The geography of post-disaster mental health: spatial patterning of psychological vulnerability and resilience factors in New York City after Hurricane Sandy.
The geography of post-disaster mental health: spatial patterning of psychological vulnerability and resilience factors in New York City after Hurricane Sandy.
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DOI：
10.1186/s12942-015-0008-6
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发表时间：
2015-06-10
影响因子：
4.9
通讯作者：
Galea S
中科院分区：
文献类型：
--
作者：
Gruebner O;Lowe SR;Sampson L;Galea S
只有很少的研究调查了自然或人为灾害后心理弹性和相关心理健康结果的地理分布。这些信息对于旨在促进灾后恢复的基于地点的干预措施至关重要。因此，本研究的目的是调查（1）纽约市受飓风桑迪影响人群的创伤后应激（PTS）和抑郁的地理变异性，以及（2）纽约市各行政区受影响地区的心理脆弱性和弹性因素。横截面电话调查数据收集13至16个月后，从家庭居民（N = 418成年人）在纽约市社区，受飓风影响最严重。创伤后应激量表（PCL-5）用于测量创伤后应激，九项患者健康问卷（PHQ-9）用于测量抑郁。我们应用空间自相关和空间制度回归分析，以测试心理健康结果的空间集群，并探讨脆弱性和弹性因素与心理健康之间的关联是否在纽约市的五个行政区之间存在差异。心理健康问题主要集中在地理上更容易暴露在海洋中的社区，这表明在行政区内和行政区之间存在风险的空间变化。我们进一步发现，脆弱性和弹性因素与心理健康之间的关联存在显着差异。种族/民族（亚洲或非西班牙裔黑人）和灾难相关的压力因素是皇后区心理健康症状的脆弱性因素，而在曼哈顿和斯塔顿岛，就业和结婚是这些症状的弹性因素。此外，父母身份是布鲁克林的一个脆弱因素，也是布朗克斯的一个弹性因素。我们的结论是，解释性特征可能表现为心理脆弱性和弹性因素不同，在不同的区域背景。我们的空间流行病学方法可以推广到地球仪的其他区域，而且鉴于气候的变化，可以用来加强灾前最有可能出现不利后果的人口群体的心理社会资源。在灾难发生后，该方法可用于确定面临最大风险的幸存者，并计划有针对性的干预措施，以帮助他们。
Only very few studies have investigated the geographic distribution of psychological resilience and associated mental health outcomes after natural or man made disasters. Such information is crucial for location-based interventions that aim to promote recovery in the aftermath of disasters. The purpose of this study therefore was to investigate geographic variability of (1) posttraumatic stress (PTS) and depression in a Hurricane Sandy affected population in NYC and (2) psychological vulnerability and resilience factors among affected areas in NYC boroughs. Cross-sectional telephone survey data were collected 13 to 16 months post-disaster from household residents (N = 418 adults) in NYC communities that were most heavily affected by the hurricane. The Posttraumatic Stress Checklist for DSM-5 (PCL-5) was applied for measuring posttraumatic stress and the nine-item Patient Health Questionnaire (PHQ-9) was used for measuring depression. We applied spatial autocorrelation and spatial regimes regression analyses, to test for spatial clusters of mental health outcomes and to explore whether associations between vulnerability and resilience factors and mental health differed among New York City’s five boroughs. Mental health problems clustered predominantly in neighborhoods that are geographically more exposed towards the ocean indicating a spatial variation of risk within and across the boroughs. We further found significant variation in associations between vulnerability and resilience factors and mental health. Race/ethnicity (being Asian or non-Hispanic black) and disaster-related stressors were vulnerability factors for mental health symptoms in Queens, and being employed and married were resilience factors for these symptoms in Manhattan and Staten Island. In addition, parental status was a vulnerability factor in Brooklyn and a resilience factor in the Bronx. We conclude that explanatory characteristics may manifest as psychological vulnerability and resilience factors differently across different regional contexts. Our spatial epidemiological approach is transferable to other regions around the globe and, in the light of a changing climate, could be used to strengthen the psychosocial resources of demographic groups at greatest risk of adverse outcomes pre-disaster. In the aftermath of a disaster, the approach can be used to identify survivors at greatest risk and to plan for targeted interventions to reach them.
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影响因子：
5.8
作者：
BREUSCH, TS;PAGAN, AR
通讯作者：
PAGAN, AR
影响因子：
3.6
作者：
ANSELIN, L
通讯作者：
ANSELIN, L
影响因子：
1.9
作者：
Kelejian, HH;Prucha, IR
通讯作者：
Prucha, IR
影响因子：
2.3
作者：
Anselin, L;Kelejian, HH
通讯作者：
Kelejian, HH
影响因子：
--
作者：
Galea, Sandro;Brewin, Chris R.;Kessler, Ronald C.
通讯作者：
Kessler, Ronald C.