psychiatry, The University of the West Indies, Mona Campus, Kingston 7, Jamaica
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Abstract
PURPOSE OF REVIEW Tropical cyclones impact human health, sometimes catastrophically. Epidemiological research characterizes these health impacts and uncovers pathways between storm hazards and health, helping to mitigate the health impacts of future storms. These studies, however, require researchers to identify people and areas exposed to tropical cyclones, which is often challenging. Here we review approaches, tools, and data products that can be useful in this exposure assessment. RECENT FINDINGS Epidemiological studies have used various operational measures to characterize exposure to tropical cyclones, including measures of physical hazards (e.g., wind, rain, flooding), measures related to human impacts (e.g., damage, stressors from the storm), and proxy measures of distance from the storm's central track. The choice of metric depends on the research question asked by the study, but there are numerous resources available that can help in capturing any of these metrics of exposure. Each has strengths and weaknesses that may influence their utility for a specific study. Here we have highlighted key tools and data products that can be useful for exposure assessment for tropical cyclone epidemiology. These results can guide epidemiologists as they design studies to explore how tropical cyclones influence human health.
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Abstract
Natural disasters are large-scale adverse events resulting from natural processes of the earth, often associated with death, trauma, and destruction of property. They threaten harm or death to a large group of people; cause disruption of services and social networks and a communal loss of resources; and involve identifiable mental and physical health outcomes, among those affected. While majority of individuals who experience a traumatic event due to natural disasters do not develop psychopathology, natural disasters can threaten our psychological well-being in many ways and they can result in both short and long-term psychological distress and thus create a significant burden of mental health conditions on individuals and the community affected by them. In this paper we provide a narrative review that focuses on the mental health effects of natural disasters. We discuss effective, evidence-based interventions that can help enhance the sense of safety, hope, and optimism, as well as serve to promote social connectedness for those who are impacted. We describe how these interventions, developed by keeping in mind the cultural context and the needs of the community, can be provided pre, peri and post-disaster period to improve the adverse mental health effects of the disaster.
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Affiliation(s)
- Sy Atezaz Saeed
- Department of Psychiatry and Behavioral Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Steven P Gargano
- Brody School of Medicine, East Carolina University, Greenville, NC, USA
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15
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Baek J, Simon-Friedt B, Lopez A, Kolman JM, Nicolas J, Jones SL, Phillips RA, Menser T. Assessing Patient Needs During Natural Disasters: Mixed Methods Analysis of Portal Messages Sent During Hurricane Harvey. J Med Internet Res 2021; 23:e31264. [PMID: 34468328 PMCID: PMC8444041 DOI: 10.2196/31264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/02/2021] [Accepted: 08/02/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Patient portals play an important role in connecting patients with their medical care team, which improves patient engagement in treatment plans, decreases unnecessary visits, and reduces costs. During natural disasters, patients' needs increase, whereas available resources, specifically access to care, become limited. OBJECTIVE This study aims to examine patients' health needs during a natural crisis by analyzing the electronic messages sent during Hurricane Harvey to guide future disaster planning efforts. METHODS We explored patient portal use data from a large Greater Houston area health care system focusing on the initial week of the Hurricane Harvey disaster, beginning with the date of landfall, August 25, 2017, to August 31, 2017. A mixed methods approach was used to assess patients' immediate health needs and concerns during the disruption of access to routine and emergent medical care. Quantitative analysis used logistic regression models to assess the predictive characteristics of patients using the portal during Hurricane Harvey. This study also included encounters by type (emergency, inpatient, observation, outpatient, and outpatient surgery) and time (before, during, and after Hurricane Harvey). For qualitative analysis, the content of these messages was examined using the constant comparative method to identify emerging themes found within the message texts. RESULTS Out of a total of 557,024 patients, 4079 (0.73%) sent a message during Hurricane Harvey, whereas 31,737 (5.69%) used the portal. Age, sex, race, and ethnicity were predictive factors for using the portal and sending a message during the natural disaster. We found that prior use of the patient portal increased the likelihood of portal use during Hurricane Harvey (odds ratio 13.688, 95% CI 12.929-14.491) and of sending a portal message during the disaster (odds ratio 14.172, 95% CI 11.879-16.907). Having an encounter 4 weeks before or after Hurricane Harvey was positively associated with increased use of the portal and sending a portal message. Patients with encounters during the main Hurricane Harvey week had a higher increased likelihood of portal use across all five encounter types. Qualitative themes included: access, prescription requests, medical advice (chronic conditions, acute care, urgent needs, and Hurricane Harvey-related injuries), mental health, technical difficulties, and provider constraints. CONCLUSIONS The patient portal can be a useful tool for communication between patients and providers to address the urgent needs and concerns of patients as a natural disaster unfolds. This was the first known study to include encounter data to understand portal use compared with care provisioning. Prior use was predictive of both portal use and message sending during Hurricane Harvey. These findings could inform the types of demands that may arise in future disaster situations and can serve as the first step in intentionally optimizing patient portal usability for emergency health care management during natural disasters.
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Affiliation(s)
- Juha Baek
- Center for Outcomes Research, Houston Methodist, Houston, TX, United States
| | | | - Adriana Lopez
- Center for Outcomes Research, Houston Methodist, Houston, TX, United States
| | - Jacob M Kolman
- Center for Outcomes Research, Houston Methodist, Houston, TX, United States
| | - Juan Nicolas
- Center for Outcomes Research, Houston Methodist, Houston, TX, United States
| | - Stephen L Jones
- Center for Outcomes Research, Houston Methodist, Houston, TX, United States.,Department of Surgery, Houston Methodist, Houston, TX, United States.,Department of Surgery, Weill Cornell Medical College, New York, NY, United States
| | - Robert A Phillips
- Center for Outcomes Research, Houston Methodist, Houston, TX, United States.,Department of Cardiology, Houston Methodist, Houston, TX, United States.,Department of Medicine, Weill Cornell Medical College, New York, NY, United States
| | - Terri Menser
- Center for Outcomes Research, Houston Methodist, Houston, TX, United States.,Department of Surgery, Houston Methodist, Houston, TX, United States.,Department of Surgery, Weill Cornell Medical College, New York, NY, United States.,Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, United States
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16
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Shin SH, Ji H. Health risks of natural hazards and resilience resources: Evidence from a U.S. nationwide longitudinal study. Soc Sci Med 2021; 281:114110. [PMID: 34139633 DOI: 10.1016/j.socscimed.2021.114110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/28/2021] [Accepted: 06/03/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although natural disasters can threaten health and well-being, some people show greater resilience to their effects than others. Identifying the characteristics related to resilience has important implications for reducing the health risks in the aftermath of a disaster. OBJECTIVE Using the Conservation of Resources Theory as a framework, we study the role of resources in moderating the adverse effects of natural disasters on people's health and coping behaviors. METHOD We match 20,658 unique individuals aged 50 or older from the 2012-2016 waves of the Health and Retirement Study to the county-level annual natural hazard data provided by the Federal Emergency Management Agency. Using individual-fixed effect models, we first model whether the experience of natural disasters can predict people's health and coping behaviors. We then explore heterogeneity in such effects by interacting individual- and county-level resilience resources with the number of natural disasters. RESULTS The results show that with increased exposure to natural disasters, older adults are more likely to experience difficulties performing instrumental daily activities. They also tend to have fewer overnight hospital stays, higher out-of-pocket medical expenses, and increased alcohol dependency. However, older adults with certain socio-economic characteristics ‒ white, higher education, higher income, and homeownership ‒ are better able than others to mitigate any adverse health effects of natural disasters. One significant community-level resource is a robust healthcare capacity in a county with a high ratio of healthcare practitioners, where older adults are more likely to seek hospital care and have lower alcohol dependency. CONCLUSIONS Health resilience can be improved by strengthening community-level healthcare capacity, with a particular focus on residents with lower socio-economic resources. Failing to address healthcare provision inequalities may exacerbate health disparities.
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Affiliation(s)
- Su Hyun Shin
- University of Utah, Department of Family & Consumer Studies, 225 South 1400 East, Alfred Emery Building, Room 236, Salt Lake City, UT, 84112, USA.
| | - Hyunjung Ji
- University of Alabama, Department of Political Science, Ten Hoor Hall, Suite 310. Tuscaloosa, AL, 35487, USA.
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