A Population-Based Assessment of Physical Symptoms and Mental Health Outcomes Among Adults Following the Flint Water Crisis
A Population-Based Assessment of Physical Symptoms and Mental Health Outcomes Among Adults Following the Flint Water Crisis
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DOI：
10.1007/s11524-021-00525-2
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发表时间：
2021-03-31
影响因子：
6.6
通讯作者：
Chase, Elizabeth C.
中科院分区：
文献类型：
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作者：
Ezell, Jerel M.;Chase, Elizabeth C.
2014年4月，由于紧缩政策导致城市更换水源，密歇根州弗林特市发生了水危机，人们对该市以黑人为主的低收入城市成年人的身心健康状况知之甚少。我们使用来自弗林特纵向社区队列的数据来调查这些动态。2019年6月至11月期间，在弗林特的9个公共场所进行了调查。采用嵌套模型来评估受访者人口统计学（包括种族/民族）和临床诊断血铅水平（bll）的自我报告与各种身体症状和心理健康结果(包括抑郁/焦虑（PHQ-4）和心理创伤（PC-PTSD-5）之间的关系。在331名受访者（平均年龄：47.9 + 16.5）中，大多数是女性（58.6%）和黑人（57.7%）。总体而言，10.0%的自我报告的bll升高，黑人的报告显著高于边缘（p = 0.07）。皮疹（58.1%比33.9%,p < 0.01）、脱发（45.5%比30.3%,p = 0.01）和恶心（35.6%比20.2%,p = 0.1）在黑人中明显高于白人。此外，29.0%和26.3%的受访者分别符合创伤和抑郁/焦虑标准。躯体症状加重与心理创伤（OR 2.1, p < 0.01）和抑郁/焦虑（OR 1.9, p < 0.01）相关。最后，弗林特的成年人，尤其是黑人，在城市的水危机之后经历了有害的身心健康后果，这似乎是过量病例的巨大负担。需要进一步研究紧缩政策如何影响经济困难城市的社区卫生，以及如何产生识别和遏制不利后果的能力。
Little is known about the physical and mental health outcomes of adults in the low-income, predominantly Black city of Flint, Michigan, following the city's water crisis which began in April 2014 after austerity policies led to the city switching its water source. We investigate these dynamics using data from a longitudinal community-based cohort in Flint. Between June and November 2019, surveys were administered at nine public sites across Flint. Nested models were employed to assess relationships between respondent demographics, including race/ethnicity, and self-report of clinician-diagnosed blood lead levels (BLLs) and various physical symptoms and mental health outcomes, including depression/anxiety (PHQ-4) and psychological trauma (PC-PTSD-5). Of the 331 respondents (mean age: 47.9 + 16.5), most were women (58.6%) and Black (57.7%). In total, 10.0% self-reported elevated BLLs, with borderline significantly higher reports among Blacks (p = 0.07). Skin rashes (58.1% vs. 33.9%, p < 0.01), hair loss (45.5% vs. 30.3%, p = 0.01), and nausea (35.6% vs. 20.2%, p = 0.1) were significantly higher among Blacks versus Whites. Additionally, 29.0% and 26.3% of respondents met trauma and depression/anxiety criteria, respectively. Increasing physical symptoms was associated with psychological trauma (OR 2.1, p < 0.01) and depression/anxiety (OR 1.9, p < 0.01). In closing, Flint adults, particularly Blacks, experienced deleterious physical and mental health outcomes following the city's water crisis that appear to represent a substantial burden of excess cases. Further research is needed on how austerity impacts community health in economically distressed urban cities and ways to generate capacity to identify and curb adverse consequences.