Association of Public Works Disasters with Substance Use Difficulties: Evidence from Flint, Michigan, Five Years after the Water Crisis Onset.
Association of Public Works Disasters with Substance Use Difficulties: Evidence from Flint, Michigan, Five Years after the Water Crisis Onset.
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DOI：
10.3390/ijerph20237090
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发表时间：
2023-11-21
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弗林特水危机等公共工程环境灾难通常发生在被剥夺公民权的社区，市政投资减少，同时存在精神健康不良的风险（贫困，社会脱节）。我们评估了危机的长期相互作用，这些因素与危机爆发五年后的物质使用困难。家庭概率样本的1970成年人生活在弗林特在危机期间进行了调查，他们的危机经验，使用的物质，因为危机，风险/弹性因素，包括以前的潜在创伤性事件暴露和当前的社会支持。对分析进行加权，以产生具有人口代表性的估计数。在调查受访者中，17.0%的人报告说，自危机以来，物质的使用导致了他们的家庭，工作或社交生活出现问题，其中11.2%的人不顾医生的警告使用物质会损害他们的健康，12.3%的人在工作或上学时使用物质，10.7%的人在大量使用物质后经历了停电。自危机以来，共有61.6%的受访者报告使用酒精，32.4%使用大麻，5.2%使用海洛因，甲基苯丙胺或非处方阿片类药物。认为接触受污染的水损害其身体健康的受访者更有可能使用损害其日常生活的物质（RR = 1.32，95%CI：1.03-1.70），既往有潜在创伤暴露的受访者也是如此（RR = 2.99，95%CI：1.90-4.71）、低社会支持（RR = 1.94，95%CI：1.41-2.66）、PTSD和抑郁（RR分别为1.78和1.49，p值< 0.01）。在被剥夺公民权的社区发生的公共工程灾难可能与物质使用困难有着复杂的长期联系。
Public works environmental disasters such as the Flint water crisis typically occur in disenfranchised communities with municipal disinvestment and co-occurring risks for poor mental health (poverty, social disconnection). We evaluated the long-term interplay of the crisis and these factors with substance use difficulties five years after the crisis onset. A household probability sample of 1970 adults living in Flint during the crisis was surveyed about their crisis experiences, use of substances since the crisis, and risk/resilience factors, including prior potentially traumatic event exposure and current social support. Analyses were weighted to produce population-representative estimates. Of the survey respondents, 17.0% reported that substance use since the crisis contributed to problems with their home, work, or social lives, including 11.2% who used despite a doctor’s warnings that it would harm their health, 12.3% who used while working or going to school, and 10.7% who experienced blackouts after heavy use. A total of 61.6% of respondents reported using alcohol since the crisis, 32.4% using cannabis, and 5.2% using heroin, methamphetamine, or non-prescribed prescription opioids. Respondents who believed that exposure to contaminated water harmed their physical health were more likely to use substances to the detriment of their daily lives (RR = 1.32, 95%CI: 1.03–1.70), as were respondents with prior potentially traumatic exposure (RR = 2.99, 95%CI: 1.90–4.71), low social support (RR = 1.94, 95%CI: 1.41–2.66), and PTSD and depression (RR’s of 1.78 and 1.49, respectively, p-values < 0.01). Public works disasters occurring in disenfranchised communities may have complex, long-term associations with substance use difficulties.