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Natural hazards and mental health among US Gulf Coast residents

Journal of Exposure Science & Environmental Epidemiology volume 31, pages 842–851 (2021)Cite this article

Abstract

Background

Individuals affected by disasters are at risk for adverse mental health sequelae. Individuals living in the US Gulf Coast have experienced many recent major disasters, but few studies have explored the cumulative burden of experiencing multiple disasters on mental health.

Objective

The objective of this study was to evaluate the relationship between disaster burden and mental health.

Methods

We used data from 9278 Gulf Long-term Follow-up Study participants who completed questionnaires on perceived stress, anxiety, depression, and post-traumatic stress disorder (PTSD) in 2011–2013. We linked 2005–2010 county-level data from the Spatial Hazard Events and Losses Database for the United States, a database of loss-causing events, to participant’s home address. Exposure measures included total count of loss events as well as severity quantified as property/crop losses per capita from all hazards. We used multilevel modeling to estimate odds ratios (OR) and 95% confidence intervals (CI) for each exposure–outcome relationship.

Results

Total count of loss events was positively associated with perceived stress (ORQ4:1.40, 95% CI:1.21–1.61) and was inversely associated with PTSD (ORQ4:0.66, 95% CI:0.45–0.96). Total duration of exposure was also associated with stress (ORQ4:1.16, 95% CI:1.01–1.33) but not with other outcomes. Severity based on cumulative fatalities/injuries was associated with anxiety (ORQ4:1.31, 95% CI:1.05–1.63) and stress (ORQ4:1.34, 95% CI:1.15–1.57), and severity based on cumulative property/crop losses was associated with anxiety (ORQ4:1.42, 95% CI:1.12–1.81), depression (ORQ4:1.22, 95% CI:0.95–1.57) and PTSD (ORQ4:1.99, 95% CI:1.44–2.76).

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Fig. 1: Study population selection criteria.

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Funding

This work was supported by the NIH Common Fund and the Intramural Research Program of the National Institutes of Health, the National Institute of Environmental Health Sciences [ZIA ES 102945].

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Authors and Affiliations

  1. Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC, USA

    Michael D. Hu, Kaitlyn G. Lawrence, Richard K. Kwok, Lawrence S. Engel & Dale P. Sandler

  2. Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA

    Michael D. Hu

  3. Center for Emergency Management and Homeland Security, Arizona State University, Phoenix, AZ, USA

    Melanie Gall

  4. College of Community Innovation and Education, University of Central Florida, Orlando, FL, USA

    Christopher T. Emrich

  5. Social & Scientific Systems, Inc, Durham, NC, USA

    Mark R. Bodkin, W. Braxton Jackson II & Nathaniel MacNell

  6. Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA

    Lawrence S. Engel

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Correspondence to Dale P. Sandler.

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The authors declare no competing interests.

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This research was approved by the Institutional Review Board of the National Institute of Environmental Health Sciences.

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Written informed consent was obtained from all participants completing the home visit.

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Hu, M.D., Lawrence, K.G., Gall, M. et al. Natural hazards and mental health among US Gulf Coast residents. J Expo Sci Environ Epidemiol 31, 842–851 (2021). https://doi.org/10.1038/s41370-021-00301-z

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