تاثیر آوارگی مسکن در بهداشت روانی والدین کم درآمد پس از طوفان کاترینا

Previous studies in the aftermath of natural disasters have demonstrated relationships between four dimensions of displacement – geographic distance from the predisaster community, type of postdisaster housing, number of postdisaster moves, and time spent in temporary housing – and adverse psychological outcomes. However, to date no study has explored how these dimensions operate in tandem. The literature is further limited by a reliance on postdisaster data. We addressed these limitations in a study of low-income parents, predominantly non-Hispanic Black single mothers, who survived Hurricane Katrina and who completed pre and postdisaster assessments (N = 392). Using latent profile analysis, we demonstrated three profiles of displacement experiences within the sample: (1) returned, characterized by return to a predisaster community; (2) relocated, characterized by relocation to a new community, and (3) unstably housed, characterized by long periods in temporary housing and multiple moves. Using regression analyses, we assessed the relationship between displacement profiles and three mental health outcomes (general psychological distress, posttraumatic stress, and perceived stress), controlling for predisaster characteristics and mental health indices and hurricane-related experiences. Relative to participants in the returned profile, those in the relocated profile had significantly higher general psychological distress and perceived stress, and those in the unstably housed profile had significantly higher perceived stress. Based on these results, we suggest interventions and policies that reduce postdisaster housing instability and prioritize mental health services in communities receiving evacuees.

Hurricane Katrina, which made landfall near New Orleans, Louisiana on August 29, 2005, caused an unprecedented population displacement. The Hurricane's storm surge inundated coastal communities and caused multiple failures of the protective levees surrounding the City of New Orleans. Floodwaters covered 80% of the City's land and damaged nearly three quarters of residents' homes (Kates et al., 2006). The slow removal of storm debris impeded residents' returns; the least damaged neighborhoods were opened to re-occupancy in late September 2005, but the most devastated neighborhoods were not opened until as late as May 2006. Consequently, the City had recovered only about 50% of its pre-Hurricane population by mid-2006 (Frey et al., 2007). Residents' returns to the City were gradual and unequal by race and class (Fussell et al., 2010). The disaster wrought by Hurricane Katrina had mental health consequences for all affected residents of the Gulf Coast, but especially for New Orleans's residents (e.g., Abramson et al., 2008, Kessler et al., 2008 and Sastry and VanLandingham, 2009). For example, a large epidemiological study found that the prevalence of anxiety-mood disorders and posttraumatic stress disorder among New Orleans's predisaster residents was higher than among those from other affected areas in Louisiana, Alabama, and Mississippi (Galea et al., 2008b and Goto et al., 2006). While stress affects mental health through multiple and interacting pathways, housing stability was found to play an important role after Hurricane Katrina (Abramson et al., 2010).

Our research demonstrates the utility of latent profile analysis to document patterns of postdisaster displacement across four dimensions – geographic distance, type of housing, moves, and time in interim housing. We find that, relative to study participants who had returned to their predisaster home or community, those who had relocated or were unstably housed were at increased risk of adverse mental health outcomes, controlling for predisaster mental health and disaster exposure. Further research exploring the mechanisms underlying the associations between displacement profiles and mental health outcomes is justified by our findings. Our research suggests that postdisaster housing policies that facilitate survivors' return to predisaster homes or communities, reduce postdisaster housing instability, and aid survivors' adjustments to new communities would attenuate the mental health impacts of disasters.