The lasting mental health effects of Hurricane Sandy on residents of the Rockaways

Rebecca M. Schwartz, PhD; Patricia Rothenberg, BA; Samantha M. Kerath, MS; Bian Liu, PhD; Emanuela Taioli, MD, PhD

doi:10.5055/jem.2016.0292

Authors

Rebecca M. Schwartz, PhD
Patricia Rothenberg, BA
Samantha M. Kerath, MS
Bian Liu, PhD
Emanuela Taioli, MD, PhD

DOI:

https://doi.org/10.5055/jem.2016.0292

Keywords:

Rockaways, mental health, substance use, Hurricane Sandy

Abstract

Objective: To examine the impact of Hurricane Sandy on the mental health and substance use of residents of the Rockaways, which is a lower income, ethnically diverse region of NYC that was devastated by the hurricane.

Design: Prospective, cross sectional.

Setting: Rockaways, Queens, NYC community residents.

Participants: From October 2013 to April 2015, 407 adult residents of the Rockaways completed self-report, validated measures of depression, anxiety, and post-traumatic stress symptoms as well as indicators of substance use (alcohol, illicit substance, and tobacco use) and exposure to Hurricane Sandy.

Main Outcome Measures: Depression, anxiety, post-traumatic stress, alcohol use, illicit substance use, and tobacco use.

Results: Differences in exposure scores on outcomes were compared using Wilcoxon tests. Associations between hurricane exposure (categorized into “personal” and “property” exposure) and outcomes were investigated using logistic regression, adjusting for demographic covariates, mental health history, and time since hurricane. The study participants were predominately female (57.5 percent) and black (63.9 percent) and average age was 44.7 years. Multivariable results showed that property exposure scores were positively associated with increased risks of mental health difficulties across all three mental health symptom outcomes, but not substance use. Increased personal and total exposures were also significantly associated with increased Posttraumatic Stress Disorder symptoms. Substance use variables were not significantly associated with any of the hurricane exposure indicators.

Conclusions: The present study quantifies the lasting impact that Hurricane Sandy has had on the mental health of Rockaways residents indicating the need for continued recovery efforts and increased mental health service provision in this vulnerable region.

Author Biographies

Rebecca M. Schwartz, PhD

Department of Occupational Medicine, Epidemiology and Prevention, Hofstra Northwell School of Medicine, Great Neck, New York

Patricia Rothenberg, BA

Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, New York

Samantha M. Kerath, MS

Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Great Neck, New York; Feinstein Institute for Medical Research, Manhasset, New York.

Bian Liu, PhD

Department of Population Health Science and Policy, Institute for Translational Epidemiology, The Icahn School of Medicine at Mount Sinai, New York, New York

Emanuela Taioli, MD, PhD

Department of Population Health Science and Policy, Institute for Translational Epidemiology, The Icahn School of Medicine at Mount Sinai, New York, New York.

References

CNN: Hurricane Sandy fast facts. Available at http://www.cnn.com/2013/07/13/world/americas/hurricane-sandy-fast-facts/index.html. Assessed June 8, 2015.

Communities NR: Rockaway East, 2014. Available at https://stormrecovery.ny.gov/sites/default/files/crp/community/documents/rockawayeast_nyrcr_plan_29mb.pdf. Assessed June 8, 2015.

Communities NR: Rockaway West, 2014. Available at https://stormrecovery.ny.gov/sites/default/files/crp/community/documents/rockawaywest_nyrcr_plan_27mb.pdf. Assessed June 8, 2015.

Communities NR: Broad Channel, 2014. Available at https://stormrecovery.ny.gov/sites/default/files/crp/community/documents/broadchannel_nyrcr_plan.pdf. Assessed June 8, 2015.

Communities NR: Breezy Point, 2014. Available at https://stormrecovery.ny.gov/sites/default/files/crp/community/documents/breezypoint_nyrcr_plan_20mb.pdf. Assessed June 8, 2015.

St. John's Episcopal Hospital: St. John's Episcopal Hospital recovers from Sandy, 2012. Available at http://www.ehs.org/Press-Center/News/2012/St-Johns-Episcopal-Hospital-Recovers-from-Sandy.aspx. Assessed June 8, 2015.

LeMoine R: TakePart, 2013. Available at http://www.huffingtonpost.com/2013/02/06/rockaway-beach-hurricane-sandy_n_2630918.html. Assessed June 8, 2015.

Jacobson J: A long, for some too slow, health care recovery after Sandy. Am J Nurs. 2013; 113(2): 19-21.

Lien C, Raimo J, Abramowitz J, et al.: Community healthcare delivery post-hurricane Sandy: Lessons from a mobile health unit. J Community Health. 2014; 39(3): 599–605.

Galea S, Nandi A, Vlahov D: The epidemiology of post-traumatic stress disorder after disasters. Epidemiol Rev. 2005; 27: 78-91.

Gros DF, Price M, Gros KS, et al.: Relations between loss of services and psychiatric symptoms in urban and non-urban settings following a natural disaster. J Psychopathol Behav. 2012; 34(3): 343-350.

Neria Y, Nandi A, Galea S: Post-traumatic stress disorder following disasters: A systematic review. Psychol Med. 2008; 38(4): 467-480.

Pietrzak RH, Tracy M, Galea S, et al.: Resilience in the face of disaster: Prevalence and longitudinal course of mental disorders following hurricane Ike. PLoS One. 2012; 7(6): e38964.

Gruebner O, Lowe SR, Sampson L, et al.: The geography of postdisaster mental health: Spatial patterning of psychological vulnerability and resilience factors in New York City after Hurricane Sandy. Int J Health Geogr. 2015; 14: 16.

Rhodes J, Chan C, Paxson C, et al.: The impact of hurricane Katrina on the mental and physical health of low-income parents in New Orleans. Am J Orthopsychiatry. 2010; 80(2): 237-247.

Caramanica K, Brackbill RM, Stellman SD, et al.: Posttraumatic stress disorder after Hurricane Sandy among persons exposed to the 9/11 disaster. Int J Emerg Ment Health. 2015; 17(1): 356-362.

Associated Press: Reminders of 9/11 victims also wiped away by Sandy, 2013. Available at http://www.nj/com/news/index.ssf/2013/09/sandy_also_destroyed_precious_reminders_of_911.html. Assessed June 8, 2016.

Foa EB, Stein DJ, McFarlane AC: Symptomatology and psychopathology of mental health problems after disaster. J Clin Psychiatry. 2006; 67(suppl 2): 15-25.

Green G, Lowe SR, Rhodes JE: What can multiwave studies teach us about disaster research: An analysis of low-income Hurricane Katrina survivors. J Trauma Stress. 2012; 25(3): 299-306.

Beaudoin CE: Hurricane Katrina: Addictive behavior trends and predictors. Public Health Rep. 2011; 126(3): 400-409.

Sastry N, Gregory J: The effect of Hurricane Katrina on the prevalence of health impairments and disability among adults in New Orleans: Differences by age, race, and sex. Soc Sci Med. 2013; 80: 121-129.

Sastry N, VanLandingham M: One year later: Mental illness prevalence and disparities among New Orleans residents displaced by Hurricane Katrina (vol 99, pg S725, 2009). Am J Public Health. 2010; 100(3): 391-392.

Toldson IA, Ray K, Hatcher SS, et al.: Examining the long-term racial disparities in health and economic conditions among Hurricane Katrina survivors: Policy implications for Gulf Coast Recovery. J Black Stud. 2011; 42(3): 360-378.

Schreiber MD, Yin R, Omaish M, et al.: Snapshot from Superstorm Sandy: American Red Cross mental health risk surveillance in lower New York State. Ann Emerg Med. 2014; 64(1): 59-65.

Boscarino JA, Hoffman SN, Kirchner HL, et al.: Mental health outcomes at the Jersey Shore after Hurricane Sandy. Int J Emerg Ment Health. 2013; 15(3): 147-158.

Lowe SR, Sampson L, Gruebner O, et al.: Psychological resilience after Hurricane Sandy: The influence of individual- and community-level factors on mental health after a large-scale natural disaster. PloS one. 2015; 10(5): e0125761.

Norris FH, Perilla JL, Riad JK, et al.: Stability and change in stress, resources, and psychological distress following natural disaster: Findings from hurricane Andrew. Anxiety Stress Coping. 1999; 12(4): 363-396.

Harville EW, Xiong X, Smith BW, et al.: Combined effects of Hurricane Katrina and Hurricane Gustav on the mental health of mothers of small children. J Psychiatric Men Health Nurs. 2011; 18(4): 288-296.

Global Adult Tobacco Survey Collaborative Group: Tobacco Questions for Surveys: A Subset of Key Questions from the Global Adult Tobacco Survey (GATS), 2nd ed., Atlanta, GA: Centers for Disease Control and Prevention, 2011.

National Institute on Alcohol Abuse and Alcoholism: Moderate and binge drinking, Atlanta, GA: NIAAA, 2011. Available at http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking. Accessed January 19, 2013.

Pietrzak RH, Van Ness PH, Fried TR, et al.: Trajectories of posttraumatic stress symptomatology in older persons affected by a large-magnitude disaster. J Psychiatric Res. 2013; 47(4): 520-526.

Leon KA, Hyre AD, Ompad D, et al.: Perceived stress among a workforce 6 months following hurricane Katrina. Soc Psychiatry Psychiatric Epidemiol. 2007; 42(12): 1005-1011.

Weathers F, Litz B, Herman D, et al.: The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Annual Convention of the International Society for Traumatic Stress Studies. October 1993. San Antonio, TX.

Cerda M, Bordelois PM, Galea S, et al.: The course of post-traumatic stress symptoms and functional impairment following a disaster: What is the lasting influence of acute versus ongoing traumatic events and stressors? Soc Psychiatry Psychiatric Epidemiol. 2013; 48(3): 385-395.

Hyre AD, Benight CC, Tynes LL, et al.: Psychometric properties of the Hurricane Coping Self-Efficacy measure following Hurricane Katrina. J Nerv Ment Dis. 2008; 196(7): 562-567.

Kroenke K, Spitzer RL, Williams JB, et al.: An ultra-brief screening scale for anxiety and depression: The PHQ-4. Psychosomatics. 2009; 50(6): 613-621.

Anastario MP, Larrance R, Lawry L: Using mental health indicators to identify postdisaster gender-based violence among women displaced by Hurricane Katrina. J Women's Health. 2008; 17(9): 1437-1444.

Schwartz RM, Sison C, Kerath SM, et al.: The impact of Hurricane Sandy on the mental health of NY area residents. Am J Disaster Med. 2015; 10(4): 339-346.

Galea S, Tracy M, Norris F, et al.: Financial and social circumstances and the incidence and course of PTSD in Mississippi during the first two years after Hurricane Katrina. J Trauma Stress. 2008; 21(4): 357-368.

Kessler RC, Galea S, Gruber MJ, et al.: Trends in mental illness and suicidality after Hurricane Katrina. Mol Psychiatry. 2008; 13(4): 374-384.

Paxson C, Fussell E, Rhodes J, et al.: Five years later: Recovery from post traumatic stress and psychological distress among low-income mothers affected by Hurricane Katrina. Soc Sci Med. 2012; 74(2): 150-157.

Schoenbaum M, Butler B, Kataoka S, et al.: Promoting mental health recovery after hurricanes Katrina and Rita: What can be done at what cost. Arch Gen Psychiatry. 2009; 66(8): 906-914.

Shirra A, Palgi Y, Hamama-Raz Y, et al.: Previous exposure to the World Trade Center terrorist attack and post-traumatic symptoms among older adults following Hurricane Sandy. Psychiatry. 2014; 77(4): 374-385.

Sullivan G, Vasterling JJ, Han X, et al.: Preexisting mental illness and risk for developing a new disorder after hurricane Katrina. J Nerv Ment Dis. 2013; 201(2): 161-166.

Boscarino JA, Hoffman SN, Adams RE, et al.: Mental health outcomes among vulnerable residents after Hurricane Sandy: Implications for disaster research and planning. Am J Disaster Med. 2014; 9(2): 107-120.

Brown S, Parton H, Driver C, et al.: Evacuation during Hurricane Sandy: Data from a rapid community assessment. PLoS Curr. 2016; 8: 1-10.

Rutkow L, Vernick JS, Smon NL, et al.: Translating legal research on mental and behavioral health during emergencies for the public health workforce. Public Health Rep. 2014; 129(suppl 4): 123-128.

Galea S, Brewin CR, Gruber M, et al.: Exposure to hurricane-related stressors and mental illness after Hurricane Katrina. Arch Gen Psychiatry. 2007; 64(12): 1427-1434.

Neria Y, Shultz JM: Mental health effects of Hurricane Sandy: Characteristics, potential aftermath, and response. JAMA. 2012; 308(24): 2571-2572.

Lowe SR, Sampson L, Gruebner O, et al.: Mental health service need and use in the aftermath of Hurricane Sandy: Findings in a population-based sample of New York City residents. Community Ment Health J. 2016; 52(1): 25-31.

Lowe SR, Fink DS, Norris FH, et al.: Frequencies and predictors of barriers to mental health service use: A longitudinal study of Hurricane Ike survivors. Soc Pyschiatry Psychiatr Epidemiol. 2015; 50(1): 99-108.

Hamama-Raz Y, Palgi Y, Shrira A, et al.: Gender differences in psychological reactions to hurricane sandy among New York metropolitan area residents. Psychiatr Q. 2015; 86(2): 285-296.