Assessing short-term and long-term mental health effects among older adults after Hurricane Sandy
Assessing short-term and long-term mental health effects among older adults after Hurricane Sandy
复制标题
DOI：
10.1016/j.scitotenv.2022.153753
复制
发表时间：
2022-02-22
影响因子：
9.8
通讯作者：
Lin, Shao
中科院分区：
文献类型：
--
作者：
Begum, Thoin F.;Lin, Ziqiang;Lin, Shao
背景：很少有研究评估灾害对老年人的长期影响。我们检查了老年人在飓风桑迪后是否立即和长期经历了心理健康（MH）影响，以及这些影响是否因社会经济地位（SES），疾病亚型，合并症数量和住院时间而异。研究方法：我们使用纽约州出院数据确定了住院和急诊（艾德）就诊（2001-2015年）的主要诊断为MH疾病的老年患者（≥ 64岁）。我们量化了桑迪飓风后的短期（桑迪后立即）和长期（3个月、1年、2年和3年）影响，并将受影响县的前桑迪时期作为对照期。Poisson回归用于比较桑迪前/后总体和多个分层的MH病例每日计数。调查结果：老年人在桑迪后即刻（32%）、3个月、1年、2年和3年（分别为2%、9%、15%和10%）的MH艾德访视风险显著增加。MH住院人数并未立即增加，但一年后显着增加了8%。男性和SES低的人在桑迪后1-3年发生MH的风险有所延迟，但增加（RR范围：1.14-1。71）。在桑迪之后，最常见的MH亚型是精神病、情绪障碍、物质滥用、自杀和焦虑（RR范围：1.12-2.62）。在桑迪之后，合并症≥ 8的患者从15%增加到> 25%，沿着住院时间。结论：我们发现了桑迪后MH的长期不利影响，特别是在弱势群体中，这可能有助于规划未来的备灾和恢复工作。
Background: Few studies have evaluated the long-term effects of disasters on older adults. We examined if older individuals experienced increased mental health (MH) effects immediately and long-term after Hurricane Sandy and if these effects varied by socioeconomic status (SES), disease subtypes, number of comorbidities, and length of stay. Methods: We identified older patients (>= 64 years) with hospital admissions and Emergency Department (ED) visits (2001-2015) with primary diagnosis of MH diseases using the New York State discharged data. We quan-tified both short-term (immediately post-Sandy) and long-t erm effects (3-month, 1-year, 2-year, and 3-year) following Hurricane Sandy, and used the pre-Sand y period in the affected counties as the control period. Poisson regression was used to compare daily counts of MH cases overall and by multiple strata pre-/post Sandy. Findings: Older individuals had significantly increased risk of MH ED visits immediately (32%), and 3-months, 1, 2, and 3-years after Sandy (2%, 9%, 15%, and 10%, respectively). MH hospital admissions did not increase immediately, but significantly increased by 8% a year later. Males and those with low SES had delayed, but in-creased risks of MH 1-3 years after Sandy (RRs range: 1.14-1. 71). The top MH subtypes after Sandy were psychosis, mood disorders, substance abuse, suicide, and anxiety (RRs range: 1.12-2.62). After Sandy, patients with >= 8 comorbidities increased from 15% to >25%, along with their length of hospital stay. Conclusion: We found long-term adverse effects of MH after Sandy, especially among vulnerable populations, which may help plan future disaster preparedness and recovery efforts.