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Phibbs S. Disability, Disasters, and Resilience. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2022. [DOI: 10.1177/0145482x221144680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Suzanne Phibbs
- School of Health Sciences, Massey University, Palmerston North, New Zealand
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Haverhals LM. How Social Determinants of Health of Individuals Living or Working in U.S. Department of Veterans Affairs Home-Based Long-Term Care Programs in Puerto Rico Influenced Recovery after Hurricane Maria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13243. [PMID: 36293827 PMCID: PMC9603221 DOI: 10.3390/ijerph192013243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
In September 2017, Hurricane Maria devastated Puerto Rico, causing extensive infrastructure damage and a significant number of deaths. In the months and years since, recovery from Maria has been slow, hampered by delayed delivery of fiscal aid, corruption, economic hardships, and Puerto Rico's colonial status. Simultaneously, Puerto Rico's population is rapidly aging and hundreds of thousands of mostly younger Puerto Ricans are migrating out of Puerto Rico for more opportunities. Many Puerto Ricans who are older or disabled and need long-term care receive this care in home-based environments, as Puerto Rico has minimal institutionalized long-term care infrastructure and limited funding to expand it. The Department of Veterans Affairs (VA) offers several home-based long-term care options for Veterans in Puerto Rico. In this qualitative case study, veterans, VA staff, veterans' caregivers, caregivers' family members, and veterans' family members receiving or involved with providing this care were interviewed regarding their experiences during and after Hurricane Maria. Specifically, this study highlights how social determinants of health of those residing in or involved with VA home-based long-term care programs influenced recovery from Hurricane Maria, and how findings can inform disaster recovery and provision of home-based long-term care going forward.
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Affiliation(s)
- Leah M. Haverhals
- Denver-Seattle VA Center of Innovation for Value Driven & Veteran-Centric Care, Rocky Mountain Regional VA Medical Center at VA Eastern Colorado Health Care System, 1700 N. Wheeling St., Aurora, CO 80045, USA; ; Tel.: +1-720-331-4176
- Department of Health Care Policy & Research, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
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Walking the talk on multi-level interventions: The power of parsimony. Soc Sci Med 2021; 283:114189. [PMID: 34246031 DOI: 10.1016/j.socscimed.2021.114189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/23/2021] [Accepted: 06/28/2021] [Indexed: 11/20/2022]
Abstract
There is strong consensus regarding the need for multi-level interventions (MLIs) to address today's complex health problems. Several longstanding social ecological frameworks are commonly referred to in guiding MLI development. The specificity and comprehensiveness of these frameworks unwittingly suggest that the totality of included influences are important in all health contexts. Not surprisingly, when viewed as requiring intervention at all levels of influence, MLIs are often considered to be infeasible due to sizeable cost and logistical barriers. Thus, efforts to develop and evaluate MLIs have been extremely limited, and comparatively few examples are found in the health literature. We argue that operational frameworks to identify which levels matter in which contexts - henceforth, referred to as parsimony - could accelerate the field towards broader use of MLIs. We suggest a hypothetical operational framework informed by complexity theory and pragmatic approaches that could enable us to conceptualize, design and evaluate MLIs to consider where reflexive and recursive process mechanisms that cross levels should be targeted by MLI. The approach also emphasizes sustainability of MLIs. Without developing parsimony-based operational frameworks to move us forward, we fear that little will change, and we will simply continue to talk, without proceeding to the walk.
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Shin SH, Ji H. Health risks of natural hazards and resilience resources: Evidence from a U.S. nationwide longitudinal study. Soc Sci Med 2021; 281:114110. [PMID: 34139633 DOI: 10.1016/j.socscimed.2021.114110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/28/2021] [Accepted: 06/03/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although natural disasters can threaten health and well-being, some people show greater resilience to their effects than others. Identifying the characteristics related to resilience has important implications for reducing the health risks in the aftermath of a disaster. OBJECTIVE Using the Conservation of Resources Theory as a framework, we study the role of resources in moderating the adverse effects of natural disasters on people's health and coping behaviors. METHOD We match 20,658 unique individuals aged 50 or older from the 2012-2016 waves of the Health and Retirement Study to the county-level annual natural hazard data provided by the Federal Emergency Management Agency. Using individual-fixed effect models, we first model whether the experience of natural disasters can predict people's health and coping behaviors. We then explore heterogeneity in such effects by interacting individual- and county-level resilience resources with the number of natural disasters. RESULTS The results show that with increased exposure to natural disasters, older adults are more likely to experience difficulties performing instrumental daily activities. They also tend to have fewer overnight hospital stays, higher out-of-pocket medical expenses, and increased alcohol dependency. However, older adults with certain socio-economic characteristics ‒ white, higher education, higher income, and homeownership ‒ are better able than others to mitigate any adverse health effects of natural disasters. One significant community-level resource is a robust healthcare capacity in a county with a high ratio of healthcare practitioners, where older adults are more likely to seek hospital care and have lower alcohol dependency. CONCLUSIONS Health resilience can be improved by strengthening community-level healthcare capacity, with a particular focus on residents with lower socio-economic resources. Failing to address healthcare provision inequalities may exacerbate health disparities.
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Affiliation(s)
- Su Hyun Shin
- University of Utah, Department of Family & Consumer Studies, 225 South 1400 East, Alfred Emery Building, Room 236, Salt Lake City, UT, 84112, USA.
| | - Hyunjung Ji
- University of Alabama, Department of Political Science, Ten Hoor Hall, Suite 310. Tuscaloosa, AL, 35487, USA.
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Radfar SR, De Jong CAJ, Farhoudian A, Ebrahimi M, Rafei P, Vahidi M, Yunesian M, Kouimtsidis C, Arunogiri S, Massah O, Deylamizadeh A, Brady KT, Busse A, Potenza MN, Ekhtiari H, Baldacchino AM. Reorganization of Substance Use Treatment and Harm Reduction Services During the COVID-19 Pandemic: A Global Survey. Front Psychiatry 2021; 12:639393. [PMID: 34025471 PMCID: PMC8135096 DOI: 10.3389/fpsyt.2021.639393] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/27/2021] [Indexed: 12/21/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted people with substance use disorders (SUDs) worldwide, and healthcare systems have reorganized their services in response to the pandemic. Methods: One week after the announcement of the COVID-19 as a pandemic, in a global survey, 177 addiction medicine professionals described COVID-19-related health responses in their own 77 countries in terms of SUD treatment and harm reduction services. The health responses were categorized around (1) managerial measures and systems, (2) logistics, (3) service providers, and (4) vulnerable groups. Results: Respondents from over 88% of countries reported that core medical and psychiatric care for SUDs had continued; however, only 56% of countries reported having had any business continuity plan, and 37.5% of countries reported shortages of methadone or buprenorphine supplies. Participants of 41% of countries reported partial discontinuation of harm-reduction services such as needle and syringe programs and condom distribution. Fifty-seven percent of overdose prevention interventions and 81% of outreach services were also negatively impacted. Conclusions: Participants reported that SUD treatment and harm-reduction services had been significantly impacted globally early during the COVID-19 pandemic. Based on our findings, we highlight several issues and complications resulting from the pandemic concerning people with SUDs that should be tackled more efficiently during the future waves or similar pandemics. The issues and potential strategies comprise the following: (1) helping policymakers to generate business continuity plans, (2) maintaining the use of evidence-based interventions for people with SUDs, (3) being prepared for adequate medication supplies, (4) integrating harm reduction programs with other treatment modalities, and (5) having specific considerations for vulnerable groups such as immigrants and refugees.
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Affiliation(s)
- Seyed Ramin Radfar
- Department of Neuroscience and Addiction, School of Advanced Technologies in Medicine (SATiM), Tehran University of Medical Sciences, Tehran, Iran
- Integrated Substance Abuse Programs Department, University of California, Los Angeles, Los Angeles, CA, United States
| | | | - Ali Farhoudian
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Ebrahimi
- Materials and Energy Research Center, Tehran, Iran
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Parnian Rafei
- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran
| | - Mehrnoosh Vahidi
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Christos Kouimtsidis
- Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, United Kingdom
| | | | - Omid Massah
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | | | - Anja Busse
- Staff Member of Prevention, Treatment and Rehabilitation Section, Drug Prevention and Health Branch, Division for Operations, United Nations Office on Drugs and Crime, Vienna, Austria
| | - Marc N. Potenza
- Connecticut Council on Problem Gambling and Connecticut Mental Health Center, Yale School of Medicine, New Haven, CT, United States
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research, Tulsa, OK, United States
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Matthewman S, Uekusa S. Theorizing disaster communitas. THEORY AND SOCIETY 2021; 50:965-984. [PMID: 33746336 PMCID: PMC7963341 DOI: 10.1007/s11186-021-09442-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/28/2021] [Indexed: 05/24/2023]
Abstract
Disaster scholars have long complained that their field is theory light: they are much better at doing and saying than analyzing. The paucity of theory doubtless reflects an understandable focus on case studies and practical solutions. Yet this works against big picture thinking. Consequently, both our comprehension of social suffering and our ability to mitigate it are fragmented. Communitas is exemplary here. This refers to the improvisational acts of mutual help, collective feeling and utopian desires that emerge in the wake of disasters. It has been observed for as long as there has been a sociology of disasters. Within the field, there have been numerous efforts to name and describe it. Yet there has been far less enthusiasm to theorize it, which means that the disaster literature has not adequately explained the social conditions under which communitas arises (or fails to). In this article, we synthesize numerous case studies to do so. This takes us beyond simple statements of what communitas is and what it should be called, to considerations of the conditions under which it emerges, how it should be conceptualized, the factors that might prevent communitas, and how we might encourage it. While primarily a theoretical work, the identification of communitas' facilitators and barriers have practical import for disaster risk reduction (DRR) policy as communitas has frequently proven to be a positive and potent force.
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Affiliation(s)
- Steve Matthewman
- Department of Sociology, University of Auckland, 10 Symonds Street, Level 9, Auckland, 1010 New Zealand
| | - Shinya Uekusa
- School of Culture and Society, Aarhus University, Aarhus, Denmark
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Farhoudian A, Radfar SR, Mohaddes Ardabili H, Rafei P, Ebrahimi M, Khojasteh Zonoozi A, De Jong CAJ, Vahidi M, Yunesian M, Kouimtsidis C, Arunogiri S, Hansen H, Brady KT, Potenza MN, Baldacchino AM, Ekhtiari H. A Global Survey on Changes in the Supply, Price, and Use of Illicit Drugs and Alcohol, and Related Complications During the 2020 COVID-19 Pandemic. Front Psychiatry 2021; 12:646206. [PMID: 34421664 PMCID: PMC8377291 DOI: 10.3389/fpsyt.2021.646206] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 06/15/2021] [Indexed: 12/21/2022] Open
Abstract
Background and Aims: COVID-19 has infected more than 77 million people worldwide and impacted the lives of many more, with a particularly devastating impact on vulnerable populations, including people with substance use disorders (SUDs). Quarantines, travel bans, regulatory changes, social distancing, and "lockdown" measures have affected drug and alcohol supply chains and subsequently their availability, price, and use patterns, with possible downstream effects on presentations of SUDs and demand for treatment. Given the lack of multicentric epidemiologic studies, we conducted a rapid global survey within the International Society of Addiction Medicine (ISAM) network in order to understand the status of substance-use patterns during the current pandemic. Design: Cross-sectional survey. Setting: Worldwide. Participants: Starting on April 4, 2020 during a 5-week period, the survey received 185 responses from 77 countries. Measurements: To assess addiction medicine professionals' perceived changes in drug and alcohol supply, price, use pattern, and related complications during the COVID-19 pandemic. Findings: Participants reported (among who answered "decreased" or "increased") a decrease in drug supply (69.0%) and at the same time an increase in price (95.3%) globally. With respect to changes in use patterns, an increase in alcohol (71.7%), cannabis (63.0%), prescription opioids (70.9%), and sedative/hypnotics (84.6%) use was reported, while the use of amphetamines (59.7%), cocaine (67.5%), and opiates (58.2%) was reported to decrease overall. Conclusions: The global report on changes in the availability, use patterns, and complications of alcohol and drugs during the COVID-19 pandemic should be considered in making new policies and in developing mitigating measures and guidelines during the current pandemic (and probable future ones) in order to minimize risks to people with SUD.
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Affiliation(s)
- Ali Farhoudian
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ramin Radfar
- Department of Neuroscience and Addiction, School of Advanced Technologies in Medicine (SATiM), Tehran University of Medical Sciences, Tehran, Iran.,Integrated Substance Abuse Programs Department, University of California, Los Angeles, Los Angeles, CA, United States
| | - Hossein Mohaddes Ardabili
- Psychiatry and Behavioral Sciences Research Center, Faculty of Medicine, Ibn-e-Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parnian Rafei
- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran.,Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Ebrahimi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Khojasteh Zonoozi
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mehrnoosh Vahidi
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Christos Kouimtsidis
- Surrey and Borders Partnership National Health Service Foundation Trust, Leatherhead, United Kingdom
| | | | - Helena Hansen
- Departments of Anthropology and Psychiatry, New York University, New York, NY, United States
| | - Kathleen T Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | | | - Marc N Potenza
- Yale School of Medicine, Connecticut Council on Problem Gambling and Connecticut Mental Health Center, New Haven, CT, United States
| | - Alexander Mario Baldacchino
- Division of Population and Behavior Sciences, Medical School, University of St Andrews, St Andrews, United Kingdom
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research, Tulsa, OK, United States
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Kelman I, Harris M. Linking Disaster Risk Reduction and Healthcare in Locations with Limited Accessibility: Challenges and Opportunities of Participatory Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E248. [PMID: 33396323 PMCID: PMC7795408 DOI: 10.3390/ijerph18010248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 01/07/2023]
Abstract
Disaster risk reduction and healthcare support each other, including the mitigation of further harm after illness or injury. These connections are particularly relevant in locations which have permanent or temporary limited accessibility. In these circumstances, people are required to be self-sufficient in providing emergency and long-term healthcare with limited resources. Planning and preparing to mitigate further harm after illness or injury from disasters (disaster risk reduction) must include people living and working in locations with limited accessibility, meaning that participatory research can be used. The challenges and opportunities of enacting participatory research in such contexts have not been thoroughly examined. The research question of this paper is therefore, "What challenges and opportunities occur when participatory research links disaster risk reduction and healthcare to mitigate illness and injury in locations with limited accessibility?" To answer this research question, the method used is a qualitative evidence synthesis, combined with an overview paper approach. Two principal themes of challenges and opportunities are examined: defining the data and collecting the data. The themes are explored in theory and then through contextual examples. The conclusion is that an overarching challenge is divergent goals of research and actions that, when recognized, lead to opportunities for improved connections between disaster risk reduction and healthcare.
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Affiliation(s)
- Ilan Kelman
- Institute for Global Health, University College London, London WC1N 1EH, UK
- Institute for Risk and Disaster Reduction, University College London, London WC1E 6BT, UK;
- University of Agder, 4630 Kristiansand, Norway
| | - Myles Harris
- Institute for Risk and Disaster Reduction, University College London, London WC1E 6BT, UK;
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Begg A, D'Aeth L, Kenagy E, Ambrose C, Dong H, Schluter PJ. Wellbeing recovery inequity following the 2010/2011 Canterbury earthquake sequence: repeated cross-sectional studies. Aust N Z J Public Health 2020; 45:158-164. [PMID: 33252823 DOI: 10.1111/1753-6405.13054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To track population mental wellbeing following the 2010/2011 Christchurch earthquakes and after-shocks. METHODS The Canterbury Wellbeing Survey, a cross-sectional survey of randomly selected adults aged ≥18 years resident in Christchurch, was repeated biannually from April 2013 until June 2017 and annually thereafter. The self-reported 5-item World Health Organization Well-Being Index (WHO-5) has been elicited from April 2013. Regression analysis was employed to model WHO-5 score patterns over time and between important socio-demographic groups. RESULTS Between 1,137 and 1,482 adults participated in each survey, totalling 14,100 overall. The mean WHO-5 significantly increased (p<0.001) from 52.4 (95% confidence interval [CI]: 51.1, 53.8) in the April 2013 survey to 60.8 (95%CI: 59.7, 61.9) in the June 2019 survey. A significant and sustained household income group disparity existed (p<0.001), even when adjusting for age, gender and ethnic differences. CONCLUSIONS The disaster appeared to affect the mental wellbeing of all, and recovery was incremental and prolonged, taking a number of years. Those within the lowest household income group had lower mean WHO-5 scores than their wealthier counterparts at every measured time point. Implications for public health: Recovery takes time, and pre-existing inequities persist despite the implementation of recovery processes aimed at mitigating these risks.
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Affiliation(s)
- Annabel Begg
- Canterbury District Health Board (CDHB), Community and Public Health, New Zealand
| | - Lucy D'Aeth
- Canterbury District Health Board (CDHB), Community and Public Health, New Zealand
| | - Emma Kenagy
- Canterbury District Health Board (CDHB), Community and Public Health, New Zealand
| | - Chris Ambrose
- Canterbury District Health Board (CDHB), Community and Public Health, New Zealand
| | - Hongfang Dong
- Canterbury District Health Board (CDHB), Community and Public Health, New Zealand
| | - Philip J Schluter
- School of Health Sciences, University of Canterbury - Te Whare Wānanga o Waitaha, New Zealand.,School of Clinical Medicine, Primary Care Clinical Unit, The University of Queensland
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