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. 2022 Dec 14;7(1):e232.
doi: 10.1097/EE9.0000000000000232. eCollection 2023 Feb.

Manmade earthquakes and healthcare visits for anxiety disorders in Oklahoma, 2010-2019

Holly Elser  1   2 , Arielle Kempinsky  3 , Sidra Goldman-Mellor  4 , Maggie Li  5 , Ralph Catalano  6 , David H Rehkopf  7 , Joan A Casey  5
Affiliations

Manmade earthquakes and healthcare visits for anxiety disorders in Oklahoma, 2010-2019

Holly Elser et al. Environ Epidemiol. .

Abstract

Since 2010, seismicity in Oklahoma has increased from wastewater injection. It remains unknown if these earthquakes have resulted in increased treatment seeking for mental healthcare services.

Methods: Using data from a nationwide United States patient-level commercial and Medicare Advantage claims database from 2010 to 2019, we identified healthcare encounters for anxiety disorders using diagnostic codes and subclassified them as adjustment reaction; anxiety-related disorders; physical symptoms of anxiety; and stress disorders. With U.S. Geological Survey Advanced National Seismic System data, we generated county-level 6-month rolling counts of felt earthquakes (≥M 4) and linked them to patient residential county at the time of the healthcare visit. In this repeated measures, individual-level analysis we used generalized estimating equations to estimate the odds of monthly anxiety-related healthcare visits as a function of the frequency of ≥M 4 earthquakes in the previous 6 months.

Results: We identified 4,594 individuals in Oklahoma observed from 2010 to 2019. For every additional five ≥M 4 earthquakes in the preceding 6 months, the odds of healthcare visits for stress disorders increased (odds ratio [OR] = 1.27; 95% confidence interval [CI] = 1.03, 1.57). We found no evidence of an association with adjustment reaction (OR = 1.05; 95% CI = 0.89, 1.23), anxiety-related disorders (OR = 0.96; 95% CI = 0.90, 1.03), or physical symptoms of anxiety (OR = 1.03; 95% CI = 0.98, 1.09).

Conclusions: We report an association between increased frequency of felt earthquakes and treatment seeking for stress disorders. This finding should motivate ongoing study of the potential consequences of the oil and gas industry for mental health outcomes including anxiety disorders.

Keywords: Anxiety; Earthquakes; Fracking; Stress disorders.

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Conflict of interest statement

J.A.C. was supported by the National Institutes of Environmental Health Sciences R00 ES027023 and P30 ES009089 (https://www.niehs.nih.gov/). The other authors have no conflicts to report.

Figures

Figure 1.
Figure 1.
Frequency of ≥ M4 earthquakes and anxiety-related healthcare visits in Oklahoma, 2005–2019. A, Depicts the rate of unique anxiety-related diagnoses per 1,000 individuals for each month of the study period. Monthly rates were calculated using the number of unique individuals eligible for insurance as the denominator and the number of unique diagnoses as the numerator. B, Depicts the number of felt earthquakes (≥ M4) across the state of Oklahoma throughout the study period.
Figure 2.
Figure 2.
Association of frequency of ≥ M4 earthquakes in previous 6 months with anxiety-related diagnoses in Oklahoma, 2005–2019. We used generalized estimating equations to estimate ORs for the association of the frequency of ≥ M4 earthquakes in the previous 6 months with adjustment reaction, anxiety-related disorders, physical symptoms, and stress disorders. We specified an exchangeable working correlation structure to account for potential nonindependence of individuals residing within the same county. Models were adjusted for sex, age group, and included a set of fixed effects for calendar year and season.
See this image and copyright information in PMC

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