Mental Health Aspects of Disasters
From the Fresno Center for Medical Education and Research, University of California, San Francisco School of Medicine, Fresno. Southern medical journal
(Impact Factor: 0.93).
01/2013; 106(1):115-9. DOI: 10.1097/SMJ.0b013e31827cd091
Disaster preparations and responses are incomplete without addressing the mental health aspects of disasters. Unpleasant mental states can be a natural and even adaptive human response following a disaster; however, disasters also can contribute to the development of mental illnesses and substance use disorders or exacerbate existing disorders for disaster survivors, response personnel, and even families and close contacts of survivors and responders. Disaster-related psychopathology can mimic or negatively affect other disaster-related illnesses and can impair health professionals and others who must respond to catastrophic events; however, disasters also can encourage tremendous human coping, perseverance, and resilience and can even enhance personal and collective feelings of purpose, connection, and meaning. Integrating mental health promotion and care into disaster planning and response has the potential to mitigate psychiatric and medical consequences of a disaster and may preserve the mission readiness of disaster response personnel and promote healing among communities traumatized by disaster.
Available from: Andy Haines
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Health is inextricably linked to climate change. It is important for clinicians to understand this relationship in order to discuss associated health risks with their patients and to inform public policy.Objectives
To provide new US-based temperature projections from downscaled climate modeling and to review recent studies on health risks related to climate change and the cobenefits of efforts to mitigate greenhouse gas emissions.Data Sources, Study Selection, and Data Synthesis
We searched PubMed and Google Scholar from 2009 to 2014 for articles related to climate change and health, focused on governmental reports, predictive models, and empirical epidemiological studies. Of the more than 250 abstracts reviewed, 56 articles were selected. In addition, we analyzed climate data averaged over 13 climate models and based future projections on downscaled probability distributions of the daily maximum temperature for 2046-2065. We also compared maximum daily 8-hour average ozone with air temperature data taken from the National Oceanic and Atmospheric Administration, National Climate Data Center.Results
By 2050, many US cities may experience more frequent extreme heat days. For example, New York and Milwaukee may have 3 times their current average number of days hotter than 32°C (90°F). High temperatures are also strongly associated with ozone exceedance days, for example, in Chicago, Illinois. The adverse health aspects related to climate change may include heat-related disorders, such as heat stress and economic consequences of reduced work capacity; respiratory disorders, including those exacerbated by air pollution and aeroallergens, such as asthma; infectious diseases, including vectorborne diseases and waterborne diseases, such as childhood gastrointestinal diseases; food insecurity, including reduced crop yields and an increase in plant diseases; and mental health disorders, such as posttraumatic stress disorder and depression, that are associated with natural disasters. Substantial health and economic cobenefits could be associated with reductions in fossil fuel combustion. For example, greenhouse gas emission policies may yield net economic benefit, with health benefits from air quality improvements potentially offsetting the cost of US and international carbon policies.Conclusions and Relevance
Evidence over the past 20 years indicates that climate change can be associated with adverse health outcomes. Health care professionals have an important role in understanding and communicating the related potential health concerns and the cobenefits from policies to reduce greenhouse gas emissions.
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ABSTRACT: Disasters have far-reaching and potentially long-lasting effects on youth and families. Research has consistently shown a clear increase in the prevalence of several mental health disorders after disasters, including depression and posttraumatic stress disorder. Widely accessible evidence-based interventions are needed to address this unmet need for youth and families, who are underrepresented in disaster research. Rapid growth in Internet and Smartphone access, as well as several web based evaluation studies with various adult populations has shown that web-based interventions are likely to be feasible in this context and can improve clinical outcomes. Such interventions also are generally cost-effective, can be targeted or personalized, and can easily be integrated in a stepped care approach to screening and intervention delivery. This is a protocol paper that describes an innovative study design in which we evaluate a self-help web-based resource, Bounce Back Now, with a population-based sample of disaster affected adolescents and families. The paper includes description and justification for sampling selection and procedures, selection of assessment measures and methods, design of the intervention, and statistical evaluation of critical outcomes. Unique features of this study design include the use of address-based sampling to recruit a population-based sample of disaster-affected adolescents and parents, telephone and web-based assessments, and development and evaluation of a highly individualized web intervention for adolescents. Challenges related to large-scale evaluation of technology-delivered interventions with high-risk samples in time-sensitive research are discussed, as well as implications for future research and practice.
Copyright © 2014. Published by Elsevier Inc.
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