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The Geography of Mental Health and General Wellness in Galveston Bay After Hurricane Ike: A Spatial Epidemiologic Study With Longitudinal Data

Published online by Cambridge University Press:  28 January 2016

Oliver Gruebner ,
Sarah R. Lowe ,
Melissa Tracy ,
Magdalena Cerdá ,
Spruha Joshi ,
Fran H. Norris  and
Sandro Galea
Oliver Gruebner*
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
Sarah R. Lowe
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
Melissa Tracy
Affiliation:
Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Albany, New York
Magdalena Cerdá
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
Spruha Joshi
Affiliation:
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
Fran H. Norris
Affiliation:
Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
Sandro Galea
Affiliation:
School of Public Health, Boston University, Boston, Massachusetts.
*
Correspondence and reprint requests to Oliver Gruebner, Columbia University, Mailman School of Public Health, Department of Epidemiology, 722 West 168th Street, New York, NY (e-mail: gruebner@hsph.harvard.edu).
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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. (Disaster Med Public Health Preparedness. 2016;10:261–273)

Keywords

natural disastersgeographic mappingmental disorderspsychological resiliencepost-traumatic stress disorders
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 10 , Supplement 2 , April 2016 , pp. 261 - 273
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2016 

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