Cultural mechanisms in the exchange of social support among Puerto Ricans after a natural disaster

Chronic Diseases and Associated Risk Factors Among Adults in Puerto Rico After Hurricane Maria

IMPORTANCE

As public health emergencies become more prevalent, it is crucial to identify adverse physical and mental health conditions that may be triggered by natural disasters. There is a lack of data on whether Hurricane Maria in 2017 influenced the disease burden of adults in Puerto Rico.

OBJECTIVE

To estimate the prevalence of chronic diseases and their associated risk factors among adults living in Puerto Rico before and after Hurricane Maria in 2017.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study used data from 2 previous cross-sectional studies, including the pre-Hurricane Maria Puerto Rico Assessment on Diet, Lifestyles and Disease (PRADLAD) study, conducted in 2015, and the post-Hurricane Maria Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT), conducted in 2019. Participants included adults aged 30 to 75 years residing in Puerto Rico. Data were analyzed from April to October 2020.

EXPOSURES

Self-reported data were obtained on sociodemographic, lifestyle, and psychosocial factors and medically diagnosed conditions using validated questionnaires. Anthropometrics were measured in triplicate.

MAIN OUTCOMES AND MEASURES

Data were obtained using similar protocols in both studies. Characteristics were contrasted for all participants across studies and for 87 PRADLAD participants who returned to PROSPECT.

RESULTS

A total of 825 participants from both cohorts were included, with 380 PRADLAD participants and 532 PROSPECT participants. In the 2019 PROSPECT study, the mean (SD) age was 53.7 (10.8) years, and 363 participants (68.2%) were assigned female at birth and 169 participants (31.8%) were assigned male at birth. In the 2019 cohort, 360 participants (67.7%) had college education or higher, 205 participants (38.5%) reported annual income greater than $20 001, and 263 participants (49.5%) were employed. Most sociodemographic variables were similar between studies, except for higher income and employment after the hurricane. In the main analysis, participants in 2019, compared with participants in 2015, had higher abdominal obesity (389 participants [73.2%] vs 233 participants [61.3%]), sedentarism (236 participants [44.4%] vs 136 participants [35.8%]), binge drinking (95 participants [17.9%] vs 46 participants [12.1%]), and social support (mean [SD] score, 26.9 [7.2] vs 24.7 [7.1]) but lower depressive symptoms (169 participants [31.7%] vs 200 participants [52.6%]) and perceived stress (mean [SD] score, 19.3 [9.5] vs 21.7 [7.7]). In 2019, compared with 2015, there were higher rates of hypertension (252 participants [47.3%] vs 149 participants [39.2%]), arthritis (172 participants [32.3%] vs 97 participants [25.6%]), high cholesterol (194 participants [36.4%] vs 90 participants [23.8%]), high triglycerides (123 participants [23.1%] vs 56 participants [14.7%]), eye disease (94 participants [17.6%] vs 48 participants [12.7%]), fatty liver disease (68 participants [12.8%] vs 29 participants [7.5%]), and osteoporosis (74 participants [13.9%] vs 20 participants [5.2%]). Secondary analysis for the 87 returning participants showed similar results.

CONCLUSIONS AND RELEVANCE

In this cross-sectional study, a higher prevalence of unhealthy behaviors and chronic conditions was noted among adults in Puerto Rico after Hurricane Maria, warranting long-term studies. Psychosocial factors were better, but still need attention. As natural disasters intensify, efforts should focus on continuous surveillance of health outcomes and promoting healthy behaviors, positive emotional health, and disease control, particularly in populations with higher risk for poor health.

Exploring Indigenous Ways of Coping After a Wildfire Disaster in Northern Alberta, Canada

In May 2016, a wildfire devastated a northern region of Alberta, Canada, resulting in negative consequences on physical and mental stress, social relationships, and overall resilience among Indigenous residents. Research on coping and managing stress following a disaster has failed to incorporate unique characteristics from Indigenous perspectives. Sharing circles were held in urban and rural community settings to capture: (a) Indigenous perspectives of coping, (b) individual and collective strengths that helped Indigenous residents and communities to cope during and after the wildfire, and (c) intergenerational experiences of coping from stress among Indigenous residents. Indigenous residents' experience with coping from the wildfire was shaped by: (a) heightened physical and emotional stress, (b) existing structural inequities, and (c) strong community cohesion and connection to culture. An unexpected outcome of this research was the therapeutic value of the sharing circles for participants to share their experience.

Tracking and Analyzing Public Emotion Evolutions During COVID-19: A Case Study from the Event-Driven Perspective on Microblogs

Objective: Coronavirus disease 2019 (COVID-19) has caused substantial panic worldwide since its outbreak in December 2019. This study uses social networks to track the evolution of public emotion during COVID-19 in China and analyzes the root causes of these public emotions from an event-driven perspective. Methods: A dataset was constructed using microblogs (n = 125,672) labeled with COVID-19-related super topics (n = 680) from 40,891 users from 1 December 2019 to 17 February 2020. Based on the skeleton and key change points of COVID-19 extracted from microblogging contents, we tracked the public’s emotional evolution modes (accumulated emotions, emotion covariances, and emotion transitions) by time phase and further extracted the details of dominant social events. Results: Public emotions showed different evolution modes during different phases of COVID-19. Events about the development of COVID-19 remained hot, but generally declined, and public attention shifted to other aspects of the epidemic (e.g., encouragement, support, and treatment). Conclusions: These findings suggest that the public’s feedback on COVID-19 predated official accounts on the microblog platform. There were clear differences in the trending events that large users (users with many fans and readings) and common users paid attention to during each phase of COVID-19.

“That day no one spoke”: Florida Puerto Ricans’ Reaction to Hurricane María

We conducted two focus groups and four individual interviews to examine the experiences of Florida Puerto Rican adults ( N = 26) with secondary exposure to the devastation caused by Hurricane María. Results from our thematic analysis yielded four major themes and eight subthemes depicting responses to Hurricane María. Four major themes emerged across participant responses: 1) Participants’ Experience with Hurricane María, 2) Participants’ Negative Reactions to Hurricane María, 3) Participants Providing Support, and 4) Resilience and Growth. We also found that Florida Puerto Ricans’ secondary stress reactions were influenced by Puerto Rico’s political status and economic crisis. Results also indicated that participants experienced vicarious posttraumatic growth not only at the individual but also at the community level.

Potentially Traumatic Events, Posttraumatic Stress Disorder, and Depression among Adults in Puerto Rico

The aims of the current study were to examine the prevalence of potentially traumatic events (PTEs), posttraumatic stress disorder (PTSD; data available in males only), and depressive symptoms in a Puerto Rican sample of 678 adult caretakers (50% female) of twins participating in the Puerto Rican Infant Twin Study. The World Health Organization Composite International Diagnostic Interview version 3.0 (CIDI 3.0) was utilized to assess rates of PTEs, PTSD, and depression among male participants while an abbreviated version of the CIDI 3.0 and the Mood and Feelings Questionnaire were administered to females to assess PTEs and depressive symptoms. Significantly more males than females reported exposure to a PTE (76.6% vs. 44.2%, χ(2) = 64.44, p < 0.001). In males, endorsement of multiple PTEs was associated with increased level of PTSD symptomatology (β = 0.33, p < 0.001). With regard to depression, a similar dose-response relationship was found in both males and females, with depressive symptoms increasing as number of PTEs increased (βs = 0.15, 0.16, ps < 0.05). Exposure to an attack with a weapon was significantly associated with increased depression symptoms in both males and females (βs = 0.24, 0.20, ps < 0.01, respectively). These findings highlight the need for identification of putative risk and resilience factors among PTE-exposed individuals in Puerto Rico.