Psychological resilience after Hurricane Sandy: the influence of individual- and community-level factors on mental health after a large-scale natural disaster

Abstract

Several individual-level factors are known to promote psychological resilience in the aftermath of disasters. Far less is known about the role of community-level factors in shaping postdisaster mental health. The purpose of this study was to explore the influence of both individual- and community-level factors on resilience after Hurricane Sandy. A representative sample of household residents (N = 418) from 293 New York City census tracts that were most heavily affected by the storm completed telephone interviews approximately 13-16 months postdisaster. Multilevel multivariable models explored the independent and interactive contributions of individual- and community-level factors to posttraumatic stress and depression symptoms. At the individual-level, having experienced or witnessed any lifetime traumatic event was significantly associated with higher depression and posttraumatic stress, whereas demographic characteristics (e.g., older age, non-Hispanic Black race) and more disaster-related stressors were significantly associated with higher posttraumatic stress only. At the community-level, living in an area with higher social capital was significantly associated with higher posttraumatic stress. Additionally, higher community economic development was associated with lower risk of depression only among participants who did not experience any disaster-related stressors. These results provide evidence that individual- and community-level resources and exposure operate in tandem to shape postdisaster resilience.

Fig 1. Map of Sampling Frame.

Fig 2. Maps of Mental Health Outcomes.

Shading represents whether the average symptom scores for participants in each tract fell into the low, medium or high tertile of posttraumatic stress (Fig 2a) and depression (Fig 2b) for the sample.

Fig 3. Maps of Community-Level Resources and Exposure.

Shading represents whether the value for each tract fell into the low, medium or high tertile of economic development (medium household income; Fig 3a), social capital (percentage of residents living alone, with a higher percentage conceptualized as an indicator of lower social capital; Fig 3b), disaster exposure (number of buildings affected, damaged, or destroyed; Fig 3c), and population density (Fig 3d) for the tracts in which survey participants lived prior to Hurricane Sandy.

Fig 4. Illustration of the Cross-Level Interaction between Community-Level Economic Development and Individual-Level Disaster-Related Stessors.

Economic development is indicated by median household income. The figure presents mean levels of depression computed with weighted individual-level data. N = 418.