Residential natural hazard risk and mental health effects.

Mental health effects are frequently reported following natural disasters. However, little is known about effects of living in a hazard-prone region on mental health. We analyzed data from 9,312 Gulf Long-term Follow-up Study participants who completed standardized mental health questionnaires including the Patient Health Questionnaire-9 (depression=score≥10), Generalized Anxiety Disorder Questionnaire-7 (anxiety=score≥10), and Primary Care PTSD Screen (PTSD=score≥3). Geocoded residential addresses were linked to census-tract level natural hazard risk scores estimated using the National Risk Index (NRI). We considered an overall risk score representing 18 natural hazards, and individual scores for hurricanes, heatwaves, coastal flooding and riverine flooding. Log binomial regression estimated prevalence ratios (PR) and 95% confidence intervals (CI) for associations between risk scores (quartiles) and mental health outcomes. Increasing hurricane and coastal flooding scores were associated with all mental health outcomes in a suggestive exposure-response manner. Associations were strongest for PTSD, with PRs for the highest vs. lowest quartile of hurricane and coastal flooding risks of 2.29(1.74-3.01) and 1.59(1.23-2.05), respectively. High heatwave risk was associated with anxiety (PR=1.25(1.12-1.38)) and depression (PR=1.19(1.04-1.36)) and suggestively with PTSD (PR=1.20(0.94-1.52)). Results suggest that living in areas prone to natural disasters is one factor associated with poor mental health status.

Examining the effects of cumulative environmental stressors on Gulf Coast child and adolescent health.

This study examines how community-level cumulative environmental stress affects child and adolescent emotional distress and chronic health conditions both directly and indirectly through stressors at the household, family, and individual levels. Data comes from the Women and their Children's Health (WaTCH) Study, which sought to understand the health implications of exposure to the 2010 Deepwater Horizon oil spill (DHOS) among a cohort of 596 mothers with children ages 10 to 17 in southeastern Louisiana. Community-level environmental stress was measured using a newly developed geospatial index. Household-level stressors included previous hurricane impacts, impacts of DHOS, degree of financial difficulty, and degree of housing physical decay. Family stressors included maternal depression, self-rated physical health, and degree of parenting stress. Child stress was based on perceived stress; child mental health was based on serious emotional disturbance; and child physical health was based on diagnosis of chronic illness. Structural equation modeling used weighted least squares means and variance and theta parameterization. Results showed a significant negative direct path between community-level cumulative environmental stress and child/adolescent serious emotional disturbance and chronic illness. However, the indirect relationship through household, family, and individual-level stressors was significant and positive for both child/adolescent serious emotional disturbance and chronic illness. These findings point to the centrality of the household and family in determining child and adolescent physical and mental health outcomes in communities exposed to frequent disasters and ongoing environmental stressors.

Degree and direction of overlap between social vulnerability and community resilience measurements.

An ongoing debate in academic and practitioner communities, centers on the measurement similarities and differences between social vulnerability and community resilience. More specifically, many see social vulnerability and community resilience measurements as conceptually and empirically the same. Only through a critical and comparative assessment can we ascertain the extent to which these measurement schemas empirically relate to one another. This paper uses two well-known indices-the social vulnerability index (SoVI) and the Baseline Resilience Indicators for Communities (BRIC) to address the topic. The paper employs spatio-temporal correlations to test for differences or divergence (negative associations) and similarities or convergence (positive associations), and the degree of overlap. These tests use continental U.S. counties, two timeframes (2010 and 2015), and two case study sub-regions (to identify changes in measurement associations going from national to regional scales given the place-based nature of each index). Geospatial analytics indicate a divergence with little overlap between SoVI and BRIC measurements, based on low negative correlation coefficients (around 30%) for both time periods. There is some spatial variability in measurement overlap, but less than 2% of counties show hot spot clustering of correlations of more than 50% in either year. The strongest overlap and divergence in both years occurs in few counties in California, Arizona, and Maine. The degree of overlap in measurements at the regional scale is greater in the Gulf Region (39%) than in the Southeast Atlantic region (21% in 2010; 28% in 2015) suggesting more homogeneity in Gulf Coast counties based on population and place characteristics. However, in both study areas SoVI and BRIC measurements are negatively associated. Given their inclusion in the National Risk Index, both social vulnerability and resilience metrics are needed to interpret the local community capacities in natural hazards risk planning, as a vulnerable community could be highly resilient or vice versa.

A spatial assessment of prostate cancer mortality-to-incidence ratios among South Carolina veterans: 1999-2015.

PURPOSE: To assess veteran-specific prostate cancer (PrCA) mortality-to-incidence ratios (MIR) in South Carolina's (SC) veteran population. METHODS: U.S. Veterans Health Administration electronic medical records from January 1999 to December 2015 identified 3,073 PrCA patients residing in 345 ZIP code tabulation areas (ZCTA) within SC. MIRs were calculated for all SC ZCTAs and by key patient- and neighborhood-level risk factors for PrCA. Comparisons between ZCTAs identified as part of a spatial cluster were compared with non-significant ZCTAs using t tests. RESULTS: The MIR was 0.17 overall, ranging from a low of 0.15 among Black men to 0.20 among White men. Among metropolitan ZCTAs, the MIR was 0.18 compared to 0.16 in non-metropolitan ZCTAs. Two clusters of higher-than-expected MIRs were found in the Upstate region. CONCLUSIONS: Identification of spatial clusters of higher- or lower-than-expected MIRs allows for further testing of possible explanatory factors, and the capacity to target resources and policies according to greatest need.

Methodological challenges to confirmatory latent variable models of social vulnerability.

Socially vulnerable communities experience disproportionately negative outcomes following natural disasters and underscoring a need for well-validated measures to identify those at risk. However, questions have surfaced regarding the factor structure, internal consistency, and generalizability of social vulnerability measures. A reliance on data-driven techniques, which are susceptible to sample-specific characteristics, has likely exacerbated the difficulty generalizing social vulnerability measures across contexts. This study sought to validate previously published structures of SoVI using confirmatory factor analysis (CFA). We fit CFA models of 28 sociodemographic variables frequently used to calculate a commonly used measure, the social vulnerability index (SoVI), drawn from the American Community Survey across 4162 census tracts in Florida. Confirmatory models generally did not support theory-driven pillars of SoVI that were previously used to study vulnerability in the New York metropolitan area. Modified models and alternative SoVI factor structures also failed to fit the data. Many of the input variables displayed little to no variability, limiting their utility and explanatory power. Taken together, our results highlight the poor generalizability of SoVI across contexts, but raise several important considerations for reliability and validity, as well as issues related to source data and scale. We discuss the implications of these findings for improved theory-driven measurement of social vulnerability.

Natural hazards and mental health among US Gulf Coast residents.

BACKGROUND: Individuals affected by disasters are at risk for adverse mental health sequelae. Individuals living in the US Gulf Coast have experienced many recent major disasters, but few studies have explored the cumulative burden of experiencing multiple disasters on mental health. OBJECTIVE: The objective of this study was to evaluate the relationship between disaster burden and mental health. METHODS: We used data from 9278 Gulf Long-term Follow-up Study participants who completed questionnaires on perceived stress, anxiety, depression, and post-traumatic stress disorder (PTSD) in 2011-2013. We linked 2005-2010 county-level data from the Spatial Hazard Events and Losses Database for the United States, a database of loss-causing events, to participant's home address. Exposure measures included total count of loss events as well as severity quantified as property/crop losses per capita from all hazards. We used multilevel modeling to estimate odds ratios (OR) and 95% confidence intervals (CI) for each exposure-outcome relationship. RESULTS: Total count of loss events was positively associated with perceived stress (ORQ4:1.40, 95% CI:1.21-1.61) and was inversely associated with PTSD (ORQ4:0.66, 95% CI:0.45-0.96). Total duration of exposure was also associated with stress (ORQ4:1.16, 95% CI:1.01-1.33) but not with other outcomes. Severity based on cumulative fatalities/injuries was associated with anxiety (ORQ4:1.31, 95% CI:1.05-1.63) and stress (ORQ4:1.34, 95% CI:1.15-1.57), and severity based on cumulative property/crop losses was associated with anxiety (ORQ4:1.42, 95% CI:1.12-1.81), depression (ORQ4:1.22, 95% CI:0.95-1.57) and PTSD (ORQ4:1.99, 95% CI:1.44-2.76).

Characterization of Florida, U.S. landfills with elevated temperatures.

The occurrence of elevated temperatures within landfills is a challenging issue for landfill operators to detect and correct. Little is known regarding the causes of elevated temperatures (ETs) or the number of landfills currently operating under such conditions. Therefore, the goal of this research was to determine which landfills within Florida have been impacted by ETs, and to develop a more complete understanding of the factors that may lead to these landfills becoming elevated temperature landfills (ETLFs). Historical landfill gas wellhead data, waste deposition reports, and landfill site geometry were collected for 27 landfill cells through the Florida Department of Environmental Protection electronic document management system, OCULUS database and from landfill operators and owners. These data were evaluated to quantify the characteristics that result in landfills having 'elevated' temperatures. Gas data included landfill gas temperatures and methane, carbon dioxide, and balance gas content. Furthermore, landfill maps were created in ArcGIS to observe spatial distribution of ETs in landfills over time. Upon analysis of the landfill gas wellhead data, it was discovered that 74% of studied landfill cells had ET readings; regulatory limits specify a maximum allowable gas temperature of 55 °C (131 °F). It was discovered that 37% of landfill cells contained MSW ash; of these cells, 90% of them are considered ETLFs. ETLF cells are on-average double the site area and approximately 6 m deeper than the average non-ETLF cell. Furthermore, results suggest that heat propagation in most landfills is limited; however, heat propagation is possible if gas wells are turned off for an extended time period.

Benchmarking Community Disaster Resilience in Nepal.

Building disaster resilience is a stated goal of disaster risk reduction programs. Recent research emphasizes a need for a greater understanding of community disaster response and recovery capacity so that communities can absorb shocks and withstand severe conditions and progress through the recovery period more efficiently. Nepal, which is prone to a multitude of hazards and having recently experienced a large earthquake in 2015, provides a unique opportunity for exploring disaster resilience in the developing world context. To date, no study investigating community disaster resilience across the entire country of Nepal exists. This study quantifies disaster resilience at Nepal's village level, primarily using census data. Guided by the Disaster Resilience of Place (DROP) model, 22 variables were selected as indicators of social, economic, community, infrastructure, and environmental resilience. Community resilience was assessed for 3971 village development communities (VDCs) and municipalities while using a principal component analysis. Additionally, a cluster analysis was performed to distinguish spatial patterns of resilience. Analyses reveal differential community disaster resilience across the country. Communities in the capital city Kathmandu and in the western and far western Hill are relatively resilient. While the entire Tarai region, which holds the greatest proportion of Nepal's population, exhibits relatively low levels of resilience when compared to the rest of the county. The results from this analysis provide empirical evidence with the potential to help decision-makers in the allocation of scarce resources to increase resilience at the local level.

Advancing emergency management higher education: Importance of cultural competence scholarship.

The evolving demographics, needs, and demands of society requires managers to be culturally competent in all phases of emergency management, especially when responding to disasters. A culturally incompetent manager and/or organization can increase a hazard's impact on often already vulnerable communities. Are cultural competencies lacking in emergency management education? Are these competencies as important as other highly regarded emergency management competencies? What are effective pedagogy and andragogy to create, implement, and evaluate cultural competency in emergency management higher education? As scholars work to advance the emergency management discipline, there is an increasing need for scholarship of teaching and learning research, especially regarding cultural competency. This article reviews the existing literature, as well as pedagogy from related disciplines, to identify gaps and provide recommendations for future research.

A GIS Approach to Identifying Socially and Medically Vulnerable Older Adult Populations in South Florida.

Purpose of the Study: We define, map, and analyze geodemographic patterns of socially and medically vulnerable older adults within the tri-county region of South Florida. Design and Methods: We apply principal components analysis (PCA) to a set of previously identified indicators of social and medical vulnerability at the census tract level. We create and map age-stratified vulnerability scores using a geographic information system (GIS), and use spatial analysis techniques to identify patterns and interactions between social and medical vulnerability. Results: Key factors contributing to social vulnerability in areas with higher numbers of older adults include age, large household size, and Hispanic ethnicity. Medical vulnerability in these same areas is driven by disease burden, access to emergency cardiac services, availability of nursing home and hospice beds, access to home health care, and available mental health services. Age-dependent areas of social vulnerability emerge in Broward County, whereas age-dependent areas of medical vulnerability emerge in Palm Beach County. Older-adult social and medical vulnerability interact differently throughout the study area. Implications: Spatial analysis of older adult social and medical vulnerability using PCA and GIS can help identify age-dependent pockets of vulnerability that are not easily identifiable in a populationwide analysis; improve our understanding of the dynamic spatial organization of health care, health care needs, access to care, and outcomes; and ultimately serve as a tool for health care planning.