Clinical Associate Professor of Social and Behavioral Sciences
Dr. David Abramson is a Clinical Associate 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.
BA, English (High Honors), Queens College, New York, NYMPH, Sociomedical Sciences, Columbia University, New York, NYPhD, Sociomedical Sciences/Political Science, Columbia University, New York, NY
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)
Community HealthDisaster HealthDisaster Impact and RecoveryEnvironmental InterventionsPopulation HealthPublic Health SystemsSocial BehaviorsSocial Determinants of Health
Adverse Physical and Mental Health Effects of the Deepwater Horizon Oil Spill among Gulf Coast Children: An Environmental Justice PerspectiveMeltzer, G. Y., Merdjanoff, A. A., & Abramson, D. M.
Journal titleEnvironmental Justice
Page(s)124-133AbstractBackground: 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 healthClay, L. A., & Abramson, D. M.
Journal titleEnvironmental Justice
Page(s)206-215AbstractSocial 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.
Factors related to self-reported distress experienced by physicians during their first COVID-19 triage decisionsChou, 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.
Journal titleDisaster medicine and public health preparednessAbstractObjective: To identify factors associated with distress experienced by physicians during their first 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: About 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 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.
Rapid Behavioral Health Assessment Post-disaster: Developing and Validating a Brief, Structured ModuleGoldmann, E., Abramson, D. M., Piltch-Loeb, R., Samarabandu, A., Goodson, V., Azofeifa, A., Hagemeyer, A., Al-Amin, N., & Lyerla, R.
Journal titleJournal of Community HealthAbstractTo develop and validate a brief, structured, behavioral health module for use by local public health practitionersto rapidlyassess behavioral health needs in disaster settings. Data were collected through in-person, telephone, and webbasedinterviewsof 101 individuals afected by Hurricanes Katrina (n = 44) and Sandy (n = 57) in New Orleans and NewJersey in Apriland May 2018, respectively. Questions included in the core module were selected based on convergent validity,internalconsistency reliability, test–retest reliability across administration modes, principal component analysis (PCA),questioncomprehension, eiciency, accessibility, and use in population-based surveys. Almost all scales showed excellentinternal consistencyreliability (Cronbach’s alpha, 0.79–0.92), convergent validity (r > 0.61), and test–retest reliability (inpersonvs. telephone,intra-class coeicient, ICC, 0.75–1.00; in-person vs. web-based ICC, 0.73–0.97). PCA of the behavioralhealth scales yieldedtwo components to include in the module—mental health and substance use. The core module has 26questions—includingself-reported general health (1 question); symptoms of posttraumatic stress disorder, depression, andanxiety (Primary Care PTSD Screen,Patient Health Questionnaire-4; 8 questions); drinking and other substance use (AlcoholUse Disorders IdentiicationTest-Concise, AUDIT-C; Drug Abuse Screening Test, DAST-10; stand-alone question regardingincreased substance usesince disaster; 14 questions); prior mental health conditions, treatment, and treatment disruption (3questions)—and can beadministered in 5–10 minutes through any mode. This lexible module allows practitioners to quicklyevaluate behavioral healthneeds, efectively allocate resources, and appropriately target interventions to help promote recoveryof disaster-afectedcommunities.
The formation of belief: An examination of factors that influence climate change belief among Hurricane Katrina survivorsTeyton, A., & Abramson, D. M.
Journal titleEnvironmental Justice
Page(s)169-177AbstractDifferences 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 spillsSolo-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., Lee, K., Liu, Y., Masi, M., Maung-Douglass, E. S., Morey, S. L., Murawski, S. A., Paris, C. B., Perlin, N., Pulster, E. L., Quigg, A., Reed, D. J., Ruzicka, J. J., Sandifer, P. A., Shepherd, J. G., Singer, B. H., Stukel, M. R., Sutton, T. T., Weisberg, R. H., Wiesenburg, D., Wilson, C. A., Wilson, M., Wowk, K. M., Yanoff, C., & Yoskowitz, D.
Journal titleMarine Policy
Volume131AbstractAlthough 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.
Framework for a Community Health Observing System for the Gulf of Mexico Region: Preparing for Future DisastersSandifer, P., Knapp, L., Lichtveld, M., Manley, R., Abramson, D., Caffey, R., Cochran, D., Collier, T., Ebi, K., Engel, L., Farrington, J., Finucane, M., Hale, C., Halpern, D., Harville, E., Hart, L., Hswen, Y., Kirkpatrick, B., McEwen, B., Morris, G., Orbach, R., Palinkas, L., Partyka, M., Porter, D., Prather, A. A., Rowles, T., Scott, G., Seeman, T., Solo-Gabriele, H., Svendsen, E., Tincher, T., Trtanj, J., Walker, A. H., Yehuda, R., Yip, F., Yoskowitz, D., & Singer, B.
Journal titleFrontiers in Public Health
Volume8AbstractThe Gulf of Mexico (GoM) region is prone to disasters, including recurrent oil spills, hurricanes, floods, industrial accidents, harmful algal blooms, and the current COVID-19 pandemic. The GoM and other regions of the U.S. lack sufficient baseline health information to identify, attribute, mitigate, and facilitate prevention of major health effects of disasters. Developing capacity to assess adverse human health consequences of future disasters requires establishment of a comprehensive, sustained community health observing system, similar to the extensive and well-established environmental observing systems. We propose a system that combines six levels of health data domains, beginning with three existing, national surveys and studies plus three new nested, longitudinal cohort studies. The latter are the unique and most important parts of the system and are focused on the coastal regions of the five GoM States. A statistically representative sample of participants is proposed for the new cohort studies, stratified to ensure proportional inclusion of urban and rural populations and with additional recruitment as necessary to enroll participants from particularly vulnerable or under-represented groups. Secondary data sources such as syndromic surveillance systems, electronic health records, national community surveys, environmental exposure databases, social media, and remote sensing will inform and augment the collection of primary data. Primary data sources will include participant-provided information via questionnaires, clinical measures of mental and physical health, acquisition of biological specimens, and wearable health monitoring devices. A suite of biomarkers may be derived from biological specimens for use in health assessments, including calculation of allostatic load, a measure of cumulative stress. The framework also addresses data management and sharing, participant retention, and system governance. The observing system is designed to continue indefinitely to ensure that essential pre-, during-, and post-disaster health data are collected and maintained. It could also provide a model/vehicle for effective health observation related to infectious disease pandemics such as COVID-19. To our knowledge, there is no comprehensive, disaster-focused health observing system such as the one proposed here currently in existence or planned elsewhere. Significant strengths of the GoM Community Health Observing System (CHOS) are its longitudinal cohorts and ability to adapt rapidly as needs arise and new technologies develop.
From information to intervention: connecting risk communication to individual health behavior and community-level health interventions during the 2016 Zika outbreakPiltch-Loeb, R., & Abramson, D.
Journal titleJournal of Risk Research
Page(s)978-993AbstractEmerging disease threats are on the rise. Risk communication in an emerging threat is used by public health officials to reach the population in a timely and effective manner. However, limited research has drawn on data gathered during an emerging threat to understand how risk communication shapes intervention perceptions. This analysis examines the relationship between risk communication, especially where information comes from, and receptivity to individual-level and community-level health interventions in an emerging threat using evidence from the 2016 rise of Zika. Data comes from a repeat cross-sectional survey conducted three times in 2016, representative of the United States population. Drawing on leading theories of risk communication, a structural model (SEM) is used to measure the relationships of interest. Two distinct SEMs are used to compare and contrast the relationship between source of information and individual health behavior change and community-level health interventions while also exploring the role of knowledge, perceived risk, and demographics. Results of both direct and indirect SEM pathways show different sources of information may be more effective in promoting particular interventions. Promoting community-level interventions can be accomplished through dissemination of information in print news to increase knowledge and ultimately receptivity. However, there is a far more complex relationship between risk communication and personal intervention receptivity. With a more nuanced understanding of the way information from a particular source effects intervention receptivity, communicators can reach the public more effectively to limit the consequences of an emerging public health threat.
Information-Accessing behavior during zika virus outbreak, United States, 2016Piltch-Loeb, R., & Abramson, D.
Journal titleEmerging Infectious Diseases
Page(s)2290-2292AbstractWe used latent class analysis to examine Zika virus-related information-accessing behavior of US residents during the 2016 international outbreak. We characterized 3 classes of information-accessing behavior patterns: universalists, media seekers, and passive recipients. Understanding these patterns is crucial to planning risk communication during an emerging health threat.
Cross-Sectional Psychological and Demographic Associations of Zika Knowledge and Conspiracy Beliefs Before and After Local Zika TransmissionPiltch-Loeb, R., Zikmund-Fisher, B. J., Shaffer, V. A., Scherer, L. D., Knaus, M., Fagerlin, A., Abramson, D. M., & Scherer, A. M.
Journal titleRisk Analysis
Page(s)2683-2693AbstractPerceptions of infectious diseases are important predictors of whether people engage in disease-specific preventive behaviors. Having accurate beliefs about a given infectious disease has been found to be a necessary condition for engaging in appropriate preventive behaviors during an infectious disease outbreak, while endorsing conspiracy beliefs can inhibit preventive behaviors. Despite their seemingly opposing natures, knowledge and conspiracy beliefs may share some of the same psychological motivations, including a relationship with perceived risk and self-efficacy (i.e., control). The 2015–2016 Zika epidemic provided an opportunity to explore this. The current research provides some exploratory tests of this topic derived from two studies with similar measures, but different primary outcomes: one study that included knowledge of Zika as a key outcome and one that included conspiracy beliefs about Zika as a key outcome. Both studies involved cross-sectional data collections that occurred during the same two periods of the Zika outbreak: one data collection prior to the first cases of local Zika transmission in the United States (March–May 2016) and one just after the first cases of local transmission (July–August). Using ordinal logistic and linear regression analyses of data from two time points in both studies, the authors show an increase in relationship strength between greater perceived risk and self-efficacy with both increased knowledge and increased conspiracy beliefs after local Zika transmission in the United States. Although these results highlight that similar psychological motivations may lead to Zika knowledge and conspiracy beliefs, there was a divergence in demographic association.
Housing Transitions and Recovery of Older Adults following Hurricane SandyMerdjanoff, A. A., Piltch-Loeb, R., Friedman, S., & Abramson, D. M.
Journal titleJournals of Gerontology - Series B Psychological Sciences and Social Sciences
Page(s)1041-1052AbstractObjectives: This study explores the effects of social and environmental disruption on emergency housing transitions among older adults following Hurricane Sandy. It is based upon the Sandy Child and Family Health (S-CAFH) Study, an observational cohort of 1,000 randomly sampled New Jersey residents living in the nine counties most affected by Sandy. Methods: This analysis examines the post-Sandy housing transitions and recovery of the young-old (55-64), mid-old (65-74), and old-old (75+) compared with younger adults (19-54). We consider length of displacement, number of places stayed after Sandy, the housing host (i.e., family only, friends only, or multi-host), and self-reported recovery. Results: Among all age groups, the old-old (75+) reported the highest rates of housing damage and were more likely to stay in one place besides their home, as well as stay with family rather than by themselves after the storm. Despite this disruption, the old-old were most likely to have recovered from Hurricane Sandy. Discussion: Findings suggest that the old-old were more resilient to Hurricane Sandy than younger age groups. Understanding the unique post-disaster housing needs of older adults can help identify critical points of intervention for their post-disaster recovery.
Hurricanes and healthcare: A case report on the influences of Hurricane Maria and managed Medicare in treating a Puerto Rican residentMellgard, G., Abramson, D., Okamura, C., & Weerahandi, H.
Journal titleBMC health services research
Issue1AbstractBackground: While Medicare is a federal health insurance program, managed Medicare limits access to healthcare services to networks within states or territories. However, if a natural disaster requires evacuation, displaced patients are at risk of losing coverage for their benefits. Previous literature has discussed the quality of managed Medicare plans within Puerto Rico but has not addressed the adequacy of this coverage if residents are displaced to the continental United States. We explore Hurricane Maria's impact on a resident of Puerto Rico with chronic health problems, and the challenges he faces seeking healthcare in New York. Case presentation: A 59-year-old male with a history of diabetes mellitus type II, coronary artery disease, peripheral vascular disease status post right foot amputation, and end-stage kidney disease on hemodialysis was admitted in October of 2017 for chest pain and swelling of legs for 5 days. The patient had missed his last three dialysis sessions after Hurricane Maria forced him to leave Puerto Rico. In examining this patient's treatment, we observe the effect of Hurricane Maria on the medical management of Puerto Rican residents and identify challenges managed Medicare may pose to patients who cross state or territory lines. Conclusions: We employ this patient's narrative to frame a larger discussion of Puerto Rican managed Medicare and provide additional recommendations for healthcare providers. Moreover, we consider this case in the context of disaster-related continuity of care for patients with complex medical conditions or treatment regimens. To address the gaps in the care of these patients, this article proposes (1) developing system-based approaches for screening displaced patients, (2) increasing the awareness of Special Enrollment Periods related to Medicare among healthcare providers, and (3) creating policy solutions to assure access to care for patients with complex medical conditions.
Support for vector control strategies in the United States during the Zika outbreak in 2016: The role of risk perception, knowledge, and confidence in governmentPiltch-Loeb, R., Merdjanoff, A. A., Bhanja, A., & Abramson, D. M.
Journal titlePreventive Medicine
Page(s)52-57AbstractLimiting the spread and impact of Zika was a major global priority in 2016, which required a variety of vector control measures. The success of vector control campaigns is varied and often dependent on public or political will. This paper examines the change over time in the United States population's support for vector control and the factors that predicted support for three vector control strategies (i.e., indoor spraying, outdoor spraying, and use of larvacide tablets) during the 2016 Zika outbreak in the United States. Data is from a nationally representative random digit dial sample conducted at three time points in 2016. Bivariate and multivariate regression analyses were used, treating data as a pooled cross-sectional sample. Results show public support for vector control strategies depends on both perceived risk for disease and knowledge of disease characteristics, as well is confidence in government to prevent the threat. Support varied based on vector control method: indoor spraying, aerial spraying, and use of larvacide tables. Results can aide public health officials in implementing effective vector control campaigns depending on the vector control strategy of choice. Results have implications for ways to design effective prevention campaigns in future emerging infectious disease threats.
Application of a Theoretical Model Toward Understanding Continued Food Insecurity Post Hurricane KatrinaClay, L. A., Papas, M. A., Gill, K., & Abramson, D. M.
Journal titleDisaster medicine and public health preparedness
Page(s)47-56AbstractObjective Disaster recovery efforts focus on restoring basic needs to survivors, such as food, water, and shelter. However, long after the immediate recovery phase is over, some individuals will continue to experience unmet needs. Ongoing food insecurity has been identified as a post-disaster problem. There is a paucity of information regarding the factors that might place an individual at risk for continued food insecurity post disaster. Methods Using data from a sample (n=737) of households severely impacted by Hurricane Katrina, we estimated the associations between food insecurity and structural, physical and mental health, and psychosocial factors 5 years after Hurricane Katrina. Logistic regression models were fit and odds ratios (OR) and 95% CI estimated. Results Nearly one-quarter of respondents (23%) reported food insecurity 5 years post Katrina. Marital/partner status (OR: 0.7, CI: 0.42, 0.99), self-efficacy (OR: 0.56, CI: 0.37, 0.84), sense of community (OR: 0.7, CI: 0.44, 0.98), and social support (OR: 0.59, CI: 0.39, 0.89) lowered the odds of food insecurity and explained most of the effects of mental health distress on food insecurity. Social support, self-efficacy, and being partnered were protective against food insecurity. Conclusions Recovery efforts should focus on fostering social-support networks and increased self-efficacy to improve food insecurity post disaster.
Factors associated with continued food insecurity among households recovering from hurricane KatrinaClay, L. A., Papas, M. A., Gill, K. B., & Abramson, D. M.
Journal titleInternational journal of environmental research and public health
Issue8AbstractIn 2010, 14.5% of US households experienced food insecurity, which adversely impacts health. Some groups are at increased risk for food insecurity, such as female-headed households, and those same groups are often also at increased risk for disaster exposure and the negative consequences that come with exposure. Little research has been done on food insecurity post-disaster. The present study investigates long-term food insecurity among households heavily impacted by Hurricane Katrina. A sample of 683 households participating in the Gulf Coast Child and Family Health Study were examined using a generalized estimation model to determine protective and risk factors for food insecurity during long-term recovery. Higher income (Odds Ratio (OR) 0.84, 95% Confidence Interval (CI) 0.77, 0.91), having a partner (OR 0.93; 95% CI 0.89, 0.97), or “other” race were found to be protective against food insecurity over a five-year period following disaster exposure. Low social support (OR 1.14; 95% CI 1.08, 1.20), poor physical health (OR 1.08; 95% CI 1.03, 1.13) or mental health (OR 1.13; 95% CI 1.09, 1.18), and female sex (OR 1.05; 95% CI 1.01, 1.10) were risk factors. Policies and programs that increase access to food supplies among high-risk groups are needed to reduce the negative health impacts of disasters.
How the US Population Engaged with and Prioritized Sources of Information about the Emerging Zika Virus in 2016Piltch-Loeb, R., Merdjanoff, A. A., & Abramson, D. M.
Journal titleHealth Security
Page(s)165-177AbstractEmerging disease threats like Zika pose a risk to naïve populations. In comparison to chronic diseases, there is scientific uncertainty surrounding emerging diseases because of the lack of medical and public health information available as the threat emerges. Further complicating this are the multiple, diverse channels through which people get information. This article used bivariate and multivariate analysis to first describe the breadth of information sources individuals accessed about the Zika virus, and then describe individuals' primary sources of information for Zika using a nationally representative pooled cross-sectional data set collected at 3 time points in 2016 (N = 3,698). The analysis also highlights how 3 subgroups - high-education, high-income adults; Hispanic women of childbearing age; and retirees over the age of 65 with less than a high school education - varied in their use of information. Results suggest individuals accessed multiple sources, but TV and radio were the primary sources of Zika information for the public, followed by print news. Demographic variation in primary source of information means public health officials should consider alternative channels to reach target groups in an emerging event. Without an understanding of how information has reached people, and who individuals engaged with regarding that information, public health practitioners are missing a key piece of the puzzle to improving public health campaigns during a future event like Zika. This analysis aims to inform the public health community about the message channels the US population uses during an emerging disease event and the most prevalent channels for different demographic groups, who can be targeted with particular messaging.
Variations in Healthcare Provider Use of Public Health and Other Information Sources by Provider Type and Practice Setting during New York City's Response to the Emerging Threat of Zika Virus Disease, 2016Quinn, C., Poirot, E., Sanders Kim, A., Viswanath, A. L., Patel, S. N., Abramson, D. M., & Piltch-Loeb, R.
Journal titleHealth Security
Page(s)252-261AbstractThe New York City (NYC) Department of Health and Mental Hygiene (DOHMH) used multiple methods to provide guidance to healthcare providers on the management and prevention of Zika virus disease during 2016. To better understand providers' use of information sources related to emerging disease threats, this article describes reported use of information sources by NYC providers to stay informed about Zika, and patterns observed by provider type and practice setting. We sent an electronic survey to all email addresses in the Provider Data Warehouse, a system used to maintain information from state and local health department sources on all prescribing healthcare providers in NYC. The survey asked providers about their use of information sources, including specific information products offered by the NYC DOHMH, to stay informed about Zika during 2016. Trends by provider type and practice setting were described using summary statistics. The survey was sent to 44,455 unique email addresses; nearly 20% (8,711) of the emails were undeliverable. Ultimately, 1,447 (5.8%) eligible providers completed the survey. Most respondents (79%) were physicians. Overall, the most frequently reported source of information from the NYC DOHMH was the NYC Health Alert Network (73%). Providers in private practice reported that they did not use any NYC DOHMH source of information about Zika more frequently than did those working in hospital settings (29% vs 23%); similarly, private practitioners reported that they did not use any other source of information about Zika more frequently than did those working in hospital settings (16% vs 8%). Maintaining timely and accurate databases of healthcare provider contact information is a challenge for local public health agencies. Effective strategies are needed to identify and engage independently practicing healthcare providers to improve communications with all healthcare providers during public health emergencies.
Risk salience of a novel virus: US population risk perception, knowledge, and receptivity to public health interventions regarding the Zika virus prior to local transmissionPiltch-Loeb, R., Abramson, D. M., & Merdjanoff, A. A.
Journal titlePloS one
Issue12AbstractBackground As the incidence of Zika infection accelerated in Central and South American countries from November 2015 through April 2016, U.S. public health officials developed vector control and risk communication strategies to address mosquito-borne and sexual modes of transmission. This study reports upon U.S. perceptions of the Zika virus prior to domestic transmission, and analyzes the association of socio-economic, political, knowledge and risk factors with population receptivity to selected behavioral, environmental, and clinical intervention strategies. Methods A representative sample of 1,233 U.S. residents was drawn from address-based telephone and mobile phone lists, including an oversample of 208 women of child-bearing age living in five U.S. southern states. Data were collected between April and June, 2016, and weighted to represent U.S. population distributions. Results Overall, 78% of the U.S. population was aware of Zika prior to domestic transmission. Those unaware of the novel virus were more likely to be younger, lower income, and of Hispanic ethnicity. Among those aware of Zika, over half would delay pregnancy for a year or more in response to public health warnings; approximately one third agreed with a possible vector-control strategy of targeted indoor spraying by the government; and nearly two-thirds agreed that the government should make pregnancy-termination services available to women who learn their fetus had a Zika-related birth defect. Receptivity to these public health interventions varied by age, risk perception, and knowledge of the virus. Conclusion Risk salience and population receptivity to public health interventions targeting a novel virus can be conditioned on pre-existing characteristics in the event of an emerging infectious disease. Risk communicators should consider targeted strategies to encourage adoption of behavioral, environmental, and clinical interventions.
Social capital, neighborhood disorder, and disaster recoveryClay, L., Papas, M., Abramson, D., & Kendra, J.
Journal titleJournal of Emergency Management
Page(s)233-246AbstractObjective: This study examined social institutions as a contextual factor that may influence perceptions of neighborhood physical and social disorder during disaster recovery. Design: The study used descriptive statistics and fit logistic regression models. Setting and Participants: Participants in this study (n = 772) were recruited from temporary housing in Louisiana and Mississippi as part of the Gulf Coast Child and Family Health Study, a longitudinal study of households heavily impacted by Hurricane Katrina. Community data were obtained from the Dun and Bradstreet Million Dollar Database and the American Community Survey. Outcome measure(s): Social disorder was assessed by asking respondents how concerned they are about issues such as being robbed or walking alone at night. Physical disorder was assessed by asking about problems experienced in the last month such as broken or missing windows and presence of mice or rats. Results: Greater income (β = -0.17, SE = 0.07), housing stability (β = -0.16, SE = 0.07), social support (β = -0.09, SE = 0.04), and home ownership (β = -0.10, SE = 0.05) were associated with lower social disorder and a larger male population at the community level was associated with greater social disorder (β = 0.00, SE = 0.00). Greater social support (β = -0.11, SE = 0.04), housing stability (β = -0.15, SE = 0.06), and higher income (β = -0.10, SE = 0.07) were associated with lower physical disorder. Conclusions: Longitudinal research is needed to understand the direction of influence between neighborhood factors and to household ability to provide for basic needs postdisaster. The findings also highlight the need for further research on postdisaster male behavior.
The Women and Their Children's Health (WaTCH) study: Methods and design of a prospective cohort study in Louisiana to examine the health effects from the BP oil spillPeters, E. S., Rung, A. L., Bronson, M. H., Brashear, M. M., Peres, L. C., Gaston, S., Sullivan, S. M., Peak, K., Abramson, D. M., Fontham, E. T., Harrington, D., Oral, E., & Trapido, E. J.
Journal titleBMJ open
Issue7AbstractPurpose The Deepwater Horizon Oil Spill is the largest marine oil spill in US history. Few studies have evaluated the potential health effects of this spill on the Gulf Coast community. The Women and Their Children's Health (WaTCH) study is a prospective cohort designed to investigate the midterm to long-term physical, mental and behavioural health effects of exposure to the oil spill. Participants Women were recruited by telephone from pre-existing lists of individuals and households using an address-based sampling frame between 2012 and 2014. Baseline interviews obtained information on oil spill exposure, demographics, physical and mental health, and health behaviours. Women were also asked to provide a household roster, from which a child between 10 and 17 years was randomly selected and recruited into a child substudy. Telephone respondents were invited to participate in a home visit in which blood samples, anthropometrics and neighbourhood characteristics were measured. A follow-up interview was completed between 2014 and 2016. Findings to date 2852 women completed the baseline interview, 1231 of whom participated in the home visit, and 628 children participated in the child's health substudy. The follow-up interview successfully reinterviewed 2030 women and 454 children. Future plans WaTCH continues to conduct follow-up surveys, with a third wave of interviews planned in 2017. Also, we are looking to enhance the collection of spatially related environmental data to facilitate assessment of health risks in the study population. In addition, opportunities to participate in behavioural interventions for subsets of the cohort have been initiated. There are ongoing studies that examine the relationship between genetic and immunological markers with mental health.
Crisis Decision-Making during Hurricane Sandy: An Analysis of Established and Emergent Disaster Response Behaviors in the New York Metro AreaChandler, T., Abramson, D. M., Panigrahi, B., Schlegelmilch, J., & Frye, N.
Journal titleDisaster medicine and public health preparedness
Page(s)436-442AbstractObjective This collective case study examined how and why specific organizational decision-making processes transpired at 2 large suburban county health departments in lower New York State during their response to Hurricane Sandy in 2012. The study also examined the relationships that the agencies developed with other emerging and established organizations within their respective health systems. Methods In investigating these themes, the authors conducted in-depth, one-on-one interviews with 30 senior-level public health staff and first responders; reviewed documentation; and moderated 2 focus group discussions with 17 participants. Results Although a natural hazard such as a hurricane was not an unexpected event for these health departments, they nevertheless confronted a number of unforeseen challenges during the response phase: prolonged loss of power and fuel, limited situational awareness of the depth and breadth of the storm's impact among disaster-exposed populations, and coordination problems with a number of organizations that emerged in response to the disaster. Conclusions Public health staff had few plans or protocols to guide them and often found themselves improvising and problem-solving with new organizations in the context of an overburdened health care system.
ForewordFothergill, A., Peek, L. A., Abramson, D., & Redlener, I. In Children of Katrina (First).
The Medical Home and Care Coordination in Disaster Recovery: Hypothesis for Interventions and ResearchKanter, R. K., Abramson, D. M., Redlener, I., & Gracy, D.
Journal titleDisaster medicine and public health preparedness
Page(s)337-343AbstractIn postdisaster settings, health care providers encounter secondary surges of unmet primary care and mental health needs that evolve throughout disaster recovery phases. Whatever a community's predisaster adequacy of health care, postdisaster gaps are similar to those of any underserved region. We hypothesize that existing practice and evidence supporting medical homes and care coordination in primary care for the underserved provide a favorable model for improving health in disrupted communities. Elements of medical home services can be offered by local or temporary providers from outside the region, working out of mobile clinics early in disaster recovery. As repairs and reconstruction proceed, local services are restored over weeks or years. Throughout recovery, major tasks include identifying high-risk patients relative to the disaster and underlying health conditions, assisting displaced families as they transition through housing locations, and tracking their evolving access to health care and community services as they are restored. Postdisaster sources of financial assistance for the disaster-exposed population are often temporary and evolving, requiring up-to-date information to cover costs of care until stable services and insurance coverage are restored. Evidence to support disaster recovery health care improvement will require research funding and metrics on structures, processes, and outcomes of the disaster recovery medical home and care coordination, based on adaptation of standard validated methods to crisis environments.
Preparedness and emergency response research centers: Early returns on investment in evidence-based public health systems researchQari, S. H., Abramson, D. M., Kushma, J. A., & Halverson, P. K.
Journal titlePublic Health Reports
School interventions after the Joplin tornadoKanter, R. K., & Abramson, D.
Journal titlePrehospital and Disaster Medicine
Page(s)214-217AbstractBackground/Objective To qualitatively describe interventions by schools to meet children's needs after the May 2011 Joplin, Missouri tornado. Methods Qualitative exploratory study conducted six months after the tornado. Key informant interviews with school staff (teachers, psychologists, guidance counselor, nurse, principal), public health official, and physicians. Report After the tornado, school staff immediately worked to contact every enrolled child to provide assistance and coordinate recovery services. Despite severe damage to half of the city's schools, the decision was made to reopen schools at the earliest possible time to provide a safe, reassuring environment and additional services. An expanded summer school session emphasized child safety and emotional wellbeing. The 2011-2012 school year began on time, less than three months after the disaster, using temporary facilities. Displaced children were bused to their usual schools regardless of their new temporary residence locations. In just-in-time training sessions, teachers developed strategies to support students and staff experiencing anxiety or depression. Certified counselors conducted school-based, small-group counseling for students. Selective referrals were made to community mental health providers for children with greatest needs. Conclusions Evidence from Joplin adds to a small body of empirical experience demonstrating the important contribution of schools to postdisaster community recovery. Despite timely and proactive services, many families and children struggled after the tornado. Improvements in the effectiveness of postdisaster interventions at schools will follow from future scientific evidence on optimal approaches.