Florida Hurricanes Research Articles

Posttraumatic Stress Disorder and Mental Distress Following the 2004 and 2005 Florida Hurricanes.

Community characteristics, such as perceived collective efficacy, a measure of community strength, can affect mental health outcomes following disasters. We examined the association of perceived collective efficacy with posttraumatic stress disorder (PTSD) and frequent mental distress (14 or more mentally unhealthy days in the past month) following exposure to the 2004 and 2005 hurricane seasons. Participants were 1486 Florida Department of Health workers who completed anonymous questionnaires that were distributed electronically 9 months after the 2005 hurricane season. Participant ages ranged from 20 to 79 years (mean, 48; SD, 10.7), and the majority were female (79%), white (75%), and currently married (64%). Fifty percent had a BA/BS degree or higher. In 2 separate logistic regression models, each adjusted for individual sociodemographics, community socioeconomic characteristics, individual injury/damage, and community storm damage, lower perceived collective efficacy was significantly associated with a greater likelihood of having PTSD (OR, 0.93; 95% CI, 0.90-0.96), and lower collective efficacy was significantly associated with frequent mental distress (OR, 0.94; 95% CI, 0.92-0.96). Programs enhancing community collective efficacy may be a significant part of prevention practices and possibly lead to a reduction in the rate of PTSD and persistent distress postdisaster. (Disaster Med Public Health Preparedness. 2019;13:44-52).

佛州飓风与加州大火有共同的原因

佛州飓风与加州大火有共同的原因

Depressive Symptom Severity and Community Collective Efficacy following the 2004 Florida Hurricanes.

There is a lack of research investigating community-level characteristics, such as community collective efficacy, mitigating the impact of disasters on psychological health, specifically depression. We examined the association of community collective efficacy with depressive symptom severity in Florida public health workers (n = 2249) exposed to the 2004 hurricane season using a multilevel approach. Cross-sectional anonymous questionnaires were distributed electronically to all Florida Department of Health (FDOH) personnel that assessed depressive symptom severity and collective efficacy nine months after the 2004 hurricane season. Analyses were conducted at the individual level and community level using zip codes. The majority of participants were female (81.9%), and ages ranged from 20 to 78 years (median = 49 years). The majority of participants (73.4%) were European American, 12.7% were African American, and 9.2% were Hispanic. Using multilevel analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with significantly lower depressive symptom severity (b = -0.09 [95% CI: -0.13, -0.04] and b = -0.09 [95% CI: -0.12, -0.06], respectively) even after adjusting for individual sociodemographic variables, community socioeconomic characteristics, individual injury/damage, and community storm damage. Lower levels of depressive symptom severity were associated with communities with high collective efficacy. Our study highlights the possible importance of programs that enrich community collective efficacy for disaster communities.

Posttraumatic Stress Disorder and Community Collective Efficacy following the 2004 Florida Hurricanes

There is a paucity of research investigating the relationship of community-level characteristics such as collective efficacy and posttraumatic stress following disasters. We examine the association of collective efficacy with probable posttraumatic stress disorder and posttraumatic stress disorder symptom severity in Florida public health workers (n = 2249) exposed to the 2004 hurricane season using a multilevel approach. Anonymous questionnaires were distributed electronically to all Florida Department of Health personnel nine months after the 2004 hurricane season. The collected data were used to assess posttraumatic stress disorder and collective efficacy measured at both the individual and zip code levels. The majority of participants were female (80.42%), and ages ranged from 20 to 78 years (median = 49 years); 73.91% were European American, 13.25% were African American, and 8.65% were Hispanic. Using multi-level analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with a lower likelihood of having posttraumatic stress disorder (OR = 0.93, CI = 0.88–0.98; and OR = 0.94, CI = 0.92–0.97, respectively), even after adjusting for individual sociodemographic variables, community socioeconomic characteristic variables, individual injury/damage, and community storm damage. Higher levels of community-level collective efficacy and individual-level collective efficacy were also associated with significantly lower posttraumatic stress disorder symptom severity (b = −0.22, p<0.01; and b = −0.17, p<0.01, respectively), after adjusting for the same covariates. Lower rates of posttraumatic stress disorder are associated with communities with higher collective efficacy. Programs enhancing community collective efficacy may be an important part of prevention practices and possibly lead to a reduction in the rate of posttraumatic stress disorder post-disaster.

Association of CRHR1 variants and posttraumatic stress symptoms in hurricane exposed adults

Posttraumatic stress disorder (PTSD) is a moderately heritable anxiety disorder that may develop after exposure to trauma. However, only few genetic variants that relate to PTSD have been studied. This study examined the relationship between 12 single nucleotide polymorphisms (SNPs) in the corticotropin-releasing hormone receptor 1 gene (CRHR1) and post-disaster PTSD symptoms and diagnosis in adults exposed to 2004 Florida hurricanes. CRHR1 regulates the hypothalamic-pituitary-adrenal (HPA) axis; dysregulation of the HPA axis is characteristic of stress phenotypes. Final analyses were conducted in the European-American (EA) subsample (n=564) due to population stratification. After correction for multiple testing, rs12938031 and rs4792887 remained associated with post-hurricane PTSD symptoms. Additionally, rs12938031 was associated with post-hurricane diagnosis of PTSD. This study is the first to examine CRHR1 in relation to PTSD in adults, and provides evidence for the importance of CRHR1 variation in the etiology of PTSD. Although results are preliminary and require replication, they justify follow-up efforts to characterize how this gene relates to PTSD.

Posttraumatic Stress Disorder, Depression, and Alcohol and Tobacco Use in Public Health Workers After the 2004 Florida Hurricanes

We examined the relationship of probable posttraumatic stress disorder (PTSD), probable depression, and increased alcohol and/or tobacco use to disaster exposure and work demand in Florida Department of Health workers after the 2004 hurricanes. Participants (N = 2249) completed electronic questionnaires assessing PTSD, depression, alcohol and tobacco use, hurricane exposure, and work demand. Total mental and behavioral health burden (probable PTSD, probable depression, increased alcohol and/or tobacco use) was 11%. More than 4% had probable PTSD, and 3.8% had probable depression. Among those with probable PTSD, 29.2% had increased alcohol use, and 50% had increased tobacco use. Among those with probable depression, 34% indicated increased alcohol use and 55.6% increased tobacco use. Workers with greater exposure were more likely to have probable PTSD and probable depression (ORs = 3.3 and 3.06, respectively). After adjusting for demographics and work demand, those with high exposure were more likely to have probable PTSD and probable depression (ORs = 3.21 and 3.13). Those with high exposure had increased alcohol and tobacco use (ORs = 3.01 and 3.40), and those with high work demand indicated increased alcohol and tobacco use (ORs = 1.98 and 2.10). High exposure and work demand predicted increased alcohol and tobacco use, after adjusting for demographics, work demand, and exposure. Work-related disaster mental and behavioral health burden indicate the need for additional mental health interventions in the public health disaster workforce.

Support for association of RORA variant and post traumatic stress symptoms in a population-based study of hurricane exposed adults

Post-traumatic stress disorder (PTSD) is moderately heritable, with estimates ranging from 30 to 70%.1 However, most of the genetic variation accounting for this heritability has yet to be identified, and the majority of molecular studies to date on PTSD have been candidate gene designs.2 Only one genome wide association study of PTSD has been published. In a sample of white non-Hispanic trauma-exposed veterans and their spouses/partners with and without PTSD, Logue and colleagues3 found that one single nucleotide polymorphism (SNP; rs8042149) in the retinoid-related orphan receptor alpha gene (RORA) reached genome-wide significance. RORA has been implicated, in part, in protecting brain cells from the damaging effects of injury, stress and disease,3 and it is possible that individuals with the variation in RORA may be at increased risk for developing PTSD due to deficits in initiating neuroprotective processes after trauma. We sought to provide supporting evidence for the genetic association between RORA*rs8042149 and PTSD using data from the 2004 Florida hurricanes study.

Hurricane Clusters in the Vicinity of Florida

AbstractModels that predict annual U.S. hurricane activity assume a Poisson distribution for the counts. Here the authors show that this assumption applied to Florida hurricanes leads to a forecast that underpredicts both the number of years without hurricanes and the number of years with three or more hurricanes. The underdispersion in forecast counts arises from a tendency for hurricanes to arrive in groups along this part of the coastline. The authors then develop an extension to their earlier statistical model that assumes that the rate of hurricane clusters follows a Poisson distribution with cluster size capped at two hurricanes. Hindcasts from the cluster model better fit the distribution of Florida hurricanes conditional on the climate covariates including the North Atlantic Oscillation and Southern Oscillation index. Results are similar to models that parameterize the extra-Poisson variation in the observed counts, including the negative binomial and the Poisson inverse Gaussian models. The authors argue, however, that the cluster model is physically consistent with the way Florida hurricanes tend to arrive in groups.

Hydrodynamics of the 2004 Florida Hurricanes

Abstract Hagen, S.C.; Bacopoulos, P.; Cox, A.T., and Cardone, V.J., 2012. Hydrodynamics of the 2004 Florida hurricanes. We studied the hydrodynamic response caused by the four major hurricanes that struck Florida's coasts in 2004: Charley, Frances, Ivan, and Jeanne. A large-scale, shallow-water-equation model was applied so as to simulate wind and tidally driven hydrodynamics from the deep ocean into the shelf and coastal waters of Florida. Hurricane Ivan served as the calibration case, where the adjusted parameter was the wind drag coefficient. We identified an “increased” wind drag coefficient to perform best and suggest it as a first approximation to the wave contribution to the hydrodynamics. The increased drag coefficient is offered to the consulting and/or forecasting communities, who are frequently without wave-modeling resources, as a pragmatic approach to approximate for waves. Hurricanes Charley, Frances, and Jeanne serve as the validation cases in which the increased wind drag coefficient was a...

Serotonin transporter gene polymorphism and psychiatric disorders: Is there a link?

Though still in infancy, the field of psychiatric genetics holds great potential to contribute to the development of new diagnostic and therapeutic options to treat these disorders. Among a large number of existing neurotransmitter systems, the serotonin system dysfunction has been implicated in many psychiatric disorders and therapeutic efficacy of many drugs is also thought to be based on modulation of serotonin. Serotonin transporter gene polymorphism is one of the most extensively studied polymorphisms in psychiatric behavioral genetics. In this article, we review the status of evidence for association between the serotonin gene polymorphism and some common mental disorders like affective disorders, post-traumatic stress disorder, obsessive-compulsive disorder, suicide, autism, and other anxiety and personality disorders. Going beyond traditional association studies, gene-environment interaction, currently gaining momentum, is also discussed in the review. While the existing information of psychiatric genetics is inadequate for putting into practice genetic testing in the diagnostic work-up of the psychiatric patient, if consistent in future research attempts, such results can be of great help to improve the clinical care of a vast majority of patients suffering from such disorders.

Interorganizational Network Coordination under Stress Caused by Repeated Threats of Disasters

The study addresses interorganizational learning and coordination as well as their impact on collaborative capacity building in disaster environments. Community coordination requires communication and planning to take necessary precautions in the face of severe threats of disasters. The historically unique case of the four Florida hurricanes of 2004 is used to assess coordinated response under conditions of repeated threats of hurricanes. The repeated threat scenario suggests that emergency managers must vigilantly work to keep the partnering public, private, and nonprofit agencies and citizens informed and apprised of the seriousness of the situation. The research examines four hurricane response operations drawing on content analyses of news and situation reports. Content analysis provides interorganizational interactions that are subject to network analysis revealing information about: (1) how critical actors interacted and coordinated, (2) sub-groups under each network, and (3) each network as a system. Using network analysis in analyzing disaster response systems is a new way of exploring the issues from another perspective and through a new methodology. The article showcases the potential use of network analysis in both organizational and emergency management research.

Improving relations between emergency management offices and nursing homes during hurricane-related disasters

Objective: To document the importance of the relationship of nursing homes to emergency management entities before, during, and after hurricanes, and the operational challenges that nursing homes face, the authors report the effects of eight Florida (FL) hurricanes on 689 nursing homes (70,000 beds) during 2004 and 2005.Design: Using a State Administrative data set of all nursing homes, the authors document the impact of the four major hurricanes on the homes’ ability to care for frail elders before, during, and after the storm. Supplementing State data are 257 self-reports from administrators on the impact of the hurricane on operations, resident care, and the importance of the relationship of the nursing home to local and state emergency operations entities.Setting: Nursing homes.Results: Almost one-third of all FL nursing homes either evacuated or sheltered residents from other facilities. No deaths during evacuation were reported for the 5,500 nursing home residents evacuated. Relationships with local emergency management offices prior to hurricanes were excellent, very good, or good for 58 percent of respondents. Regardless of the quality of the relationship, 80 percent of the respondents indicated that they would like to improve their relationship after 2004 season and 78 percent indicated they need to improve their disaster plans.Conclusions: This article highlights the importance of establishing an effective working relationship between nursing homes and local emergency management offices during all phases of disaster preparedness to ensure that nursing home residents are safe.

NPYmoderates the relation between hurricane exposure and generalized anxiety disorder in an epidemiologic sample of hurricane-exposed adults

Neuropeptide Y (NPY) has been found to be anxiolytic in animals and humans. A recent study found NPY expression to be inversely correlated with trait anxiety. We examined whether rs16147, a functional single nucleotide polymorphism in the promoter region of NPY, moderated the relationship between hurricane exposure and risk for generalized anxiety disorder (GAD) in an epidemiologic sample of adults living in areas affected by the 2004 Florida hurricanes. Data from this study comes from 616 adults from the 2004 Florida Hurricanes study who returned buccal DNA samples via mail. Selection of participants occurred via random digit-dial procedures. Participants were interviewed via telephone about hurricane exposure and post-hurricane GAD symptoms. The outcome measure was DSM-IV GAD diagnosis, assessed via structured interview. Rs16147 in NPY was associated with increased risk of GAD diagnosis under conditions of high hurricane exposure (P<.01). This gene by environment interaction remained significant after adjustment for sex, ancestry (as determined by Bayesian clustering of genotypes), and age. NPY rs16147 modifies risk of post-disaster GAD under conditions of high stressor (hurricane) exposure. This is the first demonstration of gene-environment interaction for this locus.

Variation in RGS2 is Associated with Suicidal Ideation in an Epidemiological Study of Adults Exposed to the 2004 Florida Hurricanes

This study examined whether rs4606, a single nucleotide polymorphism (SNP) in the translated region at the 3′ end of RGS2, was related to suicidal ideation in an epidemiologic sample of adults living in areas affected by the 2004 Florida hurricanes. An epidemiologic sample of residents of Florida was recruited via random digit-dial procedures after the 2004 Florida hurricanes; participants were interviewed about suicidal ideation, hurricane exposure, and social support. Participants who returned buccal DNA samples via mail (n = 607) were included here. Rs4606 in RGS2 was associated with increased symptoms of current suicidal ideation (p < 0.01). Each “C” allele was associated with 5.59 times increased risk of having current ideation. No gene-by-environment interactions were found, perhaps due to low power. RGS2 rs4606 is related to risk of current suicidal ideation in stressor-exposed adults.

Social and Psychological Resources Associated with Health Status in a Representative Sample of Adults Affected by the 2004 Florida Hurricanes

Overall health status after a disaster may be associated with long-term physical morbidity and mortality. Little is known about factors associated with overall health status in the aftermath of disasters. We examined self-rated health in relation to disaster characteristics, social resources, and post-disaster outcomes in a sample of adults who experienced the 2004 Florida hurricanes. We interviewed a representative sample of 1,452 adults aged 18 years and older residing in the 33 Florida counties that were in the direct path of at least one of the 2004 hurricanes (Charley, Frances, Ivan, Jeanne). Overall health status was assessed using a self-rating format known to be predictive of mortality. Poor self-rated health was endorsed by 14.6% of the sample. Final multivariable models showed that poor self-rated health was associated with older age (p < 0.001), extreme fear during the hurricane (p = 0.03), low social support (p = 0.03), and depression (p = 0.003) since the hurricane. Self-rated health following the Florida hurricanes was strongly associated with two variables (social support and depression) that potentially can be mitigated through targeted interventions after disasters. Future work should evaluate secondary prevention strategies that can address general health-related concerns in the wake of a disaster.

Florida Hurricanes and Damage Costs

Florida has been visited by some of the most destructive and devastating hurricanes on record in the United States causing well over $450 billion in damage since the early 20 th century. The value of insured property in Florida against windstorm damage is the highest in the nation and on the rise. The frequency and severity of hurricanes affecting Florida are examined from the best set of available data and the damages are related to characteristics of the storms at landfall. Results show that normalized losses are increasing over time consistent with small increases in hurricane intensity and hurricane size. The best predictor of potential losses is minimum central pressure. Hurricane size alone or in combination with hurricane intensity does not improve on the simpler relationship. An estimate of potential losses from hurricanes can be obtained using a formula involving only a forecast of the minimum pressure at landfall. The ability to estimate potential losses in Florida will increase the ability to estimate losses in other areas of the United States, and will also allow policy makers and insurance companies to provide relevant information to the concerned public.

Variant in RGS2 moderates posttraumatic stress symptoms following potentially traumatic event exposure

Polymorphisms in the RGS2 (regulator of G-protein signaling 2) gene were found to be associated with anxious behavior in mice and anxiety in humans. We examined whether rs4606, a single nucleotide polymorphism (SNP) of RGS2, and social support moderated risk for PTSD in an epidemiologic sample. The study examines 607 adults from the 2004 Florida Hurricanes study who returned buccal DNA samples via mail. rs4606 was associated with increased symptoms of posthurricane PTSD symptoms under conditions of high hurricane exposure and low social support ( P < .05). Further, this polymorphism was associated with lifetime PTSD symptoms under conditions of lifetime exposure to a potentially traumatic event, and low social support ( P < .001). These gene by environment interactions remained significant after adjustment for sex, ancestry, and age. RGS2 rs4606 modifies risk of postdisaster and lifetime PTSD symptoms under conditions of high stressor exposure. This is the first demonstration of gene–environment interaction for this locus.

RGS2and generalized anxiety disorder in an epidemiologic sample of hurricane-exposed adults

Generalized anxiety disorder (GAD) is a common and sometimes disabling condition often associated with stressful life events that involve significant loss or danger. The disorder appears moderately heritable. Polymorphisms in the RGS2 (regulator of G-protein signaling 2) gene were recently associated with anxious behavior in mice and panic disorder and trait anxiety in humans. We examined whether rs4606, a single nucleotide polymorphism (SNP) in the 3' UTR of RGS2, was associated with GAD in an epidemiologic sample of adults exposed to the 2004 Florida Hurricanes. The sample for the current study is 607 adults from the 2004 Florida Hurricane Study who returned buccal DNA samples via mail. Participants were selected via random digit dial procedures and interviewed via telephone about hurricane exposure, social support, and GAD symptoms. The outcome measure was DSM-IV diagnosis of GAD derived from structured interviews. RGS2 SNP rs4606 was significantly associated with GAD in this sample. In logistic regression analyses, each C allele was associated with a 100% (P=.026) increased risk of GAD after controlling for age, sex, ancestry, hurricane exposure, and social support. These findings are consistent with a previously published study showing a higher prevalence of the C allele among panic disorder patients than controls. This study points toward a relevant polymorphism for GAD at the 3' end of the RGS2 gene; and suggests that studying a recently disaster-exposed sample is both feasible and may improve power to find gene-disorder associations.

Collaborative emergency management: better community organising, better public preparedness and response

Community coordination requires communication and planning of precautions to take when faced with a severe threat of disaster. The unique case of the four Florida hurricanes of 2004--Charley, Frances, Ivan, and Jeanne--is used here to assess community responses to repeated threats of hurricanes. The paper examines how effectiveness in coordinating community disaster response efforts affects future public preparedness. The findings suggest that pre-season planning, open communication between emergency managers and elected officials, and the use of technology all had a significant impact on community responses. The repeated threat scenario indicates that emergency managers must work vigilantly to keep residents informed of the seriousness of a situation. The study describes how emergency managers in Florida countered public complacency during four hurricanes in six weeks. The strategies identified as useful by public managers in the context of hurricanes are applicable to other natural and man-made disasters.

Effective healthcare system response to consecutive Florida hurricanes

In September 2004, two consecutive hurricanes (Hurricane Frances and Hurricane Jeanne) made landfall in Stuart, FL, and created healthcare needs that overtaxed the capacity of the local healthcare system. To determine the character and structure of the response to these hurricanes, researchers from the University of New Mexico, Center for Disaster Medicine conducted both a structured written survey of employees and a guided group interview with healthcare system management. The written survey queried staff on topics related to their ability and willingness to get to work and stay at work during the storms. The roundtable interview with leadership resulted in analysis of the preexisting Emergency Operations Plan and its use during the storms, including preparation and execution of plans for staffing, facility operation, communication, community resource utilization, and recovery. In addition, the interaction with federally deployed Disaster Medical Assistance Teams was documented and reviewed. In general, prior planning on the part of the healthcare system in Stuart, FL, resulted in a successful response to both hurricanes. Employees were willing and able to provide the necessary care for patients during the hurricanes, overcoming many physical and emotional barriers that arose during the month-long response. These barriers included concern for the safety of family and pets, inoperable or insufficient communication methods, and damage to employees' personal property and homes. Recommendations for healthcare system preparedness and response were formulated by the researchers based on this healthcare system's successful response to back-to-back hurricanes, including recommendations for interacting with disaster medical resources.