David Abramson

Clinical Professor of Social and Behavioral Sciences

Professional overview

Dr. David Abramson is a Clinical Professor at NYU’s School of Global Public Health and the director of the research program on Population Impact, Recovery and Resilience (PiR2). His research employs a social ecological framework to examine the health consequences of disasters, individual and community resilience, and long-term recovery from acute collective stressors. His work has focused on population health consequences, interactions of complex systems, and risk communication strategies associated with hurricanes Katrina and Sandy, the Joplin tornado, the Deepwater Horizon oil spill, H1N1, and Zika, among other natural, technological, and man-made disasters.  Before joining NYU’s faculty, Dr. Abramson was the Deputy Director at Columbia University’s National Center for Disaster Preparedness at the Earth Institute.

In 2005 Dr. Abramson launched the Gulf Coast Child and Family Health study, an ongoing longitudinal cohort study of over 1,000 randomly sampled Katrina survivors in Louisiana and Mississippi, which is presently a core research project in the NIH-funded Katrina@10 Program (P01HD082032, NICHD).  After Superstorm Sandy he partnered with colleagues at Rutgers University, Columbia University, and the University of Colorado to conduct the Sandy Child and Family Health study, an observational cohort study modeled on the Katrina study. More recently, he was funded by the National Science Foundation and the Robert Wood Johnson Foundation to study the risk salience of an evolving threat, the Zika virus, among the US population in general and among women of child-bearing age.  In addition, Dr. Abramson serves on two National Academies of Medicine panels, the Standing Committee on Medical and Public Health Research During Large-Scale Emergency Events, and the Committee on Evidence-Based Practices for Public Health Emergency Preparedness and Response.

Prior to entering the field of public health, Dr. Abramson spent a decade as a national magazine journalist, having worked at or written for such publications as Rolling Stone, Esquire, and Outside magazines, and was a nationally-certified paramedic.  He has a PhD in sociomedical sciences, with a sub-specialization in political science, and an MPH, both from Columbia University.

Education

BA, English (High Honors), Queens College, New York, NY

MPH, Sociomedical Sciences, Columbia University, New York, NY

PhD, Sociomedical Sciences/Political Science, Columbia University, New York, NY

Honors and awards

Columbia University Alumni Association Scholarship (2003)

Eugene Litwak Prize for best doctoral dissertation proposal, Mailman School of Public Health (2002)

Columbia University School of Public Health Alumni Association Scholarship Award (1982)

Nyack Hospital Paramedic Program Valedictorian (1989)

Areas of research and study

Community Health

Disaster Health

Disaster Impact and Recovery

Environmental Impact

Population Health

Public Health Systems

Social Behaviors

Social Determinants of Health

Publications

Publications

Adverse Effects of the Deepwater Horizon oil spill Amid Cumulative Disasters: A Qualitative Analysis of the Experiences of Children and Families

Meltzer, G. Y., Merdjanoff, A. A., Gershon, R. R., Fothergill, A., Peek, L., & Abramson, D. M. (n.d.).

Publication year

2024

Journal title

Journal of Child and Family Studies

Volume

33

Issue

6

Page(s)

1995-2011

10.1007/s10826-024-02815-0

Abstract

Abstract

Limited research has examined the ramifications of the Deepwater Horizon oil spill (DHOS) on children and their families. This study builds on secondary data analysis and representative survey findings from the multi-method, multi-phase Gulf Coast Population Impact (GCPI) project. Specifically, this phase of the GCPI research draws on in-depth, semi-structured interview and focus group data to illuminate the social conditions that influenced poor child health outcomes in the aftermath of the DHOS and amid other disasters. These qualitative data were collected two years after the spill with caregivers, teachers, faith- and community-based leaders in five highly impacted Gulf Coast communities. Exploratory qualitative analysis revealed that children were affected by the DHOS and other related challenges through exposure to familial stress emerging from livelihood disruptions. Such disruptions were the result of ongoing poverty, damage to the fishing industry, and exposure to cumulative and compounding environmental disasters. In cases of severe familial stress, children may have experienced toxic stress because of caregivers’ displaced distress; ambiguous loss through caregivers’ physical and/or emotional absence; and the children’s recognition of their families’ dire financial situations. Toxic stress was most often expressed through acute and chronic physiological, emotional, and behavioral health challenges. This study expands current understandings of the impact of technological disasters and cumulative environmental disasters on children and families. It underscores the importance of investing in harm prevention strategies to reduce threats to the health and wellbeing of young people living in ecologically and socioeconomically insecure environments prone to intensifying technological and climate-fueled disasters.

COVID-19 Vaccine Information Seeking Patterns and Vaccine Hesitancy: A Latent Class Analysis to Inform Practice

Piltch-Loeb, R., Silver, D., Kim, Y., & Abramson, D. (n.d.).

Publication year

2024

Journal title

Journal of Public Health Management and Practice

Volume

30

Issue

2

Page(s)

183-194

10.1097/PHH.0000000000001834

Abstract

Abstract

Context: Throughout the COVID-19 pandemic, state and local health departments served as risk communicators to the public; however, public health practitioners have limited resources at their disposal when trying to communicate information, especially when guidance is rapidly changing. Identifying how the population gathers information across channels and which subsets of the population utilize which channels can help practitioners make the best use of these limited resources. Objective: To identify how individuals utilized different information channels to get COVID-19–related information and determine its effect on one COVID-19–related action: vaccine intentions. Design: This study applies latent class analysis to utilization of information channels to characterize information consumption patterns during the COVID-19 infodemic and then explores the relationship between these patterns and vaccine hesitancy. Setting: The data were collected from the COVID-19 Vaccine Hesitancy Survey, which is a nationally representative sample of US adults 18 years and older recruited from Social Science Research Solutions (SSRS)’s Opinion Panel. Participants: The online survey was conducted between April 7 and April 11, 2021, after the COVID-19 vaccine was available to all adults and enrolled more than 3000 respondents (n = 3014). Main Outcome Measure(s): Respondents were asked about their frequency of information seeking related to the COVID-19 vaccine, sociodemographics, and vaccine perceptions. Results: Based on fit statistics and prior research, we identified 6 latent classes that characterize information seeking: Nonseekers, Legacy, Legacy + Facebook/Instagram, Traditional Omnivore, Omnivore + Broad Social Media, and Twitter. Sociodemographics, political, economic, and COVID-19 exposure variables are associated with different patterns of seeking information about COVID-19. Membership in 3 of these classes was associated with higher rates of vaccine refusal and vaccine hesitancy. Discussion: The study has implications for public health officials and policymakers who use media channels to share news and health information with the public. Information should be tailored to the sociodemographic profiles of those users who are likely consuming information across multiple different channels.

Ethnic and Racial Disparities in Self-Reported Personal Protective Equipment Shortages Among New York Healthcare Workers During the COVID-19 Pandemic

Sodhi, A., Chihuri, S., Hoven, C. W., Susser, E. S., DiMaggio, C., Abramson, D., Andrews, H. F., Ryan, M., & Li, G. (n.d.).

Publication year

2024

Journal title

AJPM Focus

Volume

3

Issue

6

10.1016/j.focus.2024.100278

Abstract

Abstract

Introduction: To assess the association of race and ethnicity with self-reported personal protective equipment shortages during the COVID-19 pandemic among healthcare workers in New York. Methods: The COVID-19 Healthcare Personnel Study of New York was a prospective cohort study of HCWs with baseline data collected in April 2020 and follow-up data collected in February 2021. Multivariable logistic regression modeling was used to estimate the adjusted OR and 95% CIs of personal protective equipment shortages associated with race and ethnic minority status. Results: Healthcare workers of racial and ethnic minority status (n=361) were more likely than non-Hispanic White respondents (n=1,858) to report having experienced personal protective equipment shortages in the last week at baseline (36.0% vs 27.5%; p=0.001) and follow-up (13.6% vs 8.8%; p=0.005). With adjustment for demographic and clinical characteristics, racial and ethnic minority status was associated with 44% and 49% increased odds of experiencing PPE shortages at baseline (adjusted OR=1.44; 95% CI=1.10, 1.88) and follow up (adjusted OR=1.49; 95% CI=1.01, 2.21), respectively. Conclusions: Healthcare workers of racial and ethnic minority status in New York experienced more pervasive personal protective equipment shortages than their non-Hispanic White counterparts during the COVID-19 pandemic.

One year later: What role did trust in public officials and the medical profession play in decisions to get a booster and to overcome vaccine hesitancy?

Silver, D., Kim, Y., Piltch-Loeb, R., & Abramson, D. (n.d.).

Publication year

2024

Journal title

Preventive Medicine Reports

Volume

38

10.1016/j.pmedr.2024.102626

Abstract

Abstract

Physicians may have an important role to play in promoting boosters as well as reducing COVID-19 vaccine hesitancy, but the relationship between hesitancy and trust in the medical profession and these behaviors has been underexplored. A representative online panel of 1,967 US adults that included oversamples of minoritized and rural populations were surveyed in April 2021 and June 2022 regarding their booster and vaccine status and intentions, their views of the medical profession, and their levels of trust in their own doctors, and national and state/local officials. Eighty percent of those vaccinated in 2021 had received a booster by 2022, while fewer than half of those initially reluctant to get a vaccine had gotten one by Wave 2 of the survey. Mean factor scores were calculated for response to a validated scale measuring trust in the medical profession. Linear and logistic regression models estimated the relationship between these factors scores and trust in other officials for those vaccinated as well initial hesitaters/refusers in Wave 1, controlling for population factors. Trust in one's own physician was associated with those vaccinated/eager to be vaccinated getting a booster, while trust in the medical profession was associated with getting a vaccine among those who had previously refused or were hesitant. Trust in other experts was not significantly associated with these behaviors, but wide confidence intervals suggest a need for future research. Innovative strategies, including mobilizing the medical community is needed to address reluctance, uncertainty, and distrust of therapeutic agents in pandemic response.

The influence of risk perception on disaster recovery: A case study of new Jersey families impacted by hurricane sandy

Lynch, K. A., Abramson, D. M., & Merdjanoff, A. A. (n.d.).

Publication year

2024

Journal title

International Journal of Disaster Risk Reduction

Volume

100

10.1016/j.ijdrr.2023.104220

Abstract

Abstract

Introduction: Risk perceptions of extreme weather events have been explored extensively through the lens of emergency preparation, but the influence of pre-storm risk perceptions on resilience and recovery trajectories are understudied. The objective of this qualitative analysis is to explore 1) the factors which shape residents' perception of risk prior to an event, and 2) how these factors contribute to ‘sensemaking,’ after the storm to influence experiences of recovery. Methods: Eight focus groups and ten in-depth interviews (N = 38) from the Hurricane Sandy Child Impact Study were analyzed using grounded theory. The sample comprised of New Jersey residents who experienced housing damage or displacement during Hurricane Sandy. Verbatim transcripts were coded using iterative phases of open, axial, and selective coding. Results: Grounded theory analysis identified three major themes: 1) Local ecological knowledge and place-based intergenerational memory shaped respondents’ initial risk perceptions, their framing of the event, and its consequences; 2) Unclear institutional decision-making complicated recovery planning and actions; 3) Inaccurate pre-storm risk perceptions led to traumatic memories and decreased self-efficacy in managing recovery. This mismatch in perception and outcome led participants to feel that they had been ill-informed before and during the storm and created skepticism of government recommendations and services during the recovery phase. Conclusions: Local ecological knowledge and intergenerational memory are critical factors that shape pre-storm risk perception and can subsequently influence trust in officials, service utilization, and perceptions of recovery. Themes identified in this analysis suggest the need for future longitudinal research to investigate the extent to which pre-storm risk perception is predictive of post-disaster recovery and resilience.

Examining the effects of cumulative environmental stressors on Gulf Coast child and adolescent health

Meltzer, G. Y., Merdjanoff, A. A., Xu, S., Gershon, R., Emrich, C. T., & Abramson, D. M. (n.d.).

Publication year

2023

Journal title

Population and Environment

Volume

45

Issue

3

10.1007/s11111-023-00436-1

Abstract

Abstract

This study examines how community-level cumulative environmental stress affects child and adolescent emotional distress and chronic health conditions both directly and indirectly through stressors at the household, family, and individual levels. Data comes from the Women and their Children’s Health (WaTCH) Study, which sought to understand the health implications of exposure to the 2010 Deepwater Horizon oil spill (DHOS) among a cohort of 596 mothers with children ages 10 to 17 in southeastern Louisiana. Community-level environmental stress was measured using a newly developed geospatial index. Household-level stressors included previous hurricane impacts, impacts of DHOS, degree of financial difficulty, and degree of housing physical decay. Family stressors included maternal depression, self-rated physical health, and degree of parenting stress. Child stress was based on perceived stress; child mental health was based on serious emotional disturbance; and child physical health was based on diagnosis of chronic illness. Structural equation modeling used weighted least squares means and variance and theta parameterization. Results showed a significant negative direct path between community-level cumulative environmental stress and child/adolescent serious emotional disturbance and chronic illness. However, the indirect relationship through household, family, and individual-level stressors was significant and positive for both child/adolescent serious emotional disturbance and chronic illness. These findings point to the centrality of the household and family in determining child and adolescent physical and mental health outcomes in communities exposed to frequent disasters and ongoing environmental stressors.

Neighborhood Socioeconomic Status and Women’s Mental Health: A Longitudinal Study of Hurricane Katrina Survivors, 2005–2015

Nguyen, A. M., Kim, Y., & Abramson, D. M. (n.d.).

Publication year

2023

Journal title

International journal of environmental research and public health

Volume

20

Issue

2

10.3390/ijerph20020925

Abstract

Abstract

There is limited knowledge on the relationship between neighborhood factors and mental health among displaced disaster survivors, particularly among women. Hurricane Katrina (Katrina) was the largest internal displacement in the United States (U.S.), which presented itself as a natural experiment. We examined the association between neighborhood socioeconomic status (SES) and mental health among women up to 10 years following Katrina (N = 394). We also investigated whether this association was modified by move status, comparing women who were permanently displaced to those who had returned to their pre-Katrina residence. We used hierarchical linear models to measure this association, using data from the American Community Survey and the Gulf Coast Child and Family Health study. Neighborhood SES was created as an index which represented social and economic characteristics of participants’ neighborhoods. Mental health was measured using mental component summary (MCS) scores. Increased neighborhood SES was positively associated with mental health after controlling for age, race/ethnicity, economic positioning, time, and move status (19.6, 95% Confidence Interval: 5.8, 33.7). Neighborhood SES and mental health was also modified by move status. These findings underscore the need to better understand the impacts of socioeconomic conditions and health outcomes among women affected by natural disasters.

The New York State COVID-19 Healthcare Personnel Study: One-Year Follow-up of Physicians, Nurse Practitioners, and Physician Assistants, 2020-2021

DiMaggio, C., Susser, E., Frangos, S., Abramson, D., Andrews, H., Hoven, C., Ryan, M., & Li, G. (n.d.).

Publication year

2023

Journal title

Public Health Reports

Volume

138

Issue

3

Page(s)

518-525

10.1177/00333549231155473

Abstract

Abstract

Objectives: The COVID-19 Healthcare Personnel Study is a longitudinal survey to assess the changing impact of the COVID-19 pandemic on the New York State health care workforce. We analyzed results from a follow-up survey of physicians, nurse practitioners, and physician assistants on the availability of equipment and personnel, work conditions, physical and mental health of participants, and impact of the pandemic on commitment to their profession. Methods: We conducted an online survey of all licensed New York State physicians, nurse practitioners, and physician assistants in April 2020 (N = 2105) and a follow-up survey in February 2021 (N = 978). We analyzed changes in item responses from baseline to follow-up. We calculated survey-adjusted paired t tests and odds ratios (ORs) using survey-adjusted generalized linear models controlling for age, sex, region of practice, and hospital versus non–hospital-based practice. Results: Twenty percent of respondents expressed continuing concern about personnel shortages at both baseline and follow-up. Respondents reported working approximately 5 more hours on average during a 2-week period at follow-up compared with baseline (78.1 vs 72.6 hours; P =.008). For 20.4% (95% CI, 17.2%-23.5%) of respondents, mental health issues had become persistent. More than one-third (35.6%; 95% CI, 31.9%-39.4%) of respondents reported that they thought about leaving their profession more often than once per month. The association between persistent mental and behavioral health issues and contemplating leaving one’s profession was significant (OR = 2.7; 95% CI, 1.8-4.1; P <.001). Conclusions: Interventions such as decreasing the number of hours worked, ensuring health care professionals do not work directly with patients while ill, and addressing shortages of personal protective equipment can help address concerns of the health care workforce.

Association between city-wide lockdown and COVID-19 hospitalization rates in multigenerational households in New York City

Ghosh, A. K., Venkatraman, S., Reshetnyak, E., Rajan, M., An, A., Chae, J. K., Unruh, M. A., Abramson, D., DiMaggio, C., & Hupert, N. (n.d.).

Publication year

2022

Journal title

PloS one

Volume

17

Issue

3

10.1371/journal.pone.0266127

Abstract

Abstract

Background City-wide lockdowns and school closures have demonstrably impacted COVID-19 transmission. However, simulation studies have suggested an increased risk of COVID-19 related morbidity for older individuals inoculated by house-bound children. This study examines whether the March 2020 lockdown in New York City (NYC) was associated with higher COVID-19 hospitalization rates in neighborhoods with larger proportions of multigenerational households. Methods We obtained daily age-segmented COVID-19 hospitalization counts in each of 166 ZIP code tabulation areas (ZCTAs) in NYC. Using Bayesian Poisson regression models that account for spatiotemporal dependencies between ZCTAs, as well as socioeconomic risk factors, we conducted a difference-in-differences study amongst ZCTA-level hospitalization rates from February 23 to May 2, 2020. We compared ZCTAs in the lowest quartile of multigenerational housing to other quartiles before and after the lockdown. Findings Among individuals over 55 years, the lockdown was associated with higher COVID-19 hospitalization rates in ZCTAs with more multigenerational households. The greatest difference occurred three weeks after lockdown: Q2 vs. Q1: 54% increase (95% Bayesian credible intervals: 22-96%); Q3 vs. Q1: 48% (17-89%); Q4 vs. Q1: 66% (30-211%). After accounting for pandemic-related population shifts, a significant difference was observed only in Q4 ZCTAs: 37% (7-76%). Interpretation By increasing house-bound mixing across older and younger age groups, city-wide lockdown mandates imposed during the growth of COVID-19 cases may have inadvertently, but transiently, contributed to increased transmission in multigenerational households.

Association between COVID-19 vaccine hesitancy and trust in the medical profession and public health officials

Silver, D., Kim, Y., McNeill, E., Piltch-Loeb, R., Wang, V., & Abramson, D. (n.d.).

Publication year

2022

Journal title

Preventive Medicine

Volume

164

10.1016/j.ypmed.2022.107311

Abstract

Abstract

One's personal physician, national and state or local public health officials, and the broader medical profession play important roles in encouraging vaccine uptake for COVID-19. However, the relationship between trust in these experts and vaccine hesitancy has been underexplored, particularly among racial/minority groups where historic medical mistrust may reduce uptake. Using an April 2021 online sample of US adults (n = 3041) that explored vaccine hesitancy, regression models estimate levels of trust in each of these types of experts and between trust in each of these experts and the odds of being COVID-19 vaccine takers vs refusers or hesitaters. Interaction terms assess how levels of trust in the medical profession by race/ethnicity are associated with vaccine hesitancy. Trust in each expert is positively associated with trust in other experts, except for trust in the medical profession. Only trust in one's own doctor was associated with trust in the medical profession, as measured by factor scores derived from a validated scale. Lower levels of trust in experts were significantly associated with being either a hesitater or a refuser compared to being a taker. Black respondents had higher odds of being either a hesitater or a refuser compared to white respondents but the interaction with trust was insignificant. For Hispanic respondents only, the odds of being a hesitater declined significantly when trust in the medical profession rose. Mistrust in the medical profession, one's doctor and national experts contributes to vaccine hesitancy. Mobilizing personal physicians to speak to their own patients may help.

Determinants of the COVID-19 vaccine hesitancy spectrum

Piltch-Loeb, R., Silver, D. R., Kim, Y., Norris, H., McNeill, E., & Abramson, D. M. (n.d.).

Publication year

2022

Journal title

PloS one

Volume

17

Issue

6

10.1371/journal.pone.0267734

Abstract

Abstract

Vaccine hesitancy remains an issue in the United States. This study conducted an online survey [N = 3,013] using the Social Science Research Solution [SSRS] Opinion Panel web panelists, representative of U.S. adults age 18 and older who use the internet, with an over-sample of rural-dwelling and minority populations between April 8 and April 22, 2021- as vaccine eligibility opened to the country. We examined the relationship between COVID-19 exposure and socio-demographics with vaccine intentions [eager-to-take, wait-and-see, undecided, refuse] among the unvaccinated using multinomial logistic regressions [ref: fully/ partially vaccinated]. Results showed vaccine intentions varied by demographic characteristics and COVID-19 experience during the period that eligibility for the vaccine was extended to all adults. At the time of the survey approximately 40% of respondents were unvaccinated; 41% knew someone who had died of COVID-19, and 38% had experienced financial hardship as a result of the pandemic. The vaccinated were more likely to be highly educated, older adults, consistent with the United States initial eligibility criteria. Political affiliation and financial hardship experienced during the pandemic were the two most salient factors associated with being undecided or unwilling to take the vaccine.

Disasters, Displacement, and Housing Instability: Estimating Time to Stable Housing 13 Years after Hurricane Katrina

Merdjanoff, A. A., Abramson, D. M., Park, Y. S., & Piltch-Loeb, R. (n.d.).

Publication year

2022

Journal title

Weather, Climate, and Society

Volume

14

Issue

2

Page(s)

535-550

10.1175/WCAS-D-21-0057.1

Abstract

Abstract

Catastrophic disasters disrupt the structural and social aspects of housing, which can lead to varying lengths of displacement and housing instability for affected residents. Stable housing is a critical aspect of postdisaster recovery, which makes it important to understand how much time passes before displaced residents are able to find stable housing. Using the Gulf Coast Child and Family Health Study, a longitudinal cohort of Mississippi and Louisiana residents exposed to Hurricane Katrina (n = 1079), we describe patterns of stable housing by identifying protective and prohibitive factors that affect time to stable housing in the 13 years following the storm. Survival analyses reveal that median time to stable housing was 1082 days-over 3 years after Katrina. Age, housing tenure, marital status, income, and social support each independently affected time to stable housing. Findings suggest that postdisaster housing instability is similar to other forms of housing instability, including eviction, frequent moves, and homelessness.

Examining the Dose–Response Relationship: Applying the Disaster Exposure Matrix to Understand the Mental Health Impacts of Hurricane Sandy

Merdjanoff, A. A., Abramson, D. M., Piltch-Loeb, R., Findley, P., Peek, L., Beedasy, J., Park, Y. S., Sury, J., & Meltzer, G. Y. (n.d.).

Publication year

2022

Journal title

Clinical Social Work Journal

Volume

50

Issue

4

Page(s)

400-413

10.1007/s10615-021-00814-y

Abstract

Abstract

Disaster exposure is a strong predictor of survivor mental health following large-scale disasters. However, there is continued debate regarding how disaster exposure should be measured and quantified, as well as whether specific types of disaster exposure are more likely to influence certain mental health outcomes like psychological distress or post-traumatic stress disorder (PTSD). In this article, we propose the Disaster Exposure Matrix to explain how specific types and levels of disaster exposure are associated with particular mental health outcomes. We use data from the Sandy Child and Family Health study—an observational cohort study of 1000 randomly selected New Jersey residents who were living in the nine counties most-affected by Hurricane Sandy (2012)—to examine how direct and indirect disaster exposure at both the individual and community levels influence the likelihood of experiencing psychological distress and probable PTSD in the two years after Hurricane Sandy. Weighted logistic regression models demonstrate that particular measures of individual-level direct and indirect exposure uniquely influence probable PTSD and psychological distress, respectively. Community-level indirect exposure is significantly associated with psychological distress but not with probable PTSD. Findings highlight the importance of specificity when measuring the effects of disaster exposure on mental health, including separating exposures that occur at the individual and community level, as well as distinguishing those that are experienced directly from the event from those that are indirect and experienced after the meteorological or geophysical event has passed.

Factors Related to Self-Reported Distress Experienced by Physicians During Their First COVID-19 Triage Decisions

Chou, F. L., Abramson, D., Dimaggio, C., Hoven, C. W., Susser, E., Andrews, H. F., Chihuri, S., Lang, B. H., Ryan, M., Herman, D., Susser, I., Mascayano, F., & Li, G. (n.d.).

Publication year

2022

Journal title

Disaster medicine and public health preparedness

Volume

16

Issue

6

Page(s)

2520-2527

10.1017/dmp.2021.170

Abstract

Abstract

OBJECTIVE: The aim of this study was to identify factors associated with distress experienced by physicians during their first coronavirus disease 2019 (COVID-19) triage decisions.METHODS: An online survey was administered to physicians licensed in New York State.RESULTS: Of the 164 physicians studied, 20.7% experienced severe distress during their first COVID-19 triage decisions. The mean distress score was not significantly different between physicians who received just-in-time training and those who did not (6.0 ± 2.7 vs 6.2 ± 2.8; P = 0.550) and between physicians who received clinical guidelines and those who did not (6.0 ± 2.9 vs 6.2 ± 2.7; P = 0.820). Substantially increased odds of severe distress were found in physicians who reported that their first COVID-19 triage decisions were inconsistent with their core values (adjusted odds ratio, 6.33; 95% confidence interval, 2.03-19.76) and who reported having insufficient skills and expertise (adjusted odds ratio 2.99, 95% confidence interval 0.91-9.87).CONCLUSION: Approximately 1 in 5 physicians in New York experienced severe distress during their first COVID-19 triage decisions. Physicians with insufficient skills and expertise, and core values misaligned to triage decisions are at heightened risk of experiencing severe distress. Just-in-time training and clinical guidelines do not appear to alleviate distress experienced by physicians during their first COVID-19 triage decisions.

Hopelessness in New York State physicians during the first wave of the COVID-19 outbreak

Johnson, A. A., Wallace, B. K., Xu, Q., Chihuri, S., Hoven, C. W., Susser, E. S., DiMaggio, C., Abramson, D., Andrews, H. F., Lang, B. H., Ryan, M., & Li, G. (n.d.).

Publication year

2022

Journal title

Journal of Neurosurgical Anesthesiology

Volume

34

Issue

1

Page(s)

152-157

10.1097/ANA.0000000000000808

Abstract

Abstract

Background: In the United States, New York State's health care system experienced unprecedented stress as an early epicenter of the coronavirus disease 2019 (COVID-19) pandemic. This study aims to assess the level of hopelessness in New York State physicians working on the frontlines during the first wave of the COVID-19 outbreak. Methods: A confidential online survey sent to New York State health care workers by the state health commissioner's office was used to gather demographic and hopelessness data as captured by a brief Hopelessness Scale. Adjusted linear regression models were used to assess the associations of physician age, sex, and number of triage decisions made, with level of hopelessness. Results: In total, 1330 physicians were included, of whom 684 were male (51.4%). Their average age was 52.4 years (SD = 12.7), with the majority of respondents aged 50 years and older (55.2%). Almost half of the physician respondents (46.3%) worked directly with COVID-19 patients, and 163 (12.3%) were involved in COVID-19-related triage decisions. On adjusted analysis, physicians aged 40 to 49 years had significantly higher levels of hopelessness compared with those aged 50 years or more (μ = 0.441, SD = 0.152, P = 0.004). Those involved in 1 to 5 COVID-19-related triage decisions had a significantly lower mean hopelessness score (μ = −0.572, SD = 0.208, P = 0.006) compared with physicians involved in none of these decisions. Conclusion: Self-reported hopelessness was significantly higher among physicians aged 40 to 49 years and those who had not yet been involved in a life or death triage decision. Further work is needed to identify strategies to support physicians at high risk for adverse mental health outcomes during public health emergencies such as the COVID-19 pandemic.

Impact of Hurricanes and Associated Extreme Weather Events on Cardiovascular Health: A Scoping Review

Ghosh, A. K., Demetres, M. R., Geisler, B. P., Ssebyala, S. N., Yang, T., Shapiro, M. F., Setoguchi, S., & Abramson, D. (n.d.).

Publication year

2022

Journal title

Environmental health perspectives

Volume

130

Issue

11

10.1289/EHP11252

Abstract

Abstract

BACKGROUND: The frequency and destructiveness of hurricanes and related extreme weather events (e.g., cyclones, severe storms) have been increasing due to climate change. A growing body of evidence suggests that victims of hurricanes have increased incidence of cardiovascular disease (CVD), likely due to increased stressors around time of the hurricane and in their aftermath. OBJECTIVES: The objective was to systematically examine the evidence of the association between hurricanes (and related extreme weather events) and adverse CVD outcomes with the goal of understanding the gaps in the literature. METHODS: A comprehensive literature search of population-level and cohort studies focused on CVD outcomes (i.e., myocardial infarction, stroke, and heart failure) related to hurricanes, cyclones, and severe storms was performed in the following databases from inception to December 2021: Ovid MEDLINE, Ovid EMBASE, Web of Science, and The Cochrane Library. Studies retrieved were then screened for eligibility against predefined inclusion/exclusion criteria. Studies were then qualitatively synthesized based on the time frame of the CVD outcomes studied and special populations that were studied. Gaps in the literature were identified based on this synthesis. RESULTS: Of the 1,103 citations identified, 48 met our overall inclusion criteria. We identified articles describing the relationship between CVD and extreme weather, primarily hurricanes, based on data from the United States (42), Taiwan (3), Japan (2), and France (1). Outcomes included CVD and myocardial infarction–related hospitalizations (30 studies) and CVVD-related mortality (7 studies). Most studies used a retrospective study design, including one case–control study, 39 cohort studies, and 4 time-series studies. DISCUSSION: Although we identified a number of papers that reported evaluations of extreme weather events and short-term adverse CVD out-comes, there were important gaps in the literature. These gaps included a) a lack of rigorous long-term evaluation of hurricane exposure, b) lack of investigation of hurricane exposure on vulnerable populations regarding issues related to environmental justice, c) absence of research on the exposure of multiple hurricanes on populations, and d) absence of an exploration of mechanisms leading to worsened CVD outcomes. Future research should attempt to fill these gaps, thus providing an important evidence base for future disaster-related policy. https://doi.org/10.1289/EHP11252.

Occupational Conditions Associated with Negative Mental Health Outcomes in New York State Health Professionals during the COVID-19 Pandemic

Cheslack-Postava, K., Bresnahan, M., Ryan, M., Musa, G. J., Amsel, L., Dimaggio, C., Andrews, H. F., Susser, E., Li, G., Abramson, D. M., Lang, B. H., & Hoven, C. W. (n.d.).

Publication year

2022

Journal title

Journal of Occupational and Environmental Medicine

Volume

64

Issue

7

Page(s)

E417-E423

10.1097/JOM.0000000000002566

Abstract

Abstract

Objective The aim of this study was to assess occupational circumstances associated with adverse mental health among health care workers during the COVID-19 pandemic. Methods A cross-sectional study examined responses to an on-line survey conducted among 2076 licensed health care workers during the first pandemic peak. Mental health (depression, anxiety, stress, and anger) was examined as a multivariate outcome for association with COVID-related occupational experiences. Results Odds of negative mental health were increased among those who worked directly with patients while sick themselves (adjusted odds ratio, 2.29; 95% confidence interval, 1.71-3.08) and were independently associated with working more hours than usual in the past 2 weeks, having family/friends who died due to COVID-19, having COVID-19 symptoms, and facing insufficiencies in personal protective equipment/other shortages. Conclusions Occupational circumstances were associated with adverse mental health outcomes among health care workers during the COVID-19 pandemic, and some are potentially modifiable.

The COVID-19 Healthcare Personnel Study (CHPS): Overview, methods, and preliminary findings

DiMaggio, C., Abramson, D., Susser, E. S., Hoven, C. W., Chen, Q., Andrews, H. F., Herman, D., Kreniske, J., Ryan, M., Susser, I., Thorpe, L. E., & Li, G. (n.d.).

Publication year

2022

Journal title

Journal of Neurosurgical Anesthesiology

Volume

34

Issue

1

Page(s)

148-151

10.1097/ANA.0000000000000813

Abstract

Abstract

Introduction: The COVID-19 Healthcare Personnel Study (CHPS) was designed to assess adverse short-term and long-term physical and mental health impacts of the coronavirus disease-2019 (COVID-19) pandemic on New York's physicians, nurse practitioners, and physician assistants. Methods: Online population-based survey. Survey-weighted descriptive results, frequencies, proportions, and means, with 95% confidence intervals (95% CI). Odds ratios (ORs) for association. Results: Over half (51.5%; 95% CI: 49.1, 54.0) of respondents worked directly with COVID-19 patients; 27.3% (95% CI: 22.5, 32.2) tested positive. The majority (57.6%; 95% CI: 55.2, 60.0) reported a negative impact on their mental health. Negative mental health was associated with COVID-19 symptoms (OR = 1.7, 95% CI: 1.3, 2.1) and redeployment to unfamiliar functions (OR = 1.3, 95% CI: 1.1, 1.6). Conclusions: A majority of New York health care providers treated COVID-19 patients and reported a negative impact on their mental health.

Adverse Physical and Mental Health Effects of the Deepwater Horizon Oil Spill among Gulf Coast Children: An Environmental Justice Perspective

Meltzer, G. Y., Merdjanoff, A. A., & Abramson, D. M. (n.d.).

Publication year

2021

Journal title

Environmental Justice

Volume

14

Issue

2

Page(s)

124-133

10.1089/env.2020.0046

Abstract

Abstract

Background: This study applies an environmental justice lens to examine whether racial/ethnic minority and low socioeconomic status affected children's physical and mental health after the Deepwater Horizon oil spill. It expands this lens to explore whether these risk factors affected children's health due to greater direct physical exposure to crude oil or dispersant and/or household economic exposure as a result of income or job loss. Methods: We used data from the Gulf Coast Population Impact (GCPI) study, a representative survey of 1434 households in 15 highly impacted Gulf Coast communities gathered from April to August 2012. We conducted binomial logistic regression to assess the associations between race/ethnicity and annual household income, oil spill exposure routes, and children's health. Results: Non-White children (prevalence odds ratios [POR] 1.40; 95% confidence interval [CI] 1.04-1.89) and those with direct oil/dispersant exposure (POR 3.68; 95% CI 2.78-4.87) were at greater risk of physical health problems. Children in households earning less than $20,000 annually (POR 2.90; 95% CI 1.88-4.48) and those with direct oil/dispersant exposure (POR 3.74; 95% CI 2.72-5.14) were at greater risk of mental health problems. Racial/ethnic minority children were not at greater risk of physical exposure, whereas race/ethnicity and annual household income interacted to determine risk of economic exposure. We observed an interaction effect between annual household income and oil spill-related income or job loss on children's physical health problems. Discussion: Further environmental justice research should examine the pathways through which racial/ethnic minority and low socioeconomic status influence child health outcomes after technological disasters.

Bowling together: Community social institutions protective against poor child mental health

Clay, L. A., & Abramson, D. M. (n.d.).

Publication year

2021

Journal title

Environmental Justice

Volume

14

Issue

3

Page(s)

206-215

10.1089/env.2020.0042

Abstract

Abstract

Social capital is widely recognized as health bolstering and more recently as playing a central role in family and community disaster response and recovery. Community social institutions may be considered a critical mechanism for the development of social capital, as they provide opportunities for community members to interact to build the networks and relationships that are necessary for taking collective action. In particular, social institutions may have a pivotal role to play in supporting children’s health and welfare postdisaster. Community social institutions such as membership, civic, and religious organizations are community resources that stimulate learning and foster healthy child development. This study explores communities impacted by Hurricane Katrina and the Deepwater Horizon Oil Spill (DWHOS). Social institutions data were paired with household interviews from the Women and Their Children’s Health Study (n = 521) to explore whether the density and type of community social institutions in the community were associated with child mental health outcomes. Multilevel logistic regression models examining the role of social institutions, household characteristics, maternal characteristics, and child-specific factors in child mental health showed that for each additional prosocial institution established in the community during recovery from Hurricane Katrina, respondents were 21% less likely to report a child mental health diagnosis (odds ratio 0.79; 95% confidence interval 0.63–0.98). These findings highlight the potential of investment in social institutions in communities to bolster resilience and foster meaningful recovery.

Differences in post-disaster mental health among Vietnamese and African Americans living in adjacent urban communities flooded by Katrina

Zhang, M., VanLandingham, M., Park, Y. S., Anglewicz, P., & Abramson, D. M. (n.d.).

Publication year

2021

Journal title

PloS one

Volume

16

Issue

8

10.1371/journal.pone.0255303

Abstract

Abstract

Some communities recover more quickly after a disaster than others. Some differentials in recovery are explained by variation in the level of disaster-related community damage and differences in pre-disaster community characteristics, e.g., the quality of housing stock. But distinct communities that are similar on the above characteristics may experience different recovery trajectories, and, if so, these different trajectories must be due to more subtle differences among them. Our principal objective is to assess short-term and long-term post-disaster mental health for Vietnamese and African Americans living in two adjacent communities in eastern New Orleans that were similarly flooded by Hurricane Katrina. We employ data from two population-based cohort studies that include a sample of African American adults (the Gulf Coast Child and Family Health [GCAFH study]) and a sample of Vietnamese American adults (Katrina Impacts on Vietnamese Americans [KATIVA NOLA study]) living in adjacent neighborhoods in eastern New Orleans who were assessed near the second and thirteenth anniversaries of the disaster. Using the 12-Item Short Form Survey (SF-12) as the basis of our outcome measure, we find in multivariate analysis a significant advantage in post-disaster mental health for Vietnamese Americans over their African American counterparts at the two-year mark, but that this advantage had disappeared by the thirteenth anniversary of the Katrina disaster.

Rapid Behavioral Health Assessment Post-disaster: Developing and Validating a Brief, Structured Module

Goldmann, E., Abramson, D. M., Piltch-Loeb, R., Samarabandu, A., Goodson, V., Azofeifa, A., Hagemeyer, A., Al-Amin, N., & Lyerla, R. (n.d.).

Publication year

2021

Journal title

Journal of Community Health

Volume

46

Issue

5

Page(s)

982-991

10.1007/s10900-021-00966-5

Abstract

Abstract

To develop and validate a brief, structured, behavioral health module for use by local public health practitioners to rapidly assess behavioral health needs in disaster settings. Data were collected through in-person, telephone, and web-based interviews of 101 individuals affected by Hurricanes Katrina (n = 44) and Sandy (n = 57) in New Orleans and New Jersey in April and May 2018, respectively. Questions included in the core module were selected based on convergent validity, internal consistency reliability, test–retest reliability across administration modes, principal component analysis (PCA), question comprehension, efficiency, accessibility, and use in population-based surveys. Almost all scales showed excellent internal consistency reliability (Cronbach’s alpha, 0.79–0.92), convergent validity (r > 0.61), and test–retest reliability (in-person vs. telephone, intra-class coefficient, ICC, 0.75–1.00; in-person vs. web-based ICC, 0.73–0.97). PCA of the behavioral health scales yielded two components to include in the module—mental health and substance use. The core module has 26 questions—including self-reported general health (1 question); symptoms of posttraumatic stress disorder, depression, and anxiety (Primary Care PTSD Screen, Patient Health Questionnaire-4; 8 questions); drinking and other substance use (Alcohol Use Disorders Identification Test-Concise, AUDIT-C; Drug Abuse Screening Test, DAST-10; stand-alone question regarding increased substance use since disaster; 14 questions); prior mental health conditions, treatment, and treatment disruption (3 questions)—and can be administered in 5–10 minutes through any mode. This flexible module allows practitioners to quickly evaluate behavioral health needs, effectively allocate resources, and appropriately target interventions to help promote recovery of disaster-affected communities.

The effects of cumulative natural disaster exposure on adolescent psychological distress

Meltzer, G. Y., Zacher, M., Merdjanoff, A., Do, M. P., Pham, N. N. K., & Abramson, D. (n.d.).

Publication year

2021

Journal title

Journal of Applied Research on Children

Volume

12

Issue

1

10.58464/2155-5834.1454

The formation of belief: An examination of factors that influence climate change belief among Hurricane Katrina survivors

Teyton, A., & Abramson, D. M. (n.d.).

Publication year

2021

Journal title

Environmental Justice

Volume

14

Issue

3

Page(s)

169-177

10.1089/env.2020.0041

Abstract

Abstract

Differences in population-level climate change beliefs have been identified, which are often attributable to coastline proximity, urban–rural classifications, race, ethnicity, political affiliation, gender, education, socioeconomic status, and age. This study assessed the impact of spatial, experiential, and demographic-related characteristics on climate change beliefs among a population of Hurricane Katrina survivors. Participants from the Gulf Coast Child and Family Health Study who answered climate change belief questions were included in this analysis. Race was found to be the most critical contributor to climate change belief, where the adjusted odds of white individuals believing in climate change were 0.2 times the odds of Black individuals believing in climate change (confidence interval: 0.1–0.4). Other sociodemographic factors, such as age, gender, income, and education, were not found to be significant. Several theoretical perspectives were considered to explain the variation in climate change beliefs, including social vulnerability, environmental deprivation, and political ideology. Future research as to why these racial differences exist should be conducted. By doing so, climate change communication, education, and mitigation and adaptation strategies may be improved.

Towards integrated modeling of the long-term impacts of oil spills

Solo-Gabriele, H. M., Fiddaman, T., Mauritzen, C., Ainsworth, C., Abramson, D. M., Berenshtein, I., Chassignet, E. P., Chen, S. S., Conmy, R. N., Court, C. D., Dewar, W. K., Farrington, J. W., Feldman, M. G., Ferguson, A. C., Fetherston-Resch, E., French-McCay, D., Hale, C., He, R., Kourafalou, V. H., … Yoskowitz, D. (n.d.).

Publication year

2021

Journal title

Marine Policy

Volume

131

10.1016/j.marpol.2021.104554

Abstract

Abstract

Although great progress has been made to advance the scientific understanding of oil spills, tools for integrated assessment modeling of the long-term impacts on ecosystems, socioeconomics and human health are lacking. The objective of this study was to develop a conceptual framework that could be used to answer stakeholder questions about oil spill impacts and to identify knowledge gaps and future integration priorities. The framework was initially separated into four knowledge domains (ocean environment, biological ecosystems, socioeconomics, and human health) whose interactions were explored by gathering stakeholder questions through public engagement, assimilating expert input about existing models, and consolidating information through a system dynamics approach. This synthesis resulted in a causal loop diagram from which the interconnectivity of the system could be visualized. Results of this analysis indicate that the system naturally separates into two tiers, ocean environment and biological ecosystems versus socioeconomics and human health. As a result, ocean environment and ecosystem models could be used to provide input to explore human health and socioeconomic variables in hypothetical scenarios. At decadal-plus time scales, the analysis emphasized that human domains influence the natural domains through changes in oil-spill related laws and regulations. Although data gaps were identified in all four model domains, the socioeconomics and human health domains are the least established. Considerable future work is needed to address research gaps and to create fully coupled quantitative integrative assessment models that can be used in strategic decision-making that will optimize recoveries from future large oil spills.