Aging and Emotional Well-Being After Disasters: Vulnerability and Resilience.

BACKGROUND AND OBJECTIVES: Climate change threatens well-being and has increased the prevalence of weather-related disasters. We investigated age differences in emotional well-being among adults who had experienced hurricane-related, unavoidable stressors. Socioemotional selectivity theory (SST) posits that age-related motivational shifts buffer older adults against psychological distress, whereas the strength and vulnerability integration model (SAVI) posits that unavoidable stressors are more detrimental to older adults' well-being compared to younger adults. RESEARCH DESIGN AND METHODS: We used existing self-report data from a life-span sample of adults (N = 618, M age = 58.44 years, standard deviation = 16.03, 18-96 years) who resided in the U.S. Gulf Coast region. The sample was recruited in 2016 to examine the sequelae of the Deepwater Horizon oil spill and contacted again after the 2017 and 2018 hurricane seasons. In 2016, participants reported their depression, anxiety, and trauma history. After the 2017-2018 hurricane seasons, participants reported their depression, post-traumatic stress, exposure to hurricane-related adversities, injuries and casualties, self-efficacy, and perceived health. RESULTS: In line with SST, older age was associated with reporting significantly fewer depression and post-traumatic stress disorder symptoms, even after controlling for exposure to hurricane-related adversities, injuries and casualties, health, self-efficacy, pre-hurricane depression, anxiety, and trauma. The association between older age and fewer depression symptoms was stronger among those who experienced hurricane-related adversities compared to those who had not, in contrast to predictions based on SAVI. DISCUSSION AND IMPLICATIONS: We discuss the implications of age-related strengths in emotional well-being for policy and practice in the context of the ongoing climate crisis.

Spatial variation in socio-ecological vulnerability to Covid-19 in the contiguous United States.

The health and economic impacts of the Covid-19 pandemic vary across space because social, economic, health and ecological factors are also spatially variable. Social vulnerability indices are attempts to create a relative ranking of vulnerability to a natural or anthropogenic hazard across space and have been widely used to quantify community vulnerability to natural disasters. Here, we develop a hierarchical socio-ecological vulnerability index that compares counties in the contiguous United States based on 18 variables grouped into four dimensions (ecological, social, health, and economic) in order to capture a range of factors that might contribute to community vulnerability to Covid-19. Variables were chosen based on a review of the emerging literature about the factors associated with poor health outcomes from Covid-19, information about the economic sectors most at risk from the pandemic and pandemic response, and existing social vulnerability indices. We find that socio-ecological vulnerability to Covid-19 and its related economic effects varies across the contiguous U.S., with especially high vulnerability in the Southeast U.S. and especially low vulnerability in the Upper Midwest, Great Plains, and Mountain West.

Persistent Risk-Related Worry as a Function of Recalled Exposure to the Deepwater Horizon Oil Spill and Prior Trauma.

Large oil spills are disasters associated with psychological effects for exposed communities. The amount of worry that individuals experience after a disaster may be influenced by many factors, such as the type and extent of exposure to disaster impacts, prior trauma, and sociodemographic characteristics. This study examined the nature and predictors of worry about ongoing impacts of the 2010 Deepwater Horizon (DH) oil spill reported by Gulf of Mexico coastal residents. A random sample of 2,520 adult residents of Gulf of Mexico coastal counties were administered a telephone survey in 2016, including items about persistent worry and exposure to DH impacts, prior trauma, residence at the time of the spill, and sociodemographic characteristics. Respondents varied in the amount of worry they reported about ongoing health, social, and economic impacts. Controlling for sociodemographic characteristics, higher exposure to the DH oil spill was related to higher levels of worry about ongoing impacts, with past traumatic events related specifically to worry about health impacts. Unexpectedly, those who moved into the region after the spill showed similar levels of worry to residents exposed to the spill, and higher levels than residents who did not recall being exposed to the DH oil spill. This study highlights the impact of the DH oil spill on coastal residents many years after the DH disaster. The findings underscore the need to examine multiple pathways by which individuals experience disasters and for risk researchers to close knowledge gaps about long-term impacts of oil spills within a multi-dimensional framework.

Reaching vulnerable populations in the disaster-prone US Gulf Coast: Communicating across the crisis lifecycle.

Delivering risk and crisis communication to US Gulf Coast residents poses a unique challenge to individual and organizational responders. The region has endured several natural and man-made disasters, spanning Hurricane Katrina, the Deepwater Horizon oil spill, and more recently Hurricanes Harvey and Irma. In the future, the US Gulf Coast is expected to remain susceptible to a range of disasters. At the same time, the region is experiencing a growing population, struggles with systemic disparities between residents, and is home to major energy, tourism, fishing, and shrimping industries. Engaging in pre-crisis planning with vulnerable populations, and assessing response strategies, can help the region prepare for future disasters. In support of understanding vulnerabilities in the US Gulf Coast, the authors conducted a survey in 2016 of n = 2,520 adult residents of the targeted geographic region. The authors examine how demographic characteristics affect communication channel preferences (ie, television, Internet, print [newspapers, magazines], radio, word-of-mouth, or another specified channel) and trust in sources (ie, the national news media, local news media, business leaders and organizations, religious leaders and institutions, academics and academic institutions, friends and family, and doctors) in the US Gulf Coast. Weighted prevalence estimates or similar summary statistics (mean, standard deviation) are provided for both outcomes. Findings for channel preferences and trust in sources are examined by sex, race/ethnicity, age, and education. Weighted multinomial logistic regression is used in a multivariate model. Weighted linear regression is used to examine differences in trust in each source of information. Results highlight significant differences in channel preferences and trust across respondents. The authors also place these results in context to more readily accessible national estimates of these outcomes, emphasizing takeaways for the region.

Reaching vulnerable populations in the disaster-prone US Gulf Coast: Communicating across the crisis lifecycle.

Delivering risk and crisis communication to US Gulf Coast residents poses a unique challenge to individual and organizational responders. The region has endured several natural and man-made disasters, spanning Hurricane Katrina, the Deepwater Horizon oil spill, and more recently Hurricanes Harvey and Irma. In the future, the US Gulf Coast is expected to remain susceptible to a range of disasters. At the same time, the region is experiencing a growing population, struggles with systemic disparities between residents, and is home to major energy, tourism, fishing, and shrimping industries. Engaging in pre-crisis planning with vulnerable populations, and assessing response strategies, can help the region prepare for future disasters. In support of understanding vulnerabilities in the US Gulf Coast, the authors conducted a survey in 2016 of n = 2,520 adult residents of the targeted geographic region. The authors examine how demographic characteristics affect communication channel preferences (ie, television, Internet, print [newspapers, magazines], radio, word-of-mouth, or another specified channel) and trust in sources (ie, the national news media, local news media, business leaders and organizations, religious leaders and institutions, academics and academic institutions, friends and family, and doctors) in the US Gulf Coast. Weighted prevalence estimates or similar summary statistics (mean, standard deviation) are provided for both outcomes. Findings for channel preferences and trust in sources are examined by sex, race/ethnicity, age, and education. Weighted multinomial logistic regression is used in a multivariate model. Weighted linear regression is used to examine differences in trust in each source of information. Results highlight significant differences in channel preferences and trust across respondents. The authors also place these results in context to more readily accessible national estimates of these outcomes, emphasizing takeaways for the region.

Exposure to the Deepwater Horizon Oil Spill, Associated Resource Loss, and Long-Term Mental and Behavioral Outcomes.

OBJECTIVE: The aim of this study was to (1) assess the long-term mental and behavioral health outcomes of the Deepwater Horizon Oil Spill of residents in the Gulf Coast and to (2) identify populations that may be particularly vulnerable to future disasters. METHODS: The Survey of Trauma, Resilience, and Opportunity in Neighborhoods in the Gulf (STRONG) is a population-representative sample of 2520 coastal residents surveyed in Texas, Louisiana, Alabama, Mississippi, and Florida in 2016. We present prevalence estimates for positive screens of depression, anxiety, and alcohol misuse, as well as receipt of health care services. We examine differences in these outcomes across states, affected occupational groups, and demographic groups. RESULTS: Resource loss attributed to the spill was associated with positive screens for depression and anxiety. Almost 50% of adults screened positive for depression, anxiety, or alcohol misuse, but less than 20% of these currently access mental health care. Black residents were less likely to have health insurance and a usual source of care but were more likely to have visited the emergency room in the past 12 months. CONCLUSIONS: Surveillance data from STRONG can help policy-makers and other stakeholders develop targeted approaches to foster resilience, particularly among vulnerable populations, and thereby mitigate the effects of future disasters.

Esophageal sensation in premature human neonates: temporal relationships and implications of aerodigestive reflexes and electrocortical arousals.

Electrocortical arousal (ECA) as an effect of visceral provocation or of its temporal relationships with aerodigestive reflexes in premature neonates is not known. We tested the hypothesis that esophageal provocation results in both esophageal reflex responses and ECAs during sleep and that ECAs are dependent on the frequency characteristics of esophageal neuromotor responses. We defined the spatiotemporal relationship of ECAs in relation to 1) spontaneous pharyngoesophageal swallow sequences and gastroesophageal reflux (GER) events and 2) sensory-motor characteristics of esophageal reflexes. Sixteen healthy premature neonates born at 27.9 ± 3.4 wk were tested at 36.8 ± 1.9 wk postmenstrual age. Ninety-five midesophageal and 31 sham stimuli were given in sleep during concurrent manometry and videopolysomnography. With stimulus onset as reference point, we scored the response latency, frequency occurrence and duration of arousals, peristaltic reflex, and upper esophageal sphincter contractile reflex (UESCR). Changes in polysomnography-respiratory patterns and esophageal sensory-motor parameters were scored by blinded observers. Significantly (for each characteristic listed, P < 0.05), swallow sequences were associated with arousals and sleep state changes, and arousals were associated with incomplete peristalsis, response delays to lower esophageal sphincter relaxation, and prolonged esophageal clearance. GER events (73.5%) provoked arousals, and arousals were associated with response delays to peristaltic reflexes or clearance, sleep state modification, and prolonged respiratory arousal. Midesophageal stimuli (54%) provoked arousals and were associated with increased frequency, prolonged latency, prolonged response duration of peristaltic reflexes and UESCR, and increased frequency of sleep state changes and respiratory arousals. In human neonates, ECAs are provoked upon esophageal stimulation; the sensory-motor characteristics of esophageal reflexes are distinct when accompanied by arousals. Aerodigestive homeostasis is defended by multiple tiers of aerodigestive safety mechanisms, and when esophageal reflexes are delayed, cortical hypervigilance (ECAs) occurs.

Lower esophageal sphincter relaxation reflex kinetics: effects of peristaltic reflexes and maturation in human premature neonates.

We defined the sensory-motor characteristics of the lower esophageal sphincter relaxation (LESR) (stimulus threshold volume, response onset, and relaxation period, relaxation magnitude, nadir) during maturation in human neonates. We hypothesized that LESR kinetics differs during maturation and with peristaltic reflex type. Basal and adaptive esophageal motility testing was performed (N = 20 premature neonates) at 34.7 and 39.1 wk (time 1 and time 2). Effects of midesophageal provocation with graded stimuli (N = 1,267 stimuli, air and liquids) on LESR kinetics during esophagodeglutition response (EDR) and secondary peristalsis (SP) were analyzed by mixed models. Frequency of LESR with basal primary peristalsis were different during maturation (P = 0.03). During adaptive responses with maturation, 1) the frequencies of peristaltic reflexes and LESR were similar; 2) liquid stimuli resulted in a shorter LESR response latency and LESR nadir and greater LESR magnitude (all P < 0.05); 3) media differences were noted with LESR response latency (air vs. liquids, P < 0.02); and 4) infusion flow rate-LESR were different (P < 0.01 for air and liquids). Mechanistically, 1) frequency of LESR was greater during peristaltic reflexes at both times (vs. none, P < 0.0001); 2) LESR response latency, duration, and time to complete LESR were longer with EDR (all P < 0.05, vs. SP at time 2); and 3) graded stimulus volume LESR were different for air and liquids (P < 0.01). In conclusion, sensory-motor characteristics of LESR depend on the mechanosensitive properties of the stimulus (media, volume, flow), type of peristaltic reflex, and postnatal maturation. Maturation modulates an increased recruitment of inhibitory pathways that favor LESR.