Oliver Gruebner1, Sarah R Lowe1, Melissa Tracy2, Magdalena Cerdá1, Spruha Joshi1, Fran H Norris3, Sandro Galea4. 1. 1Department of Epidemiology,Mailman School of Public Health,Columbia University,New York,New York. 2. 2Department of Epidemiology and Biostatistics,School of Public Health,University at Albany,State University of New York,Albany,New York. 3. 3Geisel School of Medicine at Dartmouth,Hanover,New Hampshire. 4. 4School of Public Health,Boston University,Boston,Massachusetts.
Abstract
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.
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.
Authors: James M Shultz; Toni Cela; Louis Herns Marcelin; Maria Espinola; Ilva Heitmann; Claudia Sanchez; Arielle Jean Pierre; Cheryl YunnShee Foo; Kip Thompson; Philip Klotzbach; Zelde Espinel; Andreas Rechkemmer Journal: Disaster Health Date: 2016-11-28
Authors: Oliver Gruebner; Sarah R Lowe; Melissa Tracy; Spruha Joshi; Magdalena Cerdá; Fran H Norris; S V Subramanian; Sandro Galea Journal: Sci Rep Date: 2016-08-25 Impact factor: 4.379