Prevalence and Predictors of Mental Health Distress Post-Katrina: Findings From the Gulf Coast Child and Family Health Study

¹ Dr Abramson is the Director of Research, Ms Stehling-Ariza is a research associate, and Dr Redlener is the Director of the National Center for Disaster Preparedness, Columbia University Mailman School of Public Health; Dr Garfield is the Henrik H. Bendixen Professor of Clinical International Nursing in the Columbia University School of Nursing.

^* To whom correspondence should be addressed. E-mail: dma3{at}columbia.edu.

	Abstract

Background: Catastrophic disasters often are associated with massive structural, economic, and population devastation; less understood are the long-term mental health consequences. This study measures the prevalence and predictors of mental health distress and disability of hurricane survivors over an extended period of recovery in a postdisaster setting.

Methods: A representative sample of 1077 displaced or greatly affected households was drawn in 2006 using a stratified cluster sampling of federally subsidized emergency housing settings in Louisiana and Mississippi, and of Mississippi census tracts designated as having experienced major damage from Hurricane Katrina in 2005. Two rounds of data collection were conducted:a baseline face-to-face interview at 6 to 12 months post-Katrina, and a telephone follow-up at 20 to 23 months after the disaster. Mental health disability was measured using the Medical Outcome Study Short Form 12, version 2 mental component summary score. Bivariate and multivariate analyses were conducted examining socioeconomic, demographic, situational, and attitudinal factors associated with mental health distress and disability.

Results: More than half of the cohort at both baseline and follow-up reported significant mental health distress. Self-reported poor health and safety concerns were persistently associated with poorer mental health. Nearly 2 years after the disaster, the greatest predictors of poor mental health included situational characteristics such as greater numbers of children in a household and attitudinal characteristics such as fatalistic sentiments and poor self-efficacy. Informal social support networks were associated significantly with better mental health status. Housing and economic circumstances were not independently associated with poorer mental health.

Conclusions: Mental health distress and disability are pervasive issues among the US Gulf Coast adults and children who experienced long-term displacement or other serious effects as a result of Hurricanes Katrina and Rita. As time progresses postdisaster, social and psychological factors may play greater roles in accelerating or impeding recovery among affected populations. Efforts to expand disaster recovery and preparedness policies to include long-term social re-engagement efforts postdisaster should be considered as a means of reducing mental health sequelae.

Key Words: mental health, social-ecological model, longitudinal cohort, Hurricane Katrina

This article has been cited by other articles:

				F. M. Burkle Jr, J. Bass, and P. Bolton Becoming Responsible in a "Socially Seismic" Environment: Mental Health as a Marker of Community Recovery Disaster Med Public Health Preparedness, June 1, 2008; 2(2): 73 - 74. [Full Text] [PDF]