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Radua J, De Prisco M, Oliva V, Fico G, Vieta E, Fusar-Poli P. Impact of air pollution and climate change on mental health outcomes: an umbrella review of global evidence. World Psychiatry 2024; 23:244-256. [PMID: 38727076 PMCID: PMC11083864 DOI: 10.1002/wps.21219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2024] Open
Abstract
The impact of air pollution and climate change on mental health has recently raised strong concerns. However, a comprehensive overview analyzing the existing evidence while addressing relevant biases is lacking. This umbrella review systematically searched the PubMed/Medline, Scopus and PsycINFO databases (up to June 26, 2023) for any systematic review with meta-analysis investigating the association of air pollution or climate change with mental health outcomes. We used the R metaumbrella package to calculate and stratify the credibility of the evidence according to criteria (i.e., convincing, highly suggestive, suggestive, or weak) that address several biases, complemented by sensitivity analyses. We included 32 systematic reviews with meta-analysis that examined 284 individual studies and 237 associations of exposures to air pollution or climate change hazards and mental health outcomes. Most associations (n=195, 82.3%) involved air pollution, while the rest (n=42, 17.7%) regarded climate change hazards (mostly focusing on temperature: n=35, 14.8%). Mental health outcomes in most associations (n=185, 78.1%) involved mental disorders, followed by suicidal behavior (n=29, 12.4%), access to mental health care services (n=9, 3.7%), mental disorders-related symptomatology (n=8, 3.3%), and multiple categories together (n=6, 2.5%). Twelve associations (5.0%) achieved convincing (class I) or highly suggestive (class II) evidence. Regarding exposures to air pollution, there was convincing (class I) evidence for the association between long-term exposure to solvents and a higher incidence of dementia or cognitive impairment (odds ratio, OR=1.139), and highly suggestive (class II) evidence for the association between long-term exposure to some pollutants and higher risk for cognitive disorders (higher incidence of dementia with high vs. low levels of carbon monoxide, CO: OR=1.587; higher incidence of vascular dementia per 1 μg/m3 increase of nitrogen oxides, NOx: hazard ratio, HR=1.004). There was also highly suggestive (class II) evidence for the association between exposure to airborne particulate matter with diameter ≤10 μm (PM10) during the second trimester of pregnancy and the incidence of post-partum depression (OR=1.023 per 1 μg/m3 increase); and for the association between short-term exposure to sulfur dioxide (SO2) and schizophrenia relapse (risk ratio, RR=1.005 and 1.004 per 1 μg/m3 increase, respectively 5 and 7 days after exposure). Regarding climate change hazards, there was highly suggestive (class II) evidence for the association between short-term exposure to increased temperature and suicide- or mental disorders-related mortality (RR=1.024), suicidal behavior (RR=1.012), and hospital access (i.e., hospitalization or emergency department visits) due to suicidal behavior or mental disorders (RR=1.011) or mental disorders only (RR=1.009) (RR values per 1°C increase). There was also highly suggestive (class II) evidence for the association between short-term exposure to increased apparent temperature (i.e., the temperature equivalent perceived by humans) and suicidal behavior (RR=1.01 per 1°C increase). Finally, there was highly suggestive (class II) evidence for the association between the temporal proximity of cyclone exposure and severity of symptoms of post-traumatic stress disorder (r=0.275). Although most of the above associations were small in magnitude, they extend to the entire world population, and are therefore likely to have a substantial impact. This umbrella review classifies and quantifies for the first time the global negative impacts that air pollution and climate change can exert on mental health, identifying evidence-based targets that can inform future research and population health actions.
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Affiliation(s)
- Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Michele De Prisco
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Vincenzo Oliva
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Giovanna Fico
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Outreach and Support in South-London (OASIS) service, South London and Maudlsey NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
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Cruwys T, Macleod E, Heffernan T, Walker I, Stanley SK, Kurz T, Greenwood LM, Evans O, Calear AL. Social group connections support mental health following wildfire. Soc Psychiatry Psychiatr Epidemiol 2024; 59:957-967. [PMID: 37428193 PMCID: PMC11116249 DOI: 10.1007/s00127-023-02519-8] [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: 11/14/2022] [Accepted: 06/07/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE As environmental disasters become more common and severe due to climate change, there is a growing need for strategies to bolster recovery that are proactive, cost-effective, and which mobilise community resources. AIMS We propose that building social group connections is a particularly promising strategy for supporting mental health in communities affected by environmental disasters. METHODS We tested the social identity model of identity change in a disaster context among 627 people substantially affected by the 2019-2020 Australian fires. RESULTS We found high levels of post-traumatic stress, strongly related to severity of disaster exposure, but also evidence of psychological resilience. Distress and resilience were weakly positively correlated. Having stronger social group connections pre-disaster was associated with less distress and more resilience 12-18 months after the disaster, via three pathways: greater social identification with the disaster-affected community, greater continuity of social group ties, and greater formation of new social group ties. New group ties were a mixed blessing, positively predicting both resilience and distress. CONCLUSIONS We conclude that investment in social resources is key to supporting mental health outcomes, not just reactively in the aftermath of disasters, but also proactively in communities most at risk.
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Affiliation(s)
- Tegan Cruwys
- School of Medicine and Psychology, The Australian National University, Canberra, Australia.
| | - Emily Macleod
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
| | - Timothy Heffernan
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
- UNSW School of Built Environment, Sydney, Australia
| | - Iain Walker
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
- Melbourne Centre for Behaviour Change, University of Melbourne, Parkville, Australia
| | - Samantha K Stanley
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
| | - Tim Kurz
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Lisa-Marie Greenwood
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
| | - Olivia Evans
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
| | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
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Cerna-Turoff I, Casey JA, Keyes K, Rudolph KE, Malinsky D. Longitudinal patterns of natural hazard exposures and anxiety and depression symptoms among young adults in four low- and middle-income countries. Sci Rep 2024; 14:10538. [PMID: 38719874 PMCID: PMC11078992 DOI: 10.1038/s41598-024-60106-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/18/2024] [Indexed: 05/12/2024] Open
Abstract
We estimated the effect of community-level natural hazard exposure during prior developmental stages on later anxiety and depression symptoms among young adults and potential differences stratified by gender. We analyzed longitudinal data (2002-2020) on 5585 young adults between 19 and 26 years in Ethiopia, India, Peru, and Vietnam. A binary question identified community-level exposure, and psychometrically validated scales measured recent anxiety and depression symptoms. Young adults with three exposure histories ("time point 1," "time point 2," and "both time points") were contrasted with their unexposed peers. We applied a longitudinal targeted minimum loss-based estimator with an ensemble of machine learning algorithms for estimation. Young adults living in exposed communities did not exhibit substantially different anxiety or depression symptoms from their unexposed peers, except for young women in Ethiopia who exhibited less anxiety symptoms (average causal effect [ACE] estimate = - 8.86 [95% CI: - 17.04, - 0.68] anxiety score). In this study, singular and repeated natural hazard exposures generally were not associated with later anxiety and depression symptoms. Further examination is needed to understand how distal natural hazard exposures affect lifelong mental health, which aspects of natural hazards are most salient, how disaster relief may modify symptoms, and gendered, age-specific, and contextual differences.
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Affiliation(s)
- Ilan Cerna-Turoff
- Mailman School of Public Health, Department of Environmental Health Sciences, Columbia University, New York City, NY, USA.
| | - Joan A Casey
- Mailman School of Public Health, Department of Environmental Health Sciences, Columbia University, New York City, NY, USA
- School of Public Health, Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Katherine Keyes
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York City, NY, USA
| | - Kara E Rudolph
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York City, NY, USA
| | - Daniel Malinsky
- Mailman School of Public Health, Department of Biostatistics, Columbia University, New York City, NY, USA
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Macleod E, Heffernan T, Greenwood LM, Walker I, Lane J, Stanley SK, Evans O, Calear AL, Cruwys T, Christensen BK, Kurz T, Lancsar E, Reynolds J, Rodney Harris R, Sutherland S. Predictors of individual mental health and psychological resilience after Australia's 2019-2020 bushfires. Aust N Z J Psychiatry 2024; 58:58-69. [PMID: 37264605 PMCID: PMC10756019 DOI: 10.1177/00048674231175618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIMS We assessed the mental health effects of Australia's 2019-2020 bushfires 12-18 months later, predicting psychological distress and positive psychological outcomes from bushfire exposure and a range of demographic variables, and seeking insights to enhance disaster preparedness and resilience planning for different profiles of people. METHODS We surveyed 3083 bushfire-affected and non-affected Australian residents about their experiences of bushfire, COVID-19, psychological distress (depression, anxiety, stress, post-traumatic stress disorder) and positive psychological outcomes (resilient coping, wellbeing). RESULTS We found high rates of distress across all participants, exacerbated by severity of bushfire exposure. For people who were bushfire-affected, being older, having less financial stress, and having no or fewer pre-existing mental disorders predicted both lower distress and higher positive outcomes. Being male or having less income loss also predicted positive outcomes. Severity of exposure, higher education and higher COVID-19-related stressors predicted both higher distress and higher positive outcomes. Pre-existing physical health diagnosis and previous bushfire experience did not significantly predict distress or positive outcomes. RECOMMENDATIONS To promote disaster resilience, we recommend investment in mental health, particularly for younger adults and for those in rural and remote areas. We also recommend investment in mechanisms to protect against financial distress and the development of a broader definition of bushfire-related impacts than is currently used to capture brushfires' far-reaching effects.
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Affiliation(s)
- Emily Macleod
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Timothy Heffernan
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- School of Built Environment, University of New South Wales, Sydney, NSW, Australia
| | - Lisa-Marie Greenwood
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Iain Walker
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
- Melbourne Centre for Behaviour Change, The University of Melbourne, Parkville, VIC, Australia
| | - Jo Lane
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia
| | - Samantha K Stanley
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Olivia Evans
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Tegan Cruwys
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Bruce K Christensen
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Tim Kurz
- School of Psychological Science, The University of Western Australia, Perth, WA, Australia
| | - Emily Lancsar
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Julia Reynolds
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
| | - Rachael Rodney Harris
- Centre for Entrepreneurial Agri-Technology, The Australian National University, Canberra, ACT, Australia
| | - Stewart Sutherland
- School of Medicine and Psychology, The Australian National University, Canberra, ACT, Australia
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Ranasinghe PD, Zhou A. Women physicians and the COVID-19 pandemic: gender-based impacts and potential interventions. Ann Med 2023; 55:319-324. [PMID: 36594806 PMCID: PMC9815224 DOI: 10.1080/07853890.2022.2164046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Aim: These are extraordinary times caused by the first global pandemic in our modern era. Physicians and other frontline healthcare providers face unique challenges, for which they have had little formal preparation. This combination of challenge and deficit leads to significant negative impacts, not only on what medical practices and health care systems can deliver to the public, but also on the individual healthcare providers themselves.Methods: In this essay, we specifically address women physicians, and explore the considerable impact they bear from the COVID-19 pandemic, particularly in the contexts of response to stress, social isolation, work-life integration, and autonomy. Because the language we use is important, we think it necessary to clarify that when we refer to 'women physicians,' we are referring to physicians that self-identify as women, and we acknowledge that not all the references we cite may use the same definition.Results: We offer several potential interventions that turn the challenges women physicians are facing into opportunities to address longstanding inequity. These interventions include tackling barriers to work-life balance, addressing gender and maternal bias, and promoting women physician representation in leadership.Conclusion: The COVID-19 pandemic is likely to become a chronic part of our lives; protecting vulnerable populations, such as women physicians, through thoughtful intervention is paramount.KEY MESSAGESWomen physicians experience considerable adversity during the COVID-19 pandemic, particularly in the contexts of response to stress, social isolation, work-life integration, and autonomy.These challenges create opportunities for interventions to improve equity in medicine during the COVID-19 pandemic and in the long-term, including tackling barriers to work-life balance, addressing gender and maternal bias, and promoting women physician representation in leadership.
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Affiliation(s)
| | - Ashley Zhou
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Cuijpers P, Miguel C, Ciharova M, Kumar M, Brander L, Kumar P, Karyotaki E. Impact of climate events, pollution, and green spaces on mental health: an umbrella review of meta-analyses. Psychol Med 2023; 53:638-653. [PMID: 36606450 PMCID: PMC9975983 DOI: 10.1017/s0033291722003890] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 11/25/2022] [Accepted: 12/09/2022] [Indexed: 01/07/2023]
Abstract
Climate change may affect mental health. We conducted an umbrella review of meta-analyses examining the association between mental health and climate events related to climate change, pollution and green spaces. We searched major bibliographic databases and included meta-analyses with at least five primary studies. Results were summarized narratively. We included 24 meta-analyses on mental health and climate events (n = 13), pollution (n = 11), and green spaces (n = 2) (two meta-analyses provided data on two categories). The quality was suboptimal. According to AMSTAR-2, the overall confidence in the results was high for none of the studies, for three it was moderate, and for the other studies the confidence was low to critically low. The meta-analyses on climate events suggested an increased prevalence of symptoms of post-traumatic stress, depression, and anxiety associated with the exposure to various types of climate events, although the effect sizes differed considerably across study and not all were significant. The meta-analyses on pollution suggested that there may be a small but significant association between PM2.5, PM10, NO2, SO2, CO and mental health, especially depression and suicide, as well as autism spectrum disorders after exposure during pregnancy, but the resulting effect sizes varied considerably. Serious methodological flaws make it difficult to draw credible conclusions. We found reasonable evidence for an association between climate events and mental health and some evidence for an association between pollution and mental disorders. More high-quality research is needed to verify these associations.
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Affiliation(s)
- Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- International Institute for Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Clara Miguel
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marketa Ciharova
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Manasi Kumar
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Luke Brander
- Institute for Environmental Studies, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Pushpam Kumar
- United Nations Environment Programme, Washington, DC, USA
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Shi W, Hall BJ. Trajectories of Posttraumatic Stress Symptoms Among Young Adults Exposed to a Typhoon: A Three-Wave Longitudinal Study. Int J Public Health 2023; 67:1605380. [PMID: 36686386 PMCID: PMC9845259 DOI: 10.3389/ijph.2022.1605380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023] Open
Abstract
Objective: We used a latent class growth model to identify distinct PTSS trajectories and correlates of these trajectories among young adults who experienced Typhoon Hato, the strongest storm to strike China in the last 50 years. Methods: A longitudinal survey (three-waves) was conducted to explore the mental health status and its correlates among young adults exposed to the typhoon. Data from 362 participants were analyzed via a latent class growth model and multinomial logistic regression. Results: Three distinct classes of PTSS trajectories were identified, including: "resilience" (86.46%), "recovery" (9.12%), and "deterioration" (4.42%). The higher levels of direct typhoon exposure, media use, and posttraumatic growth significantly predicted the higher likelihood of participants being in the "recovery'' class. In addition, more social support significantly predicted the higher possibility of being in the "resilience" class. Finally, more severe depressive and anxiety symptoms significantly predicted the higher likelihood of being in the "deterioration" class. Conclusion: Further research should develop interventions to enhance protective factors (e.g., posttraumatic growth, media use), decrease risk factors (e.g., depressive and anxiety symptoms), and thereby prevent PTSS.
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Affiliation(s)
- Wei Shi
- Institute for Disaster Management and Reconstruction (IDMR), Sichuan University, Chengdu, China
| | - Brian J. Hall
- Center for Global Health Equity, NYU Shanghai, Shanghai, China,*Correspondence: Brian J. Hall,
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Callender R, Canales JM, Avendano C, Craft E, Ensor KB, Miranda ML. Economic and mental health impacts of multiple adverse events: Hurricane Harvey, other flooding events, and the COVID-19 pandemic. ENVIRONMENTAL RESEARCH 2022; 214:114020. [PMID: 35948147 PMCID: PMC9357442 DOI: 10.1016/j.envres.2022.114020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/12/2022] [Accepted: 07/29/2022] [Indexed: 05/07/2023]
Abstract
OBJECTIVES To assess the economic and mental health impacts of COVID-19 in the presence of previous exposure to flooding events. METHODS Starting in April 2018, the Texas Flood Registry (TFR) invited residents to complete an online survey regarding their experiences with Hurricane Harvey and subsequent flooding events. Starting in April 2020, participants nationwide were invited to complete a brief online survey on their experiences during the pandemic. This study includes participants in the TFR (N = 20,754) and the COVID-19 Registry (N = 8568) through October 2020 (joint N = 2929). Logistic regression and generalized estimating equations were used to examine the relationship between exposure to flooding events and the economic and mental health impacts of COVID-19. RESULTS Among COVID-19 registrants, 21% experienced moderate to severe anxiety during the pandemic, and 7% and 12% of households had difficulty paying rent and bills, respectively. Approximately 17% of Black and 15% of Hispanic households had difficulty paying rent, compared to 5% of non-Hispanic white households. The odds of COVID-19 income loss are 1.20 (1.02, 1.40) times higher for those who previously had storm-related home damage compared to those who did not and 3.84 (3.25-4.55) times higher for those who experienced Harvey income loss compared to those who did not. For registrants for whom Harvey was a severe impact event, the odds of having more severe anxiety during the pandemic are 5.14 (4.02, 6.58) times higher than among registrants for whom Harvey was a no meaningful impact event. CONCLUSIONS Multiple crises can jointly and cumulatively shape health and wellbeing outcomes. This knowledge can help craft emergency preparation and intervention programs.
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Affiliation(s)
- Rashida Callender
- Children's Environmental Health Initiative, Rice University, Houston, TX, USA
| | - Joally M Canales
- Children's Environmental Health Initiative, Rice University, Houston, TX, USA
| | - Carolina Avendano
- Children's Environmental Health Initiative, University of Notre Dame, South Bend, IN, USA
| | | | | | - Marie Lynn Miranda
- Children's Environmental Health Initiative, University of Notre Dame, South Bend, IN, USA; Department of Applied and Computational Mathematics and Statistics, University of Notre Dame, South Bend, IN, USA.
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Massazza A, Teyton A, Charlson F, Benmarhnia T, Augustinavicius JL. Quantitative methods for climate change and mental health research: current trends and future directions. Lancet Planet Health 2022; 6:e613-e627. [PMID: 35809589 DOI: 10.1016/s2542-5196(22)00120-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 03/09/2022] [Accepted: 04/12/2022] [Indexed: 06/15/2023]
Abstract
The quantitative literature on climate change and mental health is growing rapidly. However, the methodological quality of the evidence is heterogeneous, and there is scope for methodological improvement and innovation. The first section of this Personal View provides a snapshot of current methodological trends and issues in the quantitative literature on climate change and mental health, drawing on literature collected through a previous scoping review. The second part of this Personal View outlines opportunities for methodological innovation concerning the assessment of the relationship between climate change and mental health. We then highlight possible methodological innovations in intervention research and in the measurement of climate change and mental health-related variables. This section draws upon methods from public mental health, environmental epidemiology, and other fields. The objective is not to provide a detailed description of different methodological techniques, but rather to highlight opportunities to use diverse methods, collaborate across disciplines, and inspire methodological innovation. The reader will be referred to practical guidance on different methods when available. We hope this Personal View will constitute a roadmap and launching pad for methodological innovation for researchers interested in investigating a rapidly growing area of research.
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Affiliation(s)
- Alessandro Massazza
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
| | - Anaïs Teyton
- Herbert Wertheim School of Public Health and Human Longevity Science and Scripps Institution of Oceanography, University California San Diego, San Diego, CA, USA; School of Public Health, San Diego State University, San Diego, CA, USA
| | - Fiona Charlson
- Queensland Centre for Mental Health Research, Queensland Health, Brisbane, QLD, Australia; School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Institute for Health Metrics and Evaluation, Department of Global Health, University of Washington, Seattle, WA, USA
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Human Longevity Science and Scripps Institution of Oceanography, University California San Diego, San Diego, CA, USA
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Post-Hurricane Distress Scale (PHDS): Determination of General and Disorder-Specific Cutoff Scores. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095204. [PMID: 35564598 PMCID: PMC9100105 DOI: 10.3390/ijerph19095204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/11/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022]
Abstract
The Post-Hurricane Distress Scale (PHDS) was developed to assess mental health risk in the aftermath of hurricanes. We derive both disorder-specific cutoff values and a single nonspecific cutoff for the PHDS for field use by disaster relief and mental health workers. Data from 672 adult residents of Puerto Rico, sampled 3 to 12 months after Hurricane Maria, were collected. Participants completed a five-tool questionnaire packet: PHDS, Kessler K6, Patient Health Questionnaire 9, Generalized Anxiety Disorder 7, and Post-Traumatic Stress Disorder Checklist for DSM V (PCL-5). ROC curves, AUC values, sensitivities, specificities, Youden’s index, and LR+ ratios are reported. The recommended single cutoff value for the PHDS is 41, whereby a respondent with a PHDS score of 41 or above is deemed high-risk for a mental health disorder. The single field use PHDS cutoff demonstrated high specificity (0.80), an LR + ratio (2.84), and a sensitivity of 0.56. The mean ROC values of PHDS for Kessler K6, Patient Health Questionnaire 9, Generalized Anxiety Disorder 7, and PCL-5 were all above 0.74. The derived cutoff for the PHDS allows efficient assessment of respondents’ and/or a community’s risk status for mental health disorders in the aftermath of hurricanes and natural disasters.
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Scratch my back and I'll scratch yours: The impact of user effort and recommendation agent effort on perceived recommendation agent quality. INFORMATION & MANAGEMENT 2022. [DOI: 10.1016/j.im.2021.103571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Zhen R, Zhang J, Pang H, Ruan L, Liu X, Zhou X. Full and partial posttraumatic stress disorders in adults exposed to super typhoon Lekima: a cross-sectional investigation. BMC Psychiatry 2021; 21:512. [PMID: 34663269 PMCID: PMC8522036 DOI: 10.1186/s12888-021-03528-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 10/06/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Super typhoon Lekima had a maximum wind force of 16 (52 m/s) and hit Wenling city, Zhejiang province in China on August 10, 2019. The typhoon left many victims showing symptoms of posttraumatic stress disorder (PTSD). OBJECTIVE This study aimed to assess the prevalence of full and partial PTSD to inform targeted interventions for adult victims. METHOD In total, four thousand seven hundred and forty-six adults who are parents of students in local primary and middle schools were recruited to participate in this study. Participants completed a trauma exposure scale and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition PTSD Checklist. Logistic regression analysis was used to examine the factors of full and partial PTSD. RESULTS Nine hundred and ten (19.2%) adults had full PTSD and 1775 (37.4%) had partial PTSD. Adults with a monthly income > 10,000 RMB (about 1530 dollars) and a high education level (bachelor's degree or above) were less likely to have full or partial PTSD than those with lower income and lower education levels. In addition, married adults were less likely to have full PTSD than divorced or widowed ones. Higher rates of PTSD were observed among those aged ≥40 years, who were injured/trapped, whose family members/friends were injured/trapped, and who lost property. CONCLUSIONS Partial and full PTSD were common among adults following super typhoon Lekima, and high income, high education level, and married status were protective factors, whereas trauma exposure was a risk factor of PTSD. Target psychological intervention should be provided to these victims who are in low income and education level, divorced and widowed, and experienced more serious trauma.
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Affiliation(s)
- Rui Zhen
- grid.410595.c0000 0001 2230 9154Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, 311121 China
| | - Junjie Zhang
- Teaching and Research Office, Wenling Education Bureau, Wenling, 317500 China
| | - Hongwei Pang
- Zhejiang Research Institute of Education Science, Hangzhou, 310028 China
| | - Lingling Ruan
- Zhejiang Research Institute of Education Science, Hangzhou, 310028 China
| | - Xuanwen Liu
- Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, 311121, China. .,Research and Training Center of School Mental Health Education of Zhejiang Province, Hangzhou, 311121, China.
| | - Xiao Zhou
- grid.13402.340000 0004 1759 700XDepartment of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, 310028 China
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Yuan G, Shi W, Lowe S, Chang K, Jackson T, Hall BJ. Associations between posttraumatic stress symptoms, perceived social support and psychological distress among disaster-exposed Chinese young adults: A three-wave longitudinal mediation model. J Psychiatr Res 2021; 137:491-497. [PMID: 33798977 DOI: 10.1016/j.jpsychires.2021.03.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 01/06/2023]
Abstract
Research has documented a strong association between perceived social support, posttraumatic stress symptoms (PTSS), and psychological distress (PD) among people exposed to natural disasters. However, the direction of associations between these factors remains unclear. This study examined possible mediational relationships among perceived social support, PTSS, and PD. A three-wave longitudinal design (6 months intervals) was employed in a sample of 341 Chinese university students (Mage = 21.24, SD = 2.72; 75.7% female) aged 18 to 34 who were directly exposed to a typhoon that occurred in Macao, China, during August 2017. Results indicated that perceived social support at T2 mediated the linkage between PTSS at T1 and PD at T3, and that PTSS at T2 significantly mediated the relationship between PD at T1 and perceived social support at T3. This three-wave longitudinal study highlights the key role of perceived social support on the aggravating effect of acute PTSS on long-term psychological problems, and demonstrates that adverse psychological health outcomes negatively affect the perception of supportive social resources in the context of a natural disaster.
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Affiliation(s)
- Guangzhe Yuan
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao (SAR), People's Republic of China
| | - Wei Shi
- Institute for Disaster Management and Reconstruction, Sichuan University, People's Republic of China
| | - Sarah Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, USA
| | - Kay Chang
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao (SAR), People's Republic of China
| | - Todd Jackson
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao (SAR), People's Republic of China
| | - Brian J Hall
- New York University (Shanghai), Shanghai, People's Republic of China.
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Zacher M, Raker EJ, Arcaya MC, Lowe SR, Rhodes J, Waters MC. Physical Health Symptoms and Hurricane Katrina: Individual Trajectories of Development and Recovery More Than a Decade After the Storm. Am J Public Health 2021; 111:127-135. [PMID: 33211584 PMCID: PMC7750613 DOI: 10.2105/ajph.2020.305955] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2020] [Indexed: 11/04/2022]
Abstract
Objectives. To examine how physical health symptoms developed and resolved in response to Hurricane Katrina.Methods. We used data from a 2003 to 2018 study of young, low-income mothers who were living in New Orleans, Louisiana, when Hurricane Katrina struck in 2005 (n = 276). We fit logistic regressions to model the odds of first reporting or "developing" headaches or migraines, back problems, and digestive problems, and of experiencing remission or "recovery" from previously reported symptoms, across surveys.Results. The prevalence of each symptom increased after Hurricane Katrina, but the odds of developing symptoms shortly before versus after the storm were comparable. The number of traumatic experiences endured during Hurricane Katrina increased the odds of developing back and digestive problems just after the hurricane. Headaches or migraines and back problems that developed shortly after Hurricane Katrina were more likely to resolve than those that developed just before the storm.Conclusions. While traumatic experiences endured in disasters such as Hurricane Katrina appear to prompt the development of new physical symptoms, disaster-induced symptoms may be less likely to persist or become chronic than those emerging for other reasons.
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Affiliation(s)
- Meghan Zacher
- Meghan Zacher is with the Population Studies and Training Center and the Data Science Initiative, Brown University, Providence, RI. Ethan J. Raker and Mary C. Waters are with the Department of Sociology, Harvard University, Cambridge, MA. Mariana C. Arcaya is with the Department of Urban Studies, Massachusetts Institute of Technology, Cambridge. Sarah R. Lowe is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. Jean Rhodes is with the Department of Psychology, University of Massachusetts, Boston
| | - Ethan J Raker
- Meghan Zacher is with the Population Studies and Training Center and the Data Science Initiative, Brown University, Providence, RI. Ethan J. Raker and Mary C. Waters are with the Department of Sociology, Harvard University, Cambridge, MA. Mariana C. Arcaya is with the Department of Urban Studies, Massachusetts Institute of Technology, Cambridge. Sarah R. Lowe is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. Jean Rhodes is with the Department of Psychology, University of Massachusetts, Boston
| | - Mariana C Arcaya
- Meghan Zacher is with the Population Studies and Training Center and the Data Science Initiative, Brown University, Providence, RI. Ethan J. Raker and Mary C. Waters are with the Department of Sociology, Harvard University, Cambridge, MA. Mariana C. Arcaya is with the Department of Urban Studies, Massachusetts Institute of Technology, Cambridge. Sarah R. Lowe is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. Jean Rhodes is with the Department of Psychology, University of Massachusetts, Boston
| | - Sarah R Lowe
- Meghan Zacher is with the Population Studies and Training Center and the Data Science Initiative, Brown University, Providence, RI. Ethan J. Raker and Mary C. Waters are with the Department of Sociology, Harvard University, Cambridge, MA. Mariana C. Arcaya is with the Department of Urban Studies, Massachusetts Institute of Technology, Cambridge. Sarah R. Lowe is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. Jean Rhodes is with the Department of Psychology, University of Massachusetts, Boston
| | - Jean Rhodes
- Meghan Zacher is with the Population Studies and Training Center and the Data Science Initiative, Brown University, Providence, RI. Ethan J. Raker and Mary C. Waters are with the Department of Sociology, Harvard University, Cambridge, MA. Mariana C. Arcaya is with the Department of Urban Studies, Massachusetts Institute of Technology, Cambridge. Sarah R. Lowe is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. Jean Rhodes is with the Department of Psychology, University of Massachusetts, Boston
| | - Mary C Waters
- Meghan Zacher is with the Population Studies and Training Center and the Data Science Initiative, Brown University, Providence, RI. Ethan J. Raker and Mary C. Waters are with the Department of Sociology, Harvard University, Cambridge, MA. Mariana C. Arcaya is with the Department of Urban Studies, Massachusetts Institute of Technology, Cambridge. Sarah R. Lowe is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. Jean Rhodes is with the Department of Psychology, University of Massachusetts, Boston
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Raker EJ, Arcaya MC, Lowe SR, Zacher M, Rhodes J, Waters MC. Mitigating Health Disparities After Natural Disasters: Lessons From The RISK Project. Health Aff (Millwood) 2020; 39:2128-2135. [PMID: 33284697 PMCID: PMC8533028 DOI: 10.1377/hlthaff.2020.01161] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Climate change exacerbates the severity of natural disasters, which disproportionately affect vulnerable populations. Mitigating disasters' health consequences is critical to promoting health equity, but few studies have isolated the short- and long-term effects of disasters on vulnerable groups. We filled this gap by conducting a fifteen-year (2003-2018) prospective study of low-income, predominantly Black parents who experienced Hurricane Katrina: the Resilience in Survivors of Katrina (RISK) Project. Here we describe this project and synthesize lessons from work that has resulted from it. Our findings can guide policy makers, service providers, and health officials in disaster planning and response. We synthesize them into an organizational schema of five priorities: Primary efforts should be aimed at preventing exposure to trauma through investments in climate resilience and by eliminating impediments to evacuation, health care policies should promote uninterrupted and expanded access to care, social services should integrate and strive to reduce the administrative burden on survivors, programs should aid survivors in forging or strengthening connections to their communities, and policy makers should fund targeted long-term services for highly affected survivors.
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Affiliation(s)
- Ethan J Raker
- Ethan J. Raker is a PhD candidate in the Department of Sociology at Harvard University, in Cambridge, Massachusetts
| | - Mariana C Arcaya
- Mariana C. Arcaya is an associate professor of urban planning at the Massachusetts Institute of Technology, in Cambridge, Massachusetts
| | - Sarah R Lowe
- Sarah R. Lowe is an assistant professor in the Department of Social and Behavioral Sciences at the Yale School of Public Health, in New Haven, Connecticut
| | - Meghan Zacher
- Meghan Zacher is a postdoctoral fellow in the Population Studies and Training Center at Brown University, in Providence, Rhode Island
| | - Jean Rhodes
- Jean Rhodes is the Frank L. Boyden Professor of Psychology at the University of Massachusetts, Boston, in Boston, Massachusetts
| | - Mary C Waters
- Mary C. Waters is the PVK Professor of Arts and Sciences and the John L. Loeb Professor of Sociology at Harvard University
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Wang L, de Ángel Solá D, Acevedo Flores M, Schriefer A, Wang L, Gerónimo López K, Chang A, Warner B, Shan L, Holtz LR, Rosario Matos N. Prenatal food insecurity post Hurricane Maria is associated with decreased Veillonella in the infant gut. Pediatr Res 2020; 88:917-924. [PMID: 32172280 PMCID: PMC7492397 DOI: 10.1038/s41390-020-0839-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/14/2020] [Accepted: 02/17/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Hurricane Maria struck Puerto Rico on 20 September 2017 causing catastrophic devastation. Prolonged shortage of food had been a substantial challenge to the residents after Maria. Experiencing food insecurity in utero has been associated with negative health outcomes later in life. We aim to examine whether there is any alteration in the infant gut microbiome that is associated with prenatal food insecurity. METHODS We established a cohort of infants aged 2-6 months who were exposed in utero to Hurricane Maria near San Juan, Puerto Rico and examined the gut microbiota (n = 29) using 16S ribosomal RNA gene sequencing. RESULTS Among the enrolled infants, 30% of their mothers experienced "post-Maria poor access to food" for at least 1 month during pregnancy. The relative abundance of gut Veillonella spp. is significantly decreased among infants who experienced prenatal food insecurity, compared to those who did not (adjusted p = 0.025). There is no significant difference observed by prenatal food insecurity at the microbial community level in this cohort. CONCLUSIONS Our finding indicated that infants who experienced prenatal food insecurity post hurricane harbor microbial alternations of specific bacterial taxa, which may further influence the microbial maturation and place the individual at a high-risk health trajectory. IMPACT We identified that in utero exposure to food insecurity post Hurricane Maria is associated with decreased abundance of Veillonella in the infant gut. Our findings indicated that infants who experienced prenatal food insecurity post hurricane may harbor alterations of specific bacterial taxa in their gut microbiota. This study showed the association between prenatal adverse exposure and alterations of gut microbiome early in life in the context of an extreme event. This study provided insights into the mechanisms underlying prenatal adverse exposure and increased disease risks later in life. Our findings will potentially raise awareness of the negative impact of extreme climate events on the unborn.
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Affiliation(s)
- Leyao Wang
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
| | - David de Ángel Solá
- Departments of Pediatrics and Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Midnela Acevedo Flores
- San Juan City Hospital Research Unit, Department of Pediatrics and Obstetrics and Gynecology, San Juan Hospital, San Juan, Puerto Rico
| | - Andrew Schriefer
- Department of Genetics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Leran Wang
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Kamil Gerónimo López
- San Juan City Hospital Research Unit, Department of Pediatrics and Obstetrics and Gynecology, San Juan Hospital, San Juan, Puerto Rico
| | - Alison Chang
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Barbara Warner
- Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Liang Shan
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Lori R Holtz
- Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Nicolás Rosario Matos
- San Juan City Hospital Research Unit, Department of Pediatrics and Obstetrics and Gynecology, San Juan Hospital, San Juan, Puerto Rico
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17
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The Correlation of English Language Proficiency and Indices of Stress and Anxiety in Migrants from Puerto Rico after Hurricane Maria: A Preliminary Study. Disaster Med Public Health Prep 2020; 14:23-27. [PMID: 31221231 DOI: 10.1017/dmp.2019.22] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Using validated psychological assessment instruments, this study examined the psychological distress associated with potential language barriers experienced by over 135 000 Puerto Rican residents who either temporarily or permanently migrated to the continental United States with the landfall of Hurricane Maria in 2017. METHODS Participants were Puerto Rican residents (n = 107) who remained in Puerto Rico (control) or left the island for at least 3 months because of Hurricane Maria (migrants). Participants completed an online survey in their preferred language (Spanish or English), which assessed self-reported English language proficiency, Kessler Psychological Distress Scale (K6), Posttraumatic Stress Disorder Checklist for DSM 5, Patient Health Questionnaire 9-item depression scale, and the Generalized Anxiety Disorder 7-item scale. It was hypothesized that migrants with lower self-reported English proficiency would have comparatively higher indices of post-disaster distress than those with a higher proficiency. RESULTS Dividing the migrant group by preferred language for questionnaire completion, the Fisher's exact test showed significant differences in prevalence of severe mental distress, as defined by K6 scores above 13, between the Spanish-preferring migrants (30.4%), English-preferring migrants (0%), and controls (9.6%). CONCLUSION Our results support a possible correlation between decreased language proficiency in post-disaster migrants and a higher risk factor for severe mental distress.
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Blanco C, Wall MM, Olfson M. Psychological Aspects of the COVID-19 Pandemic. J Gen Intern Med 2020; 35:2757-2759. [PMID: 32542499 PMCID: PMC7295318 DOI: 10.1007/s11606-020-05955-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/05/2020] [Accepted: 06/01/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Carlos Blanco
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, Bethesda, MD, USA.
| | - Melanie M Wall
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, USA
| | - Mark Olfson
- Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, USA
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Watkins DJ, Torres Zayas HR, Vélez Vega CM, Rosario Z, Welton M, Agosto Arroyo LD, Cardona N, Díaz Reguero ZJ, Santos Rivera A, Huerta-Montañez G, Brown P, Alshawabkeh A, Cordero JF, Meeker JD. Investigating the impact of Hurricane Maria on an ongoing birth cohort in Puerto Rico. POPULATION AND ENVIRONMENT 2020; 42:95-111. [PMID: 33746324 PMCID: PMC7967016 DOI: 10.1007/s11111-020-00345-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Prior to Hurricane Maria, Puerto Rico already had 200+ hazardous waste sites, significant contamination of water resources, and among the highest rates of preterm birth in the US. To address these issues, the Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) Center was formed in 2010 to investigate prenatal environmental exposures, particularly phthalates, and adverse birth outcomes. Recent work from the PROTECT study confirms that in utero exposure to certain phthalates is associated with shorter gestation and increased risk of preterm birth. However, previous research also suggests that pregnant women who experience a natural disaster such as Hurricane Maria are at higher risk of adverse birth outcomes, but it is unknown whether this is due to stress, hazardous exposures, or a combination of factors. Thus, the aim of this analysis was to characterize hurricane-related changes in phthalate exposures and experiences within the PROTECT cohort. Among 176 participants who were pregnant during or within 5 months after Maria, 122 completed a questionnaire on hurricane-related experiences. Questionnaire results and biomarkers of exposure suggest that participants did not have regular access to fresh foods and water during hurricane recovery, and almost half reported structural damage to their home. In addition, biomarker concentrations of phthalates commonly used in food packaging were higher among participants post-hurricane, while phthalates commonly used in personal care products were lower compared to pre-hurricane levels. Hurricane-related increases in phthalate exposure, as well as widespread structural damage, food and water shortages, and long-term absence of electricity and cell phone service, likely increased the risk of adverse birth outcomes among this already vulnerable population.
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Affiliation(s)
- Deborah J. Watkins
- University of Michigan, Department of Environmental Health Sciences - Ann Arbor, Michigan
| | | | - Carmen M. Vélez Vega
- University of Puerto Rico - Medical Sciences Campus, School of Public Health – San Juan, PR
| | - Zaira Rosario
- University of Puerto Rico - Medical Sciences Campus, School of Public Health – San Juan, PR
| | - Michael Welton
- University of Georgia, College of Public Health, University of Georgia, Department of Epidemiology and Biostatistics – Athens, GA
| | - Luis D. Agosto Arroyo
- University of Puerto Rico - Medical Sciences Campus, School of Public Health – San Juan, PR
| | - Nancy Cardona
- University of Puerto Rico - Medical Sciences Campus, School of Public Health – San Juan, PR
| | | | - Amailie Santos Rivera
- University of Puerto Rico - Medical Sciences Campus, School of Public Health – San Juan, PR
| | - Gredia Huerta-Montañez
- University of Puerto Rico - Medical Sciences Campus, School of Public Health – San Juan, PR
| | - Phil Brown
- Northeastern University, Social Science Environmental Health Research Institute – Boston, MA
| | - Akram Alshawabkeh
- Northeastern University, Department of Civil and Environmental Engineering – Boston, MA
| | - José F. Cordero
- University of Georgia, College of Public Health, University of Georgia, Department of Epidemiology and Biostatistics – Athens, GA
| | - John D. Meeker
- University of Michigan, Department of Environmental Health Sciences - Ann Arbor, Michigan
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Metregiste D, Boucaud-Maitre D, Aubert L, Noubou L, Jehel L. Explanatory factors of post-traumatic distress and burnout among hospital staff 6 months after Hurricane Irma in Saint-Martin and Saint-Barthelemy. PLoS One 2020; 15:e0229246. [PMID: 32155185 PMCID: PMC7064261 DOI: 10.1371/journal.pone.0229246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 02/03/2020] [Indexed: 12/03/2022] Open
Abstract
Background In September 2017, the Hurricane Irma devastated the islands of Saint-Martin and Saint-Barthelemy (French West Indies). This was a particularly distressing time for the local healthcare staff in charge of rescuing the population. The aim of this study was to identify the explanatory factors of post-traumatic distress and burnout in hospital staff. Methods An anonymous questionnaire was sent to all 509 hospital workers of Saint-Martin and Saint-Barthelemy. Post-traumatic distress and burnout was assessed using the Post-Traumatic Stress Disorder Checklist (PCL-S) and Copenhagen Burnout Inventory (CBI) scales. Bivariate and multivariate analyses were used to determine the explanatory variables for these two psychological disorders. Results Two hundred and sixty-two questionnaires were completed (response rate of 51.7%). The explanatory factors of post-traumatic distress were female gender (OR = 12.93, 95% CI: 2.70–232.10), electricity shortages (OR = 2.92, 95% CI: 1.13–8.19) and home damage (OR = 1.16, 95% CI [1.02–1.33]). In parallel, the explanatory factors of burnout were post-traumatic distress (OR: 10.42, 95% CI: 4.72–25.58), female gender (OR = 2,41, 95% CI: 1.24–5.02) and paramedical staff (OR = 2,53, 95% CI: 1.15–6.21). In the multivariate analysis, only burnout was significantly associated with post-traumatic distress (OR = 9.26, 95% CI: 4.11–23.14). Conclusions Six months after Irma, post-traumatic distress among hospital staff was strongly linked to burnout. This study revealed the lack of electricity as a new factor related to post-traumatic distress. It also suggested that psychological intervention should be strengthened.
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Affiliation(s)
- Damien Metregiste
- Service des Urgences, Centre hospitalo-Universitaire de Martinique, Fort de France, France
- * E-mail:
| | - Denis Boucaud-Maitre
- Direction de la Recherche Clinique et de l’Innovation, Centre hospitalo-Universitaire de Guadeloupe, Point-à-Pitre, France
| | - Lyderic Aubert
- CIRE Antilles, Santé-Publique France, Pointe-à-Pitre, Guadeloupe, France
| | - Lazare Noubou
- Centre Hospitalier de Saint Martin et Saint Barthélémy, Service des Urgences et du SMUR, Commission de Qualité et de la Sécurité des Soins, Marigot, France
| | - Louis Jehel
- Service de Psychiatrie, Centre hospitalo-Universitaire de Martinique, Fort de France, Université des Antilles-Guyane, INSERM, Fort de France, France
- Président de la Commission Formation et Vie Universitaire pôle formation de la Martinique, Université des Antilles et de la Guyane, Fort de France, France
- Centre de recherche en Santé Mentale et Santé Publique, INSERM U1176, Paris, France
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Bubin SFA, Mat Ali S, Shukri R, Wan Ibadullah WZ, Ramli NS, Mustapha NA, Mohammad Rashedi IF. Characterization and stability of pitaya pearls from hydrocolloids by reverse spherification. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2019. [DOI: 10.1080/10942912.2019.1647234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Siti Fatimah Azzahra Bubin
- Department of Food Technology, Faculty of Food Science and Technology, Universiti Putra Malaysia, Selangor, Malaysia
| | - Solihah Mat Ali
- Department of Food Technology, Faculty of Food Science and Technology, Universiti Putra Malaysia, Selangor, Malaysia
| | - Radhiah Shukri
- Department of Food Technology, Faculty of Food Science and Technology, Universiti Putra Malaysia, Selangor, Malaysia
| | - Wan Zunairah Wan Ibadullah
- Department of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, Selangor, Malaysia
| | - Nurul Shazini Ramli
- Department of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, Selangor, Malaysia
| | - Nor Afizah Mustapha
- Department of Food Technology, Faculty of Food Science and Technology, Universiti Putra Malaysia, Selangor, Malaysia
| | - Ismail Fitry Mohammad Rashedi
- Department of Food Technology, Faculty of Food Science and Technology, Universiti Putra Malaysia, Selangor, Malaysia
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Post-Hurricane Distress Scale (PHDS): A Novel Tool for First Responders and Disaster Researchers. Disaster Med Public Health Prep 2019; 13:82-89. [PMID: 30841955 DOI: 10.1017/dmp.2019.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim of this study was the construction and validation of a novel research instrument to quantify the degree of post-hurricane trauma and distress in an affected population. The Post-Hurricane Distress Scale (PHDS) has quantitative measures of both acute and prolonged distress, attributable to meteorological and hydrological disasters. METHODS A careful evaluation of existing questionnaires, as well as extensive canvasing of the post-Maria population of Puerto Rico, availed the construction of the PHDS. The PHDS consists of 20 items, organized into 4 subscales. The PHDS was pre-validated (n=79), revised, and then distributed to a broad sampling of the post-Hurricane Maria Puerto Rican population (n=597). Validation, including factor analysis, analyses of concurrent validity, discriminant validity, and internal reliability, was performed. RESULTS After comparing various scales, factor loading profiles, concurrent validities, and models of fit, we show that the PHDS is best scored as a single 0-6 distress scale. When compared with the Traumatic Exposure Severity Scale, the PHDS shows superior concurrent validity, more accurately predicting scores for the Peritraumatic Distress Inventory, Impact of Event Scale - Revised, and Generalized Anxiety Disorder 7 Scale. The PHDS shows good internal reliability and discriminant validity. CONCLUSIONS The PHDS represents a novel, useful instrument for disaster first-responders and researchers. The prompt identification of high-risk populations is possible using this instrument. (Disaster Med Public Health Preparedness. 2019;13:82-89).
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Hall BJ, Xiong YX, Yip PSY, Lao CK, Shi W, Sou EKL, Chang K, Wang L, Lam AIF. The association between disaster exposure and media use on post-traumatic stress disorder following Typhoon Hato in Macao, China. Eur J Psychotraumatol 2019; 10:1558709. [PMID: 30693078 PMCID: PMC6338284 DOI: 10.1080/20008198.2018.1558709] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 11/26/2018] [Accepted: 11/30/2018] [Indexed: 11/14/2022] Open
Abstract
Background: Direct exposure to natural disasters and related losses are associated with post-traumatic stress disorder (PTSD). It is less clear whether indirect media exposure is associated with PTSD. Objective: This study investigated key exposure-related risk factors for PTSD and examined the effect of media exposure on the prevalence of disaster-related PTSD. Method: Typhoon Hato directly hit Macao on 23 August 2017. It was one of the most serious natural disasters ever to strike southern China. One month after the event, 1876 Chinese university students in Macao were recruited into a cross-sectional study (mean age 20.01 years, SD = 2.63; 66.2% female). Self-reported typhoon exposure, media use and exposure to disaster-related content, and PTSD symptoms were collected using an electronic survey. Univariable analyses assessed associations between risk factors and PTSD, which were then included in a series of multivariable logistic regressions. Results: The prevalence of PTSD was 5.1%. Adjusted models demonstrated that being male (vs female) [adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI) 1.07-2.63], home damage (aOR = 2.86, 95% CI 1.71-4.78), witnessing people injured (aOR = 2.33, 95% CI 1.36-4.00), and almost drowning during the storm (aOR = 8.99, 95% CI 1.92-41.99) were associated with PTSD. After adjusting for direct exposure, indirect exposure to disaster-related social media content, including information related to drowning victims (aOR = 1.29, 95% CI 1.00-1.67) and residents' emotional reactions (aOR = 1.98, 95% CI 1.44-2.72), was associated with PTSD. Viewing more information about the storm itself (aOR = 0.37, 95% CI 0.28-0.49) and images of heroic acts (aOR = 0.72, 95% CI 0.55-0.94) were significantly associated with lower odds of PTSD. Conclusion: These findings add to the literature demonstrating that some types of media use and certain media content following a natural disaster are associated with PTSD.
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Affiliation(s)
- Brian J. Hall
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macao, Macao (SAR), People’s Republic of China
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ying Xin Xiong
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macao, Macao (SAR), People’s Republic of China
| | - Paul S. Y. Yip
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macao, Macao (SAR), People’s Republic of China
| | - Chao Kei Lao
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macao, Macao (SAR), People’s Republic of China
| | - Wei Shi
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macao, Macao (SAR), People’s Republic of China
| | - Elvo K. L. Sou
- Student Affairs Office, The University of Macao, Macao (SAR), People’s Republic of China
| | - Kay Chang
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macao, Macao (SAR), People’s Republic of China
| | - Li Wang
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People’s Republic of China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, People’s Republic of China
| | - Agnes I. F. Lam
- Centre for Macau Studies, The University of Macao, Macao (SAR), People’s Republic of China
- Department of Communications, The University of Macao, Macao (SAR), People’s Republic of China
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Hobfoll SE, Gaffey AE, Wagner LM. PTSD and the influence of context: The self as a social mirror. J Pers 2018; 88:76-87. [PMID: 30298916 DOI: 10.1111/jopy.12439] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 09/14/2018] [Accepted: 09/21/2018] [Indexed: 11/28/2022]
Abstract
The principal accepted models of posttraumatic stress disorder (PTSD) are based on both memory processing and biological/brain changes occurring when one's life or well-being is threatened. It is our thesis that these models would be greatly informed by community studies indicating that PTSD is predicted to a greater extent by earlier life experience and experiences that occur distant from the threatening event. These findings suggest posttraumatic responding is best conceptualized through the lens of the self-in-context, as opposed to imprinting that results from a given event at a given time. Moreover, studies of non-Western populations often do not express trauma as PTSD, or at least not primarily as PTSD, which argues against specific neural or memory encoding processes, but rather for a more plastic neural process that is shaped by experience and how the self develops in its cultural context, as a product of a broad array of experiences. We posit that fear and emotional conditioning as well as the ways traumas are encoded in memory are only partial explanatory mechanisms for trauma responding, and that issues of safety and harm, which are long term and developmental, are the common and principal underpinnings of the occurrence of posttraumatic distress, including PTSD.
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Affiliation(s)
- Stevan E Hobfoll
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Allison E Gaffey
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois.,Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Linzy M Wagner
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
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Springgate BF, Arevian AC, Wennerstrom A, Johnson AJ, Eisenman DP, Sugarman OK, Haywood CG, Trapido EJ, Sherbourne CD, Everett A, McCreary M, Meyers D, Kataoka S, Tang L, Sato J, Wells KB. Community Resilience Learning Collaborative and Research Network (C-LEARN): Study Protocol with Participatory Planning for a Randomized, Comparative Effectiveness Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1683. [PMID: 30720791 PMCID: PMC6121437 DOI: 10.3390/ijerph15081683] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 08/04/2018] [Indexed: 11/16/2022]
Abstract
This manuscript presents the protocol and participatory planning process for implementing the Community Resilience Learning Collaborative and Research Network (C-LEARN) study. C-LEARN is designed to determine how to build a service program and individual client capacity to improve mental health-related quality of life among individuals at risk for depression, with exposure to social risk factors or concerns about environmental hazards in areas of Southern Louisiana at risk for events such as hurricanes and storms. The study uses a Community Partnered Participatory Research (CPPR) framework to incorporate community priorities into study design and implementation. The first phase of C-LEARN is assessment of community priorities, assets, and opportunities for building resilience through key informant interviews and community agency outreach. Findings from this phase will inform the implementation of a two-level (program-level and individual client level) randomized study in up to four South Louisiana communities. Within communities, health and social-community service programs will be randomized to Community Engagement and Planning (CEP) for multi-sector coalition support or Technical Assistance (TA) for individual program support to implement evidence-based and community-prioritized intervention toolkits, including an expanded version of depression collaborative care and resources (referrals, manuals) to address social risk factors such as financial or housing instability and for a community resilience approach to disaster preparedness and response. Within each arm, the study will randomize individual adult clients to one of two mobile applications that provide informational resources on services for depression, social risk factors, and disaster response or also provide psychoeducation on Cognitive Behavioral Therapy to enhance coping with stress and mood. Planned data collection includes baseline, six-month and brief monthly surveys for clients, and baseline and 12-month surveys for administrators and staff.
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Affiliation(s)
- Benjamin F Springgate
- LSU Health Sciences Center, New Orleans School of Medicine, New Orleans, LA 70112, USA.
- LSU Health Sciences Center, New Orleans School of Public Health, New Orleans, LA 70112, USA.
| | - Armen C Arevian
- UCLA Semel Institute for Neuroscience and Human Behavior, Research Center for Health Services and Society, Los Angeles, CA 90024, USA.
| | | | - Arthur J Johnson
- Center for Sustainable Engagement and Development, New Orleans, LA 70117, USA.
| | - David P Eisenman
- David Geffen School of Medicine at UCLA and UCLA Center for Public Health and Disasters, Los Angeles, CA 90095, USA.
| | - Olivia K Sugarman
- LSU Health Sciences Center, New Orleans School of Medicine, New Orleans, LA 70112, USA.
- LSU Health Sciences Center, New Orleans School of Public Health, New Orleans, LA 70112, USA.
| | | | - Edward J Trapido
- LSU Health Sciences Center, New Orleans School of Public Health, New Orleans, LA 70112, USA.
| | | | - Ashley Everett
- LSU Health Sciences Center, New Orleans School of Medicine, New Orleans, LA 70112, USA.
| | - Michael McCreary
- UCLA Semel Institute for Neuroscience and Human Behavior, Research Center for Health Services and Society, Los Angeles, CA 90024, USA.
| | - Diana Meyers
- St. Anna's Episcopal Church, New Orleans, LA 70116, USA.
| | - Sheryl Kataoka
- UCLA Semel Institute for Neuroscience and Human Behavior, Research Center for Health Services and Society, Los Angeles, CA 90024, USA.
| | - Lingqi Tang
- UCLA Semel Institute for Neuroscience and Human Behavior, Research Center for Health Services and Society, Los Angeles, CA 90024, USA.
| | - Jennifer Sato
- LSU Health Sciences Center, New Orleans School of Medicine, New Orleans, LA 70112, USA.
| | - Kenneth B Wells
- UCLA Semel Institute for Neuroscience and Human Behavior, Research Center for Health Services and Society, Los Angeles, CA 90024, USA.
- The RAND Corporation, Santa Monica, CA 90401, USA.
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Labarda CE, Chan CS. Sleep disturbances, posttraumatic stress, and psychological distress among survivors of the 2013 Super Typhoon Haiyan. Psychiatry Res 2018; 266:284-290. [PMID: 29609982 DOI: 10.1016/j.psychres.2018.03.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 01/03/2018] [Accepted: 03/07/2018] [Indexed: 01/08/2023]
Abstract
Sleep disturbances and their relation with posttraumatic stress and general psychological distress were examined after the 2013 Super Typhoon Haiyan. Sleep disturbances were hypothesized to be associated with posttraumatic stress and general psychological distress in two samples of survivors across two time points (N = 361) in the Philippines. Sample 1 (n = 223) and Sample 2 (n = 138) were collected 18 months and 30 months after the storm, respectively. Results from structural regression modeling indicated that insomnia was associated with both posttraumatic stress and general psychological distress. Poor sleep quality was associated with posttraumatic stress but not with general psychological distress. Findings underscore the longer-term relationship between sleep disturbances and overall sleep quality to posttraumatic stress in the context of a natural disaster. Implications for public mental health interventions in disaster settings are discussed.
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Affiliation(s)
- Charlie E Labarda
- Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region, PRC
| | - Christian S Chan
- Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region, PRC.
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Travers C, Degeling C, Rock M. Companion Animals in Natural Disasters: A Scoping Review of Scholarly Sources. J APPL ANIM WELF SCI 2017; 20:324-343. [PMID: 28494169 DOI: 10.1080/10888705.2017.1322515] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
During a disaster, people may make evacuation decisions based on their companion animal's welfare, therefore exposing themselves, their companion animals, and emergency responders to increased risk for injury or death. The loss and suffering of companion animals in disasters causes deep distress, diminishing people's capacity to rebuild their lives. This scoping review presents scholarly research studies and reviews relating to people and their companion animals in the context of disasters, with an aim of informing researchers, policymakers, and practitioners and providing direction for future research. Using the Arksey and O'Malley framework, articles in scholarly journals from 2004 to 2014 are discussed. Analysis included 38 articles: 20 research studies, 12 reviews, and 6 editorials. Findings revealed 2 central themes: companion animals as a risk factor to human health and safety and companion animals being "at risk" themselves. An emerging theme was "responsibility": Who is responsible for companion animals in disasters and how? Understanding the implications of human-nonhuman animal relationships for disaster response and having a broader public consensus on what is owed to animals at times of emergency are important to community preparedness and resilience.
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Affiliation(s)
- Cheryl Travers
- a Centre for Values, Ethics and the Law in Medicine, School of Public Health , The University of Sydney , Sydney , Australia
| | - Chris Degeling
- a Centre for Values, Ethics and the Law in Medicine, School of Public Health , The University of Sydney , Sydney , Australia.,b The Marie Bashir Institute for Infectious Diseases and Biosecurity , The University of Sydney , Sydney , Australia
| | - Melanie Rock
- c Community Health Sciences, Faculty of Medicine , University of Calgary , Calgary , Alberta , Canada.,d Department of Ecosystem and Public Health, Faculty of Veterinary Medicine , University of Calgary , Calgary , Alberta , Canada
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Women's Mental Health and Intimate Partner Violence Following Natural Disaster: A Scoping Review. Prehosp Disaster Med 2016; 31:648-657. [PMID: 27641740 DOI: 10.1017/s1049023x16000911] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Introduction Survivors of natural disasters in the United States experience significant health ramifications. Women particularly are vulnerable to both post-disaster posttraumatic stress disorder (PTSD) and depression, and research has documented that these psychopathological sequelae often are correlated with increased incidence of intimate partner violence (IPV). Understanding the link between these health concerns is crucial to informing adequate disaster response and relief efforts for victims of natural disaster. Purpose The purpose of this review was to report the results of a scoping review on the specific mental health effects that commonly impact women following natural disasters, and to develop a conceptual framework with which to guide future research. METHODS A scoping review of mental and physical health effects experienced by women following natural disasters in the United States was conducted. Articles from 2000-2015 were included. Databases examined were PubMed, PsycInfo, Cochrane, JSTOR, Web of Science, and databases available through ProQuest, including ProQuest Research Library. RESULTS A total of 58 articles were selected for inclusion, out of an original 149 that were selected for full-text review. Forty-eight articles, or 82.8%, focused on mental health outcomes. Ten articles, or 17.2%, focused on IPV. Discussion Certain mental health outcomes, including PTSD, depression, and other significant mental health concerns, were recurrent issues for women post-disaster. Despite the strong correlation between experience of mental health consequences after disaster and increased risk of domestic violence, studies on the risk and mediating factors are rare. The specific challenges faced by women and the interrelation between negative mental health outcomes and heightened exposure to IPV following disasters require a solid evidence base in order to facilitate the development of effective interventions. Additional research informed by theory on probable health impacts is necessary to improve development/implementation of emergency relief policy. Bell SA , Folkerth LA . Women's mental health and intimate partner violence following natural disaster: a scoping review. Prehosp Disaster Med. 2016;31(6):648-657.
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Morris KA, Deterding NM. The emotional cost of distance: Geographic social network dispersion and post-traumatic stress among survivors of Hurricane Katrina. Soc Sci Med 2016; 165:56-65. [PMID: 27494240 PMCID: PMC5003656 DOI: 10.1016/j.socscimed.2016.07.034] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 07/16/2016] [Accepted: 07/25/2016] [Indexed: 11/18/2022]
Abstract
RATIONALE Social networks offer important emotional and instrumental support following natural disasters. However, displacement may geographically disperse network members, making it difficult to provide and receive support necessary for psychological recovery after trauma. OBJECTIVES We examine the association between distance to network members and post-traumatic stress using survey data, and identify potential mechanisms underlying this association using in-depth qualitative interviews. METHODS We use longitudinal, mixed-methods data from the Resilience in Survivors of Katrina (RISK) Project to capture the long-term effects of Hurricane Katrina on low-income mothers from New Orleans. Baseline surveys occurred approximately one year before the storm and follow-up surveys and in-depth interviews were conducted five years later. We use a sequential explanatory analytic design. With logistic regression, we estimate the association of geographic network dispersion with the likelihood of post-traumatic stress. With linear regressions, we estimate the association of network dispersion with the three post-traumatic stress sub-scales. Using maximal variation sampling, we use qualitative interview data to elaborate identified statistical associations. RESULTS We find network dispersion is positively associated with the likelihood of post-traumatic stress, controlling for individual-level socio-demographic characteristics, exposure to hurricane-related trauma, perceived social support, and New Orleans residency. We identify two social-psychological mechanisms present in qualitative data: respondents with distant network members report a lack of deep belonging and a lack of mattering as they are unable to fulfill obligations to important distant ties. CONCLUSION Results indicate the importance of physical proximity to emotionally-intimate network ties for long-term psychological recovery.
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Affiliation(s)
- Katherine Ann Morris
- Harvard University, Department of Sociology, William James Hall, 33 Kirkland Street, Cambridge, MA 02138, United States.
| | - Nicole M Deterding
- University of Wisconsin-Madison, Institute for Research on Poverty, United States
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Hikichi H, Aida J, Tsuboya T, Kondo K, Kawachi I. Can Community Social Cohesion Prevent Posttraumatic Stress Disorder in the Aftermath of a Disaster? A Natural Experiment From the 2011 Tohoku Earthquake and Tsunami. Am J Epidemiol 2016; 183:902-10. [PMID: 27026337 PMCID: PMC4867157 DOI: 10.1093/aje/kwv335] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/23/2015] [Indexed: 12/22/2022] Open
Abstract
In the aftermath of a disaster, the risk of posttraumatic stress disorder (PTSD) is high. We sought to examine whether the predisaster level of community social cohesion was associated with a lower risk of PTSD after the earthquake and tsunami in Tohoku, Japan, on March 11, 2011. The baseline for our natural experiment was established in a survey of older community-dwelling adults who lived 80 kilometers west of the epicenter 7 months before the earthquake and tsunami. A follow-up survey was conducted approximately 2.5 years after the disaster. We used a spatial Durbin model to examine the association of community-level social cohesion with the individual risk of PTSD. Among our analytic sample (n = 3,567), 11.4% of respondents reported severe PTSD symptoms. In the spatial Durbin model, individual- and community-level social cohesion before the disaster were significantly associated with lower risks of PTSD symptoms (odds ratio = 0.87, 95% confidence interval: 0.77, 0.98 and odds ratio = 0.75, 95% confidence interval: 0.63, 0.90, respectively), even after adjustment for depression symptoms at baseline and experiences during the disaster (including loss of loved ones, housing damage, and interruption of access to health care). Community-level social cohesion strengthens the resilience of community residents in the aftermath of a disaster.
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Affiliation(s)
- Hiroyuki Hikichi
- Correspondence to Dr. Hiroyuki Hikichi, Department of Social and Behavioral Sciences, Harvard School of Public Health, 401 Park Drive, Landmark Center 4th Floor, Boston, MA 02215 (e-mail: )
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Abstract
BACKGROUND In October 2012, Hurricane Sandy ravaged the East coast claiming 159 lives and destroying an estimated $65 billion in property. Overnight, hospitals still in operation, such as Maimonides Medical Center, were faced with seemingly insurmountable challenges in providing adequate health care services. OBJECTIVES This study had 3 goals: (1) to assess the impact of Hurricane Sandy on the number and pattern of visits to the psychiatric emergency room (PER) at Maimonides Medical Center; (2) to analyze the procedures implemented in addressing increased demands; and (3) to identify any shortcomings in our response and explore how it can be altered to face future challenges. METHODS We reviewed systems data for the 12 months before and after Hurricane Sandy, including total number of visits to the PER, length of stay in the PER, and percentage of admissions and discharges from the PER. We also reviewed the interventions implemented by the designated response unit, the Command Center, and interviewed senior leadership involved in the process. RESULTS The total number of visits increased dramatically, with the highest increase recorded in the first month after Hurricane Sandy. There were 3554 visits in the 12 months before the hurricane compared with 4674 in the 12 months after the storm (P<0.001). In addition, there were 273 visits to the PER in November 2011 compared with 408 in November 2012, which was the month after the hurricane (P<0.001). The average length of stay increased and the percentage of admissions decreased significantly (P<0.001). There were no increased staff assignments, but significant resources were provided by the Command Center. CONCLUSIONS The results of this study highlight the fact that hospitals can never be over-prepared for disasters. By being adaptive and creative, the PER was able to serve a greater number of patients, which is critical in the current health care environment.
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Chan CS, Tang KNS, Hall BJ, Yip SYT, Maggay M. Psychological Sequelae of the 2013 Super Typhoon Haiyan Among Survivor-Responders. Psychiatry 2016; 79:282-296. [PMID: 27880626 DOI: 10.1080/00332747.2015.1129874] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Super Typhoon Haiyan (known as Yolanda in the Philippines), one of the strongest tropical cyclones recorded in history, made landfall in the Philippines in November 2013. This cross-sectional study examined the psychological impact of the typhoon and its aftermath, as well as the impact of individual typhoon-related stressors among a group of survivor-responders. METHOD A total of 192 Filipino adult survivors who were also disaster-relief responders and 45 unaffected disaster-relief responders (N = 237) completed a questionnaire that assessed their general psychological distress (GPD), symptoms of posttraumatic stress (PTS), and disaster experiences 1.5 to 4 months after the event. RESULTS The disaster-exposed group was more distressed and suffered from more symptoms of PTS, but the prevalence of posttraumatic stress disorder (PTSD) was not statistically different between the two groups (7.9% versus 9.4%). Regression analysis revealed that financial instability (β = .52), physical injury (β = .21), and perceived life threat (β = .17) were associated with GPD. Physical injury (β = .20) and perceived life threat (β = .20) were also associated with PTS symptoms. CONCLUSIONS Although a marked difference in PTSD was not noted, the psychological impact of Super Typhoon Haiyan on survivor-responders in terms of nonspecific psychological distress and symptoms of PTS was considerable. Some typhoon-related stressors, including financial instability, physical injury, and perceived life threat, appear to be more detrimental to mental health than other stressors.
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Hall BJ, Sou K, Chen W, Zhou F, Chang K, Latkin C. An evaluation of the buffering effects of types and sources of support on depressive symptoms among natural disaster exposed Chinese adults. Psychiatry 2016; 79:389-402. [PMID: 27997324 PMCID: PMC5676455 DOI: 10.1080/00332747.2016.1158004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Social support is a key protective factor for people exposed to natural disasters. The effect of type and source of this support is not well documented. Investigations are needed to identify the specific modifying role of received and perceived support from family and friends on the association between disaster exposure and depressive symptoms. METHODS Face-to-face household interviews were conducted in 2014 with a random sample of 751 adults recruited from Yuexiu and Tianhe districts in Guangzhou, China. Sampling was accomplished through spatial epidemiological methods. Participants' exposure to disaster, depressive symptoms, and social support networks was recorded on tablet devices. Multiple regression analysis was used to test the potential moderating role of social support on depression symptoms. RESULTS A total of 30.24% reported natural disaster exposure. Disaster exposure and received family support were significantly and positively related to depressive symptoms. In contrast, perceived family support moderated the relationship between disaster exposure and depressive symptoms. No association was found between support from friends and depressive severity. CONCLUSION Perceived family support buffered the effect of disaster exposure in this sample, while received family support was associated with increased depression. Perceived family support is an important resource among those who experience disaster exposure and actual provision of family support may be harmful or miscarried. Natural disasters are becoming increasingly prevalent in Asia. According to the Economic and Social Commission for Asia and the Pacific (ESCAP, 2015a), a total of 119 disaster events, accounting for more than half of the total number of disasters occurred in the world, took place in Asia in 2014, affecting 79.6 million people, among whom 6050 died. The Chinese Mainland experienced several major natural disasters, including the earthquake in Wechuan, Sichuan Province, in 2008 and natural disasters affected more than 500,000 people causing 0.4% of GDP loss (roughly US$3 trillion; ESCAP, 2015b). The current study investigated the effect of social resources on mental health following natural disaster exposure.
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Affiliation(s)
- Brian J. Hall
- Global and Community Mental Health Research Group, University of Macau, Macau (SAR), People’s Republic of China,Department of Health Behavior and Society and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kalon Sou
- Global and Community Mental Health Research Group, University of Macau, Macau (SAR), People’s Republic of China
| | - Wen Chen
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, People’s Republic of China,School of Public Health, Sun Yat-sen Center for Migrant Health Policy, People’s Republic of China
| | - Fangjing Zhou
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, People’s Republic of China,School of Public Health, Sun Yat-sen Center for Migrant Health Policy, People’s Republic of China
| | - Kay Chang
- Global and Community Mental Health Research Group, University of Macau, Macau (SAR), People’s Republic of China
| | - Carl Latkin
- Department of Health Behavior and Society and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Chan CS, Lowe SR, Weber E, Rhodes JE. The contribution of pre- and postdisaster social support to short- and long-term mental health after Hurricanes Katrina: A longitudinal study of low-income survivors. Soc Sci Med 2015; 138:38-43. [DOI: 10.1016/j.socscimed.2015.05.037] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jacobs MB, Harville EW. Long-Term Mental Health Among Low-Income, Minority Women Following Exposure to Multiple Natural Disasters in Early and Late Adolescence Compared to Adulthood. CHILD & YOUTH CARE FORUM 2015; 44:511-525. [PMID: 26412956 DOI: 10.1007/s10566-015-9311-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND High impact experiences following a natural disaster have been shown to influence later psychopathology. Individual-level factors such as age may also contribute to a disaster's impact on mental health, though it is unclear whether young age confers a protective effect or represents a period of increased risk as compared to adulthood. OBJECTIVE The present study evaluated the influence of adolescent age and hurricane experiences on mental health in the years following multiple hurricanes in the New Orleans region. METHODS 794 women, currently aged 18-45, participating in a cohort study of lifetime adversity and reproductive health completed a survey about hurricane experience and current mental health. Joint associations between disaster experience and age at the time of disaster on depression and post-traumatic stress disorder (PTSD) were evaluated. RESULTS Compared to women who were adults at the time of the disaster, being in early adolescence resulted in reduced depression and PTSD up to 9-years post-disaster, controlling for hurricane experiences, time since disaster, and income. A similar effect was not observed among older adolescents. Increased endorsement of feeling one's life was in danger and experiencing illness or injury resulted in increased odds of depression, while danger was associated with increased odds of PTSD. CONCLUSIONS Younger age at the time of a natural disaster may confer a protective effect on mental health outcomes post-disaster, even when disaster experiences are considered, potentially representing the importance of parental support and cognitive development on disaster effects.
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Affiliation(s)
- Marni B Jacobs
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2000, New Orleans, LA 70112-2715, USA
| | - Emily W Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2000, New Orleans, LA 70112-2715, USA
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