The Geography of Mental Health and General Wellness in Galveston Bay After Hurricane Ike: A Spatial Epidemiologic Study With Longitudinal Data
The Geography of Mental Health and General Wellness in Galveston Bay After Hurricane Ike: A Spatial Epidemiologic Study With Longitudinal Data
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DOI：
10.1017/dmp.2015.172
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发表时间：
2016-04-01
影响因子：
2.7
通讯作者：
Galea, Sandro
中科院分区：
文献类型：
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作者：
Gruebner, Oliver;Lowe, Sarah R.;Galea, Sandro
目的探讨一种空间流行病学方法，该方法可用于灾难后(1)检测空间聚集性和(2)探索心理健康和一般健康预测因子的地理异质性。方法我们使用飓风艾克幸存者(n=508)的队列研究来评估德克萨斯州加尔维斯顿灾后心理健康(创伤后应激症状(PTSS)和抑郁症的最可能弹性轨迹)和一般健康(PTSS、抑郁、功能障碍和健康不良天数的最可能弹性轨迹)的空间分布。应用空间扫描统计量(SATScan)和地理加权回归。结果发现德克萨斯州北部地区存在高概率健康的空间聚集性，加尔维斯顿岛存在低可能性健康的空间集聚。在健康预测因素中发现了地理差异，受访者距离加尔维斯顿岛加尔维斯顿市越近，这两种健康形式的关联度越高。结论灾后健康预测因素在不同的地理空间可能表现不同，在风险较高的地区集中在可能性较低的健康状况，与预测因素的关联度增加。我们的方法可以被用来提供地理上有针对性的干预措施，以促进受灾社区的心理健康和总体健康。(灾难医学公共卫生准备。2016；10：261-273)
Objectives To demonstrate a spatial epidemiologic approach that could be used in the aftermath of disasters to (1) detect spatial clusters and (2) explore geographic heterogeneity in predictors for mental health and general wellness.Methods We used a cohort study of Hurricane Ike survivors (n=508) to assess the spatial distribution of postdisaster mental health wellness (most likely resilience trajectory for posttraumatic stress symptoms [PTSS] and depression) and general wellness (most likely resilience trajectory for PTSS, depression, functional impairment, and days of poor health) in Galveston, Texas. We applied the spatial scan statistic (SaTScan) and geographically weighted regression.Results We found spatial clusters of high likelihood wellness in areas north of Texas City and spatial concentrations of low likelihood wellness in Galveston Island. Geographic variation was found in predictors of wellness, showing increasing associations with both forms of wellness the closer respondents were located to Galveston City in Galveston Island.Conclusions Predictors for postdisaster wellness may manifest differently across geographic space with concentrations of lower likelihood wellness and increased associations with predictors in areas of higher exposure. Our approach could be used to inform geographically targeted interventions to promote mental health and general wellness in disaster-affected communities. (Disaster Med Public Health Preparedness. 2016;10:261-273)