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Background Depression is a common and potentially debilitating consequence of traumatic events. Mass traumatic events cause wide-ranging disruptions to community characteristics, influencing the population risk of depression. In the aftermath of such events, population displacement is common. Stressors associated with displacement may increase risk of depression directly. Indirectly, persons who are displaced may experience erosion in social cohesion, further exacerbating their risk for depression. Methods Using data from a population-based cross-sectional survey of adults living in the 23 southernmost counties of Mississippi (N = 708), we modeled the independent and joint relations of displacement and county-level social cohesion with depression 18–24 months after Hurricane Katrina. Results After adjustment for individual- and county-level sociodemographic characteristics and county-level hurricane exposure, joint exposure to both displacement and low social cohesion was associated with substantially higher log-odds of depression (b = 1.34 [0.86–1.83]). Associations were much weaker for exposure only to low social cohesion (b = 0.28 [−0.35–0.90]) or only to displacement (b = 0.04 [−0.80– 0.88]). The associations were robust to additional adjustment for individually perceived social cohesion and social support. Conclusion Addressing the multiple, simultaneous disruptions that are a hallmark of mass traumatic events is important to identify vulnerable populations and understand the psychological ramifications of these events.

Background The neighborhood distribution of education (education inequality) may influence substance use among neighborhood residents. Methods Using data from the New York Social Environment Study (conducted in 2005; n=4,000), we examined the associations of neighborhood education inequality (measured using Gini coefficients of education) with alcohol use prevalence and levels of alcohol consumption among alcohol users. Analyses were adjusted for neighborhood education level, income level, and income inequality, as well as for individual demographic and socioeconomic characteristics and history of drinking prior to residence in the current neighborhood. Neighborhood social norms about drinking were examined as a possible mediator. Results In adjusted generalized estimating equation regression models, one-standard-deviationhigher education inequality was associated with 1.18 times higher odds of alcohol use (logistic regression odds ratio = 1.18, 95% confidence interval 1.08–1.30) but 0.79 times lower average daily alcohol consumption among alcohol users (Poisson regression relative rate = 0.79, 95% confidence interval 0.68–0.92). The results tended to differ in magnitude depending on respondents’ individual educational levels. There was no evidence that these associations were mediated by social drinking norms, although norms did vary with education inequality. Conclusions Our results provide further evidence of a relation between education inequality and drinking behavior while illustrating the importance of considering different drinking outcomes and heterogeneity between neighborhood subgroups. Future research could fruitfully consider other potential mechanisms, such as alcohol availability or the role of stress; research that considers multiple mechanisms and their combined effects may be most informative.