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
Neighborhood Socioeconomic Status and Women’s Mental Health: A Longitudinal Study of Hurricane Katrina Survivors, 2005–2015Nguyen, A. M., Kim, Y., & Abramson, D. M. (n.d.).
Journal titleInternational journal of environmental research and public health
Issue2AbstractThere 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, 2020-2021DiMaggio, C., Susser, E., Frangos, S., Abramson, D., Andrews, H., Hoven, C., Ryan, M., & Li, G. (n.d.).
Journal titlePublic Health Reports
Page(s)518-525AbstractObjectives: 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 CityGhosh, A. K., Venkatraman, S., Reshetnyak, E., Rajan, M., An, A., Chae, J. K., Unruh, M. A., Abramson, D., DiMaggio, C., & Hupert, N. (n.d.).
Journal titlePloS one
Issue3AbstractBackground 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 officialsSilver, D., Kim, Y., McNeill, E., Piltch-Loeb, R., Wang, V., & Abramson, D. (n.d.).
Journal titlePreventive Medicine
Volume164AbstractOne'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 spectrumPiltch-Loeb, R., Silver, D. R., Kim, Y., Norris, H., McNeill, E., & Abramson, D. M. (n.d.).
Journal titlePloS one
Issue6AbstractVaccine 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 KatrinaMerdjanoff, A. A., Abramson, D. M., Park, Y. S., & Piltch-Loeb, R. (n.d.).
Journal titleWeather, Climate, and Society
Page(s)535-550AbstractCatastrophic 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 SandyMerdjanoff, A. A., Abramson, D. M., Piltch-Loeb, R., Findley, P., Peek, L., Beedasy, J., Park, Y. S., Sury, J., & Meltzer, G. Y. (n.d.).
Journal titleClinical Social Work Journal
Page(s)400-413AbstractDisaster 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.
Hopelessness in New York State physicians during the first wave of the COVID-19 outbreakJohnson, 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.).
Journal titleJournal of Neurosurgical Anesthesiology
Page(s)152-157AbstractBackground: 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 ReviewGhosh, A. K., Demetres, M. R., Geisler, B. P., Ssebyala, S. N., Yang, T., Shapiro, M. F., Setoguchi, S., & Abramson, D. (n.d.).
Journal titleEnvironmental health perspectives
Issue11AbstractBACKGROUND: 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 PandemicCheslack-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.).
Journal titleJournal of Occupational and Environmental Medicine
Page(s)E417-E423AbstractObjective 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 findingsDiMaggio, 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.).
Journal titleJournal of Neurosurgical Anesthesiology
Page(s)148-151AbstractIntroduction: 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 PerspectiveMeltzer, G. Y., Merdjanoff, A. A., & Abramson, D. M. (n.d.).
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. (n.d.).
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.
Differences in post-disaster mental health among Vietnamese and African Americans living in adjacent urban communities flooded by KatrinaZhang, M., VanLandingham, M., Park, Y. S., Anglewicz, P., & Abramson, D. M. (n.d.).
Journal titlePloS one
Issue8AbstractSome 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.
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. (n.d.).
Journal titleDisaster medicine and public health preparednessAbstractOBJECTIVE: 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.
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. (n.d.).
Journal titleJournal of Community Health
Page(s)982-991AbstractTo 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 distressMeltzer, G. Y., Zacher, M., Merdjanoff, A., Do, M. P., Pham, N. N. K., & Abramson, D. (n.d.).
Journal titleJournal of Applied Research on Children
The formation of belief: An examination of factors that influence climate change belief among Hurricane Katrina survivorsTeyton, A., & Abramson, D. M. (n.d.).
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., … Yoskowitz, D. (n.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., … Singer, B. (n.d.).
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. (n.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. (n.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. (n.d.).
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. (n.d.).
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. (n.d.).
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.