Natural and anthropogenic disasters are large-scale traumatic events that often lead to the unanticipated destruction of property and death [1]. These hazards threaten large groups of people and disrupt access to services and resources. Yearly, 90,000 people are killed in hazardous events, and approximately 160 million people are impacted worldwide [2]. Natural disasters are increasingly becoming commonplace due to climate change and population pressures [3]. The state of Texas is particularly vulnerable to natural disasters and is ranked first in the United States due to the immense variety and frequency of them [4]. Every year in Texas, at least one major disaster is declared [4]. This study aims to analyze the impact of repeated exposures to hazard disasters on mental health for the population in the Houston Metropolitan Statistical Area (HMSA), Texas.
Disasters are typically categorized into different types, which include natural disasters (i.e., hurricanes), anthropogenic disasters (human-made), non-intentional technological disasters (i.e., natural gas explosions), and intentional acts such as terrorist attacks. Studies claim that the type of disaster influences the gravity of the affected populations' mental health consequences [5]. Relief response after disasters customarily focuses on the physical; however, there is an increased understanding of the importance of providing mental health support [6]. Specific mental health concerns that present themselves after disasters include anxiety, post-traumatic stress disorder (PTSD), depression, substance abuse, and non-disordered psychological stress [7]. A majority of individuals demonstrate signs of emotional disturbance after a disaster [8]. Researchers have found that the prevalence of mental health problems in populations experiencing a disaster is higher by two to three times compared to the general population [9]. People that live in disaster-prone areas and experience more than one event have more significant adverse health effects, leading to “chronic disaster syndrome” [10]. The term signifies the physiological and psychological effects that arise because of the repeated social disruption and the socioeconomic and political conditions produced by these incidents [10].
In 1951, Tyhurst defined psychological responses to disasters in phases, including a “period of impact, a period of recoil, and a posttraumatic period” [8, 11–12]. The “period of impact” is the initial exposure to stressors associated with experiencing a disaster whereas the “period of recoil” occurs when an individual can bounce-back. The last phase, “post-traumatic period”, occurs when an individual becomes aware of the immense toll a disaster may have on their individual lives, such as destroyed homes, belongings, financial security, and the death of a loved one [12]. Some individuals are recovering from a disaster, unable to move from one phase to another, experience lifelong adverse effects on their mental health and well-being.
Researchers Goldmann and Galea (2014) state that several pre-disaster risk factors are indicators of post-disaster mental illness. These risk factors include prior mental health problems, gender, and younger age [11]. Additionally, a history of mental illness is a strong predictor of successive episodes of both depressive and anxiety disorders [13]. Researchers agree that the psychological effects experienced after a disaster are likely to be more severe among children, females, and dependent elderly populations [14]. Young children under the age of eight are at risk for mental health issues after disasters and experience anxiety, fear, difficulty sleeping and concentrating, irritability, and outbursts of anger [15].
Maclean, Popovici, and French (2016) suggest that children who experience a natural disaster by age five will likely experience adverse mental health and substance use outcomes in their lifetimes [16]. Yet, others indicate that older populations are amongst the most vulnerable due to natural disasters' direct impact [17]. After Hurricane Charley, a rapid needs assessment indicated that one-third of households had at least one adult with a pre-existing condition that worsened due to the hurricane [18]. Mental health effects of elderly populations may worsen after disasters owing to pre-existing feelings of powerlessness brought on by changes in health, mobility, and sensory awareness [19]. Residential evacuation may compound feelings of stress, uncertainty, and confusion for this population specifically [19, 20].
Disadvantaged populations that are physically, economically, culturally, politically, or otherwise are particularly vulnerable to experiencing disasters [21]. Results from the National Comorbidity Survey showed that 18.9 percent of men and 15.2 percent of women reported a lifetime experience of a disaster [22]. Most studies concentrate on adults who were direct victims of the disaster. An analysis of PTSD of Turkish earthquake survivors suggested that females had higher rates (34.8%) of PTSD compared to males (19.1%) [23]. According to a study that examined recovery from PTSD following Hurricane Katrina, 17.1% of respondents had a history of estimated hurricane-related PTSD at baseline, and 29.2% after the follow-up survey was administered [24].