Ecological Approaches to Understanding Post-Disaster Distress

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DESCRIPTION (provided by applicant): The purpose of this study is to assess the role that contextual factors (e.g., community-level health and social resources, community socioeconomic status) play in shaping mental health and recovery in the aftermath of a disaster. The notion that community characteristics are important determinants of post disaster functioning was dramatically brought home in much of the public discourse about Hurricane Katrina that focused extensively on the role that underlying socio-economic position, resource availability, and preparedness may have played in the aftermath of this disaster. The proposed research would be the first study, to our knowledge, to provide a full, rigorous, and theoretically-based test of the various pathways through which community-level factors shape individual risk and community rates of psychopathology and adverse behavioral outcomes after disasters. Our broad aim is to demonstrate the utility of an ecological conceptualization of disaster recovery, focusing on individuals' health outcomes such as the occurrence/severity of posttraumatic stress disorder (PTSD), depressive symptoms, and chronic stress. To achieve these aims we will collect both secondary and primary data to describe (A) community characteristics of Mississippi counties before and after the disasters, and (B) sociodemographics, event exposures, and mental health among 1,000 residents of Mississippi. To characterize pre-disaster community resources in ways that are not subject to recall bias, we will assemble a contextual database from publicly available sources, such as the US Census and the Mississippi Development Authority. We will also assemble objective information about community-level exposure and postdisaster community resources, including estimates of need and amounts of FEMA monies awarded. In order to obtain individual-level information, we will select a random sample of 1,000 adults from three geographic areas formed by levels of damage caused by Hurricane Katrina. Using multiple sampling modalities we will sample persons proportional to their representation in the general population before the hurricane and include both persons who were and those who were not evacuated as a result of the hurricane. Key hypotheses will be tested using multi-level hierarchical models and ecologic analyses.