Preliminary Assessment of Hurricane Harvey Exposures and Mental Health Impact

Abstract

Hurricane Harvey made landfall in Houston, Texas on 25 August 2017, the psychological and physical effects of which are still unknown. We assessed hurricane exposure and the immediate mental health needs of the population to define public health priorities for a larger epidemiological study. Convenience sampling was used to recruit participants (n = 41) from the greater Houston area aged ≥18 years. Participants completed a questionnaire about demographics, hurricane exposures, and physical/mental health. Post-Traumatic Stress Disorder (PTSD) was measured with the Post-Traumatic Stress Disorder Checklist-S (PCL-S; a score ≥30 indicated probable PTSD symptoms). The Patient Health Questionnaire-4 (PHQ-4) was used to assess symptoms of depression and generalized anxiety disorder. The average PTSD score was 32.9 (SD = 17.1); a total of 46% of participants met the threshold for probable PTSD. Increased overall hurricane exposure (adjusted odds ratio (ORadj) 1.42; 95% confidence interval (CI): 1.06–2.05) and property-related exposure (ORadj 1.53; 95% CI: 1.07–2.18) were both statistically significantly associated with increased odds of probable PTSD symptoms. A perception of chemical/toxin exposure due to Hurricane Harvey was reported by 44% of participants. A higher number of personal or property exposures were associated with greater mental health symptoms three weeks post-hurricane. This work has implications for the ongoing response to Hurricane Harvey and for assessing the immediate needs of the population.

Hurricane Harvey and Greater Houston households: comparing pre‐event preparedness with post‐event health effects, event exposures, and recovery

“…One literature review estimated the prevalence of PTSD at 30–40 per cent among direct disaster victims, 10–20 per cent among rescue workers, and 5–10 per cent in the general population (Goldmann and Galea, ). Among 41 evacuees at the George R. Brown Convention Center in Houston, 46 per cent had probable PTSD three weeks after Harvey (Schwartz et al, ), exceeding slightly the average reported in Goldmann and Galea (). One year after Katrina, researchers found that 50 per cent of evacuees still in Louisville, Kentucky, were suffering from PTSD (LaJoie, Sprang, and McKinney, ).…”

“…To create the variable, the respondents’ responses to each experience were summed; Table lists the individual items. A similar summed event experience variable was used by Schwartz et al (). A list of 13 adverse experiences in a previous flood disaster study (Collins, Jimenez, and Grineski, ) was modified to make it specific to the Harvey case, including the addition of ‘smelled unpleasant chemical odors’. Home damage extent : the respondents were asked: ‘Was the home you were living in at the time of Hurricane Harvey “completely destroyed”, “seriously damaged”, “damaged to a limited degree”, “damaged to a minor degree”, or “not damaged at all”?’.…”

“…Previous exposure to disasters can lead households to take these sorts of steps so as to be better prepared for the next event (Norris, Smith, and Kaniasty, 2010). When examining Greater Houston after Hurricane Rita in September 2005, researchers reported that 60 per cent of interviewed residents prepared their related effects (such as property damage, financial hardship, familial separation, and/ or a lost pet) (Schwartz et al, 2018).…”

“…To create the variable, the respondents' responses to each experience were summed; Table 5 lists the individual items. A similar summed event experience variable was used by Schwartz et al (2018). A list of 13 adverse experiences in a previous flood disaster study ) was modified to make it specific to the Harvey case, including the addition of 'smelled unpleasant chemical odors'.…”

“…Factors often grouped together under the rubric of social vulnerability are associated with PTSD, such as having a lower income (Lamond, Joseph, and Proverbs, ), being of older or middle age, belonging to a ethnic/racial minority, and having a lower level of education (Gruebner et al, ). Storm‐related challenges have also been associated with PTSD, including more flooding at one's home (Lamond, Joseph, and Proverbs, ), having to relocate permanently (Lamond, Joseph, and Proverbs, ), having more hurricane‐related stressors (such as displacement, absence of electricity, and a decline in income) (Gruebner et al, ), and greater hurricane‐related effects (such as property damage, financial hardship, familial separation, and/or a lost pet) (Schwartz et al, ).…”